W12 - Trauma Cases - Mistry

Question 1

What question should be asked to assess if PDL was injured at time of trauma

Answer 1

Was there any bleeding?

Question 2

If there was bleeding during the injury, how long should the recall be? (# of weeks) (PDL involvement)

Answer 2

3-4 weeks

Question 3

If there was no bleeding during the injury (No PDL injury) when should you recall?

Answer 3

6-8 weeks

Question 4

If soft tissue has been damaged, when to recall

Answer 4

1 week, then

3-4 weeks, then

6-8 weeks, then

3 months, then

1 year

until 5 years old

Question 5

Answer 5

51 extruded

anterior open bite (thumb sucking)

Question 6

Describe the risk of damaging the successor

Answer 6

Low

crown is positioned palatally which means roots are moving away from successor

Question 7

Reasons for primary tooth discolouration (4)

Answer 7

Bruising

Trauma

Resorption

Necrosis or pulp obliteration

Question 8

ID + what can happen if it stays there + what to do

Answer 8

Intrusion

• 51 can become necrotic and impact development of successor
• May become ankylotic
• May re-erupt

Monitor → 1 week, 3 weeks, 1 month, every month

If they havent re-erupted after 3 months → Extract

Question 9

What two injuries have the most impact on sucessors?

Answer 9

Intrusion and avulsion

Question 10

How may a permanent successor be affected by injury (4)

Answer 10

Hypoplasia

Hypomineralisation

Dilaceration

Impaction

Question 11

Pulp involved. DX? what to do?

Answer 11

Complicated crown fracture

• Pulpotomy → Remove a couple mm of coronal pulp until haemostasis is achieved

Question 12

What is more successful, pulp cap or pulpotomy

Answer 12

Pulpotomy

Question 13

Answer 13

Nothing wrong tooth just immature

Question 14

Problem and tx

Answer 14

Sinus tract originating from 63

• Extract 63

Invasion of bacteria caused by attrition

Question 15

ID + Tx?

Answer 15

Coronal fracture

• Will most likely fall out
• Perhaps extract the root
• Prosthesis
• Implant when older

Question 16

What has worse prognosis, further coronal or further apical fractures?

Answer 16

Further coronally → more mobile

Question 17

What are the three options for abscessed priamry teeth

Answer 17

Extract

Pulpectomy

Monitor (only if tooth is about to fall out on its own)

Question 18

What to do

Answer 18

• Elective pulpectomy
• Extrude the tooth
• Post, core, crown

Question 19

ID and tx options

What happens if it stays up there?

Answer 19

Intrusion

Orthodontic extrusion

Surgical extrusion

monitor

If stays up there can be anklyosed or resorbed

Question 20

Why must we RCT a mature intruded tooth? What if it was immature?

Answer 20

Prevent external inflammatory root resorption

If immature, allow tooth more time to develop root

Question 21

Immature teeth age vs mature teeth age

(determines intrusion tx)

Answer 21

Immature - <12

Mature - >12

Question 22

What would you do if you recalled them in 3-4 weeks and there was signs of external inflammatory root resorption?

Answer 22

Extirpate the pulp

Question 23

ID + tx

Answer 23

Replacement resorption / ankylosis

• tooth is infraoccluded
• need to decoronate, otherwise the surrounding teeth will keep erupting and drift mesially
• decoronating will preserve alveolar ridge
• will prevent gingival line from being further disturbed
• Replace missing space with bridge/denture

Question 24

ID + tx

Answer 24

Replacement resorption / ankylosis

• tooth is infraoccluded
• need to decoronate, otherwise the surrounding teeth will keep erupting and drift mesially
• decoronating will preserve alveolar ridge
• will prevent gingival line from being further disturbed
• Replace missing space with bridge/denture

Question 25

removal of infection successful. Why is it discoloured?

Answer 25

MTA → discolours teeth

Question 26

How long to use splints for trauma

Answer 26

1-2 weeks

flexible splint