Primary Trauma Flashcards

1
Q

Enamel only fracture

A

X-rays: none
Tx: smooth
P/O: care when eating, brush w/ 0.12% CHX rinse 2x/day for 1 wk
F/U: none

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2
Q

Enamel + Dentin (no pulp)

A

X-rays: Baseline optional, soft tissue PRN
Tx:

  • Cover exposed dentin with GI or composite
  • restore w/ composite now or later

P/O: care when eating, brush w/ 0.12% CHX rinse 2x/day for 1 wk
F/U:

  • 6-8wk (x-ray only if clinical signs of pulp infection)
  • tells parents to monitor for unfavorable outcomes
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3
Q

Complicated crown fracture (exposed pulp)

A

X-rays: PA/Occlusal, soft tissue PRN
Tx:

  • Partial Pulpotomy (CaOH paste, GI cement, composite)
  • Cervical Pulpotomy for larger pulp exposures

P/O: care when eating brush w/ CHX 2x/day for 1 wk
F/U:

  • 1 wk
  • 6-8wk
  • 1y (x-ray, unless pathoses earlier)
  • tell parents to monitor for unfavorable outcomes
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4
Q

Crown root fracture (pulp or no pulp exposure)

A

X-rays: PA/Occlusal
Tx:

  • Remove loose fragments, determine if restorable
  • If restorable and no pulp exposure: restore w/ GI over dentin and restoration
  • If restorable and pulp exposure: do pulpotomy/pulpectomy and restore
  • If unrestorable ext all loose pieces or entire tooth

P/O: Care when eating, brush with CHX 2x/day for 1 wk
F/U:

  • 1 wk
  • 6-8wk
  • 1 y (x-ray, unless pathoses earlier)
  • tell parents monitor for unfavorable outcomes
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5
Q

Root Fracture

A

X-rays: PA/Occlusal
Tx:

  • Coronal fragment not displaced –> no tx
  • Coronal fragment displaced, but not very mobile –>
  • let it reposition itself even if slight occlusal
  • interference
  • Coronal fragment displaced, very mobile –> ext loose
  • fragment or reposition and splint 4 wks

P/O: Care when eating, brush with CHX 2x/day for 1 wk
F/U: x-rays only when signs of pathoses

  • No displacement –> 1 wk, 6-8wk, 1y until perm tooth
  • Displacement w/ ext –> 1 y
  • Displacement w/ splint –> 1 wk, 4wk (splint removed), 8wk, 1 yr
  • tell parents monitor for unfavorable outcomes
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6
Q

Alveolar Fracture

A

X-rays: PA/Occlusal, lateral, further imaging only if it will change tx
Tx: reposition and stabilize w/ flex splint 4 wks
P/O: Care when eating, brush with CHX 2x/day for 1 wk
F/U:

  • 1 wk
  • 4 wk (splint removal + PA)
  • 8 wk, 1y (x-ray)
  • 6yrs old to monitor eruption of perm teeth
  • If fracture at apex can –> abscess
  • tell parents monitor for unfavorable outcomes
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7
Q

Concussion (tender, no mobility/bleeding)

A

X-rays: None

Tx: None, observation

P/O: care when eating, brush w/ 0.12% CHX 2x/day for 1 wk

F/U:

  • 1 wk
  • 6-8wk
  • X-rays only when signs of pathoses

tell parents monitor for unfavorable outcomes

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8
Q

Subluxation (tender, mobility, no displacement, bleeding)

A

X-rays: PA/Occlusal

Tx: None, observation

P/O: care when eating, brush w/ 0.12% CHX 2x/day for 1wk

F/U:

  • 1 wk
  • 6-8 wk
  • X-ray only when signs of pathoses, f/u every yr until perm teeth erupt if concerned

tell parents to monitor for unfavorable outcomes

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9
Q

Extrusion (can be mobile)

A

X-rays: PA/Occlusal

Tx:

  • If not interfering w/ occlusion let it reposition itself
  • If VERY mobile or extruded >3mm –> ext

P/O: care when eating, brush w/ 0.12% CHX 2x/day for 1wk

F/U:

  • 1 wk
  • 6-8 wk
  • 1y
  • X-ray only when signs of pathoses, f/u every yr until perm teeth erupt if concerned

tell parents to monitor for unfavorable outcomes

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10
Q

Intrusion (either thru labial bone or into perm bud)

A

X-rays: PA/Occlusal

Tx:

  • Allow to spont reposition itself (usually w/in 6 mo-1y)

P/O: care when eating, brush w/ 0.12% CHX 2x/day for 1wk

F/U:

  • 1 wk
  • 6-8 wk
  • 6 mo
  • 1 y
  • 6yr old f/u for severe intrusion to check perm teeth
  • X-ray only when signs of pathoses

tell parents to monitor for unfavorable outcomes

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11
Q

Lateral Luxation (displaced palatally or labialy, not mobile)

A

X-rays: PA/Occlusal

Tx:

  • If minimal or no occlusal interference allow to reposition itself w/in 6 mo
  • If severe displacement ext if risk of asp or resposition + splint 4 wks

P/O: care when eating, brush w/ 0.12% CHX 2x/day for 1wk

F/U:

  • 1 wk
  • 4 wk if splinted to remove splint
  • 6-8 wk
  • 6 mo
  • 1 y
  • X-ray only when signs of pathoses, f/u every yr until perm teeth erupt if concerned
  • tell parents to monitor for unfavorable outcomes
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12
Q

Avulsion (find tooth, if can’t send to ED esp if resp signs)

A

X-rays: PA/Occlusal if tooth not found to make sure tooth not intruded and to check on perm tooth bud

Tx: None

P/O: care when eating, brush w/ 0.12% CHX 2x/day for 1wk

F/U:

  • 6-8 wk
  • 6 yr old to check on perm tooth eruption
  • X-ray only when signs of pathoses, f/u every yr until perm teeth erupt if concerned
  • tell parents to monitor for unfavorable outcomes
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