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paediatrics > dental trauma > Flashcards

dental trauma Flashcards

1
Q

what is the most common trauma dental injury in 1) primary 2) permanent dentition?

A

1) luxation
2) crown fractures

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2
Q

what is the most common cause of loss or permanent incisors in childhood?

A

trauma

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3
Q

what is the most common complication of dental trauma?

A

pulpal necrosis

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4
Q

what kind of dental problem can increase the incidence of trauma?

A

overjets

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5
Q

prevention is hard, but what is one way?

A

mouthgaurds

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6
Q

what is the best management of dental trauma?

A

-proper diagnosis
-tx planning
-follow up

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7
Q

what are the first things we should do when someone presents with a TDI?

A

-check for head injury
-assess dental/facial injury
-does story make sense?
-do emergency tx
-clean up pt
-refer if needed
-document everything

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8
Q

what injures can occur to the tooth?

A

crown or root fracture

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9
Q

what would cause an injury to the tooth?

A

hard blow- e.g pavement or gold club

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10
Q

what injuries occur to the socket?

A

intact tooth-but displaced or loosened in socket

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11
Q

what would cause an injury to the socket?

A

soft blow- elbow, fist

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12
Q

what is the main problem with dental injuries?

A

bacteria can enter the pulp- must always cover expose dentine asap

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13
Q

what is the main problem with dents-alveolar injuries?

A

injuries that cause significant movement within the socket almost always sever the blood supply entering the pulp via the apical foreman- causing pulp necrosis

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14
Q

what are 4 types of traumas?

A

-luxation
-avulsion
-crown fractures
-root fractures

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15
Q

what is luxation?

A

luxation is the displacement of the tooth in the alveolar bone without total avulsion

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16
Q

what are the types of luxation?

A

-concussion
-subluxation
-intrusive luxation
-extrusive or lateral luxation

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17
Q

what is a concussion luxation?

A

injury to tooth without displacement or mobility of tooth. Alveolar bone is intact.

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18
Q

is it likely for concussion luxation to give positive or negative sensitivity tests?

A

positive

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19
Q

what is subluxation?

A

injury to the tooth causing mobility but no displacement

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20
Q

is it likely for subluxation to give positive or negative sensitivity tests?

A

can initially be negative to sensitivity tests e.g ethyl chloride- due to transient pulpal damage- monitor until definitive diagnosis.

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21
Q

what does concussion subluxation damage?

A

minor damage to the PDL- OH is important as bacteria entry risk increases

22
Q

how will concussion or subluxation appear on radiographs?

A

normal

23
Q

what is seen clinically with subluxation or concussion?

A

-tooth will be TTP
-haemorrage and oedema within ligament
-gingival bleeding and mobility only occur with subluxation

24
Q

when would you not check TTP with a subluxation?

A

if recent injury- vitality test 1 week post trauma

25
Q

what is the management of subluxation/concussion?

A

-periapical radiograph
-soft diet for one week
-advice to parents
-splint for subluxation.
-follow up
-check immunisation- tetanus

26
Q

what is intrusive luxation?

A

when injury causes tooth to displace axially into alveolar bone.

27
Q

what teeth are commonly affected by intrusive luxation?

A

upper anteriors

28
Q

is intrusive luxation mobile?

A

no and TTP will likely cause metallic sound

29
Q

how will intrusive luxation likely respond to sensitivity tests?

A

negatively

30
Q

how will intrusive laxations appear radiographically?

A

-loss of apical pdl space
-ACJ will be further apically than adjacent tooth

31
Q

how do you manage intrusive luxation?

A

-if crown visible and minor alveolar damage- leave to re-erupt - if root not fully formed.

-if crown fully intruded- extract.

32
Q

what is extrusive luxation?

A

tooth will appear elongated and very mobile.PDL will partially or fully be separated from alveolar bone apically.

33
Q

how will extrusive luxation appear on radiographs?

A

increased apical pdl space

34
Q

will response to sensitivity tests be pos or neg for extrusive laxations?

A

likely negative

35
Q

what is the tx for extrusive luxation?

A

-reposition tooth
-use splint 2 weeks
-RCT if necrotic

36
Q

what is a lateral luxation?

A

-tooth is displaced most likely in palatal/labial/lingual direction.
-mobile
-TTP will likely give high metallic sound
-alveolar bone will be fractured

37
Q

how will lateral luxation respond to sensitivity tests?

A

likely negative

38
Q

what is the tx for lateral luxation?

A

-reposition
-splint for 4 weeks
-monitor pulp- RCT if necrotic to prevent bone resorption

39
Q

what is avulsion?

A

complete displacement of tooth from alveolar bone

40
Q

when should you replant primary avulsed tooth?

A

NEVER- can damage permanent tooth

41
Q

if a parent or carer has replanted primary tooth, what should you do?

A

leave if viable and in situ

42
Q

how should you approach permeant tooth avulsion?

A

clean with saliva- and replant immediately. Bite on clean cloth gently

43
Q

how do you treat primary crown fractures without pulpal involvement?

A

-smooth fracture
-restore with GI or composite resin

44
Q

how should you manage a more complication primary tooth fracture?

A

-remove loose fragments
-rest of tooth can be extracted at later date
-if small amount of root left in socket remain- leave in situ as will resorb

45
Q

how would you know if primary tooth has a root fracture?

A

-pulp necrosis
-mobility
-sinus formation

46
Q

how is a primary tooth with a root fracture treated?

A

remove coronal part of tooth- root will be resorbed

47
Q

what type of tooth trauma requires follow up?

A

all traumatised teeth

-avoid predicting prognosis
-reassure pt and parent
-discuss all possible outcomes

48
Q

what is the management of permanent crown fracture close to pulp?

A

use lining and restore
-if no one available use composite bandage

49
Q

what is the management of permanent crown involving the pulp?

A

-refer to dentist same day- always document everything.

50
Q

list the possible damage that can occur following trauma to primary/permenant teeth?

A

-pulpal necroris- grey discolouration and possible abcess
-internal resorption of primary tooth
-ankylosis (high metallic sound) of primary tooth
-hypoplasia- less quantity
-hypomineralisation- less mineralised -sensitivity
-dilaceration of crown or root
-resorption of permanent tooth germ

51
Q

what are the main aims when treating trauma to primary teeth?

A

prevent further damage to permanent teeth

52
Q

what are the main aims when treating trauma to permanent teeth?

A

maintain or regain vitality of dental pulp

paediatrics (13 decks)

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