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MODULE 6 > Trauma 1 and 2 - intro > Flashcards

Trauma 1 and 2 - intro Flashcards

1
Q

what is the most common trauma injury in preschoolers up to the age of 5 years old?

A

luxation

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2
Q

what type of occlusion is a predisposing factor for dental trauma?

A

increased overjet with protrusion upper incisors

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3
Q

what dental tissues are involved in healing post dental trauma?

A

pulp
PDL
apex formation
bone and gingivae/ mucosa

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4
Q

do mature or immature teeth withstand trauma better? and why?

A

immature teeth
they have a bigger blood supply and open apex

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5
Q

if an immature tooth loses vitality, what must be used to close its apex?

A

MTA - mineral trioxide aggregate

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6
Q

what are the physiological properties of enamel?

A

hard and brittle

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7
Q

what are the physiological properties of dentine?

A

porous
pulpodentinal complex - odontoblasts

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8
Q

what must be performed if a tooths dentine is traumatised?

A

immediate seal

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9
Q

what are the physiological components of gingivae?

A

gingival fibres
junctional epithelium
alveolar mucosa

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10
Q

how many days does it take for junctional epithelium to reattach after trauma?

A

up to 5 days

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11
Q

what is the difference between primary and secondary healing intention?

A

primary - wound closure by surgical treatment
secondary - wound left to heal by itself

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12
Q

what are the physiological properties of pulp?

A

encased in hard tissue
can repair

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13
Q

what is the function of root sheath of hertwig?

A

guides root formation

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14
Q

what does the PDL connect and what is it composed of?

A

connects the tooth cementum to gingiva and alveolar bone

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15
Q

had the PDL got good healing potential?

A

yes

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16
Q

what are the 2 ways the PDL may be disrupted after dental trauma?

A

crush
separation

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17
Q

what are the physiological properties of bone?

A

vascular
active remodelling

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18
Q

what happens to dental bone when there is inflammation?

A

resorption
inflammatory mediators induce osteoclasts

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19
Q

what may occur if there is displacement of the apex of a tooth?

A

ischaemia

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20
Q

can revascularisation occur if the apex is displaced?

A

likely if apex is more than 1mm
rare if apex is less than 0.5mm

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21
Q

what is a special consideration when there is trauma to a primary tooth?

A

the developing permanent dentition beneath

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22
Q

how may a developing permanent dentition be damaged?

A

direct trauma
infection/ inflammation of primary teeth

23
Q

what are the classifications of dental trauma injuries following WHO1995?

A

dental injuries
periodontal injuries
soft tissue injuries
skeletal injuries

24
Q

what are the classifications of dental (tooth) injuries following WHO 1995?

A

enamel infraction (incomplete crack)
enamel #
enamel dentine # (uncomplicated)
enamel dentine pulp #(complicated)
crown root # without pulp involvement
crown root # with pulp involvement
root # (cervical or mid 1/3)

25
Q

how is an enamel infarction described?

A

incomplete # (crack) of the enamel without loss of tooth structure
- not tender
- no radiographic abnormalities

26
Q

how is an enamel # described and investigation results?

A

complete # of enamel
- loss of enamel
- no sign of exposed dentin
- not tender
- no mobility
- positive sensibility test
- enamel loss radiographically

27
Q

how is enamel dentine # (uncomplicated) described and investigation results?

A

confined to enamel and dentin with loss of tooth structure but not exposing pulp
- no TTP
- no mobility
- positive sensibility test
- enamel-dentin loss radiographically

28
Q

how is enamel dentin pulp # (complicated) described and investigation results?

A

involving enamel and dentin with loss of tooth structure and exposed pulp
- no mobility
- no TTP
- exposed pulp sensitive to stimuli
- enamel-dentin loss radiographically

29
Q

how is a crown root # without pulp involvement described and investigation results?

A

involving enamel, dentin and cementum with loss of tooth structure but not exposing the pulp
- crown fracture extending below gingival margin
- TTP
- coronal fragment mobile
- positive sensibility test for apical fragment
- apical extension of fracture usually not seen radiographically

30
Q

how is crown root # with pulp involvement described and investigation results?

A

involving enamel, dentin and cementum and exposing the pulp
- TTP
- coronal fragment mobile
- apical extension of fracture not seen radiographically

31
Q

how is root # (cervical or mid 1/3) described and investigation results?

A

coronal segment may be mobile and displaced
- may be TTP
- bleeding from gingival sulcus
- sensibility testing initially negative
- transient crown discolouration (red or grey) may occur

32
Q

if a tooth has a root # (cervical or mid 1/3rd), what may sensibility testing result in and indicate? and what must be monitored regularly?

A

sensibility testing may initially be negative which indicates transient or permanent neural damage
pulpal status should be monitored

33
Q

what angle if the fracture in a tooth that is classified as a root # cervical or mid 1/3

A

horizontal or oblique plane

34
Q

how may horizontal fractures be detected?

A

PA 90 degree

35
Q

how may oblique fractures in the apical third be detected?

A

occlusal
varying horizontal angles

36
Q

4 types of periodontal injuries?

A

concussion
subluxation
luxation
avulsion

37
Q

describe concussion and investigation results

A

“bruised”
no displacement
TTP
no radiographic abnormalities

38
Q

describe subluxation and its investigation results

A

“loosened”
no displacement
TTP
increased mobility
negative initial sensibility testing
no radiographic abnormalities

39
Q

what must be monitored for a tooth with subluxation?

A

pulpal response as sensibility testing may be initially negative - transient pulpal damage

40
Q

describe extrusive luxation and its investigation results

A

tooth appears elongated
excessively mobile
negative sensibility result
radiographically - increased PDL apically

41
Q

describe intrusive luxation and its investigation results

A

tooth displaced axially into alveolar bone
immobile
percussion may give a high, metallic (ankylotic) sound
negative sensibility tests
radiographically - absent PDL from all/ part of root, CEJ located more apically

42
Q

describe lateral luxation and its investigation results

A

tooth displaced palatal/ lingual
immobile
percussion gives a high, metallic (ankylotic) sound
fractured alveolar process
negative sensibility tests
radiographically - widened PDL on eccentric or occlusal exposures

43
Q

how may you treat a primary tooth that has experienced lateral luxation?

A

if there is no occlusal interference - tooth can reposition spontaneously
if tooth interferes with occlusion - selectively grind the tooth

44
Q

list 3 types of intra oral soft tissue injuries

A

grazes/ lacerations
degloving
contusions (bruises)

45
Q

list 3 extra oral soft tissue injuries

A

grazes/ lacerations
contusions (bruises)
inclusion of foreign bodies e.g., gravel, tooth fragments

46
Q

list 4 areas for skeletal injuries

A

alveolus
mandible
maxilla
cranial

47
Q

describe an alveolar fracture and its investigation results

A

2 or more teeth moving as a block
segment mobility and dislocation
occlusal change
sensibility testing may or may not be positive

48
Q

what may be seen radiographically with alveolar fractures? and what radiographs should be taken?

A

fracture lines located at any level from marginal bone to root apex and above apex
in addition, 3 angulations and occlusal film, panoramics can be helpful

49
Q

what can be considered in prevention of trauma for a child with double digit overjet in mixed dentition?

A

2 phase overjet reduction with functional appliance
provide mouthguards for sports

50
Q

what are the 3 types of gumshields?

A

stock type I
boil and bite type II
custom made type III

51
Q

describe a stock type I gumshield

A

bulky plastic
constant biting force to retain

52
Q

describe a boil and bite type II gumshield

A

thermoplastic moulded within mouth
deform over time

53
Q

describe a custom made type III gumshield

A

ethylene vinyl acetate
vacuum formed over stone cast
5mm thick and extend to distal 6s
can be built in multiple layers (laminations)

54
Q

what are features of an ideal gumshield?

A

covers teeth
extends into labial sulcus
greater extension more evenly impact force

MODULE 6 (69 decks)

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