Adult Consequences of Childhood Trauma

Question 1

what three aspects depict the outcome of dental treatment for trauma

Answer 1

severity of injury sustained
stage of root development
timing of treatment

Question 2

what is the complication associated with enamel-dentine fracture

Answer 2

pulp necrosis

Question 3

what is the complication associated with enamel-dentine- pulp fracture

Answer 3

pulp canal obliteration

Question 4

what is a subluxation injury

Answer 4

tooth is a bit wobbly but has not bee pushed out of place

Question 5

what is a concussion injury

Answer 5

injury to the supporting tooth structures without any mobility of the tooth but responds to percussion

Question 6

what is an extrusion injury

Answer 6

tooth is pushed out of socket in axial direction

Question 7

what is a lateral luxation injury

Answer 7

tooth is pushed out of socket palatally or labially

Question 8

what is a dento-alveolar fracture

Answer 8

the alveolus supporting the tooth is fractured

Question 9

what is an intrusion injury

Answer 9

tooth is pushed into the alveolus, the PDL is crushed and the blood supply to the tooth is crushed

Question 10

what is an avulsion injury

Answer 10

complete displacement of the tooth from the socket

Question 11

what is usually the treatment for an intrusion

Answer 11

endo

Question 12

what are the aspects of treatment when treating a tooth with an open apex

Answer 12

maintain pulpal vitality
preserve blood supply
causes regeneration

Question 13

what are the aspects of treatment when treating a tooth with a closed apex

Answer 13

maintain pulpal vitality
preservation of blood supply
prevent ingress or eliminate bacteria and toxins

Question 14

what time period would an acute treatment be associated with

Answer 14

less than 3 hours

Question 15

what time period would a subacute treatment be associated with

Answer 15

3-24 hours

Question 16

what time period would a delayed treatment be associated with

Answer 16

more than 24 hours

Question 17

what timing for treatment is needed for avulsions

Answer 17

immediate reimplantation or acute

Question 18

what timing for treatment is needed for an alveolar fracture

Answer 18

acute

Question 19

what timing for treatment is needed for an extrusion or lateral luxation

Answer 19

acute or subacute

Question 20

what timing for treatment is needed for a root fracture

Answer 20

acute or subacute

Question 21

what timing for treatment is required for a concussion or subluxation

Answer 21

subacute

Question 22

what timing for treatment is required for crown or crown-root fractures

Answer 22

subacute or delayed

Question 23

what are some potential long term complications of trauma

Answer 23

discolouration
loss of vitality
inflammatory root resorption
unfavourable tooth positions
defects in hard and soft tissues

Question 24

what discolouration can occur internally following trauma

Answer 24

yellow, pink, grey and black

Question 25

what is yellow discolouration indicative of

Answer 25

canal obliteration

Question 26

what causes internal yellow discolouration

Answer 26

tertiary dentine produced reduces light transmission

Question 27

what is the treatment for internal yellow discolouration

Answer 27

local external bleaching

Question 28

what is pink discolouration indicative of

Answer 28

rupture of blood vessels causing haemorrhage in pulp chamber

Question 29

what causes pink discolouration

Answer 29

blood components flow into dentinal tubules and cause discolouration of surrounding dentine

Question 30

what may present as a pink dot at the cervical margin of the crown

Answer 30

cervical root resorption

Question 31

can pink discolouration be reversed

Answer 31

if there is no necrosis - maybe when the pulp revascularizes if there is pulpal necrosis - no

Question 32

what is grey discolouration indicative of

Answer 32

non-infected traumatised teeth accumulating haemoglobin molecules

Question 33

what causes grey discolouration

Answer 33

hydrogen sulphates produced by bacteria convert iron into dark coloured iron sulphates

Question 34

when would pulpal necrosis and apical periodontitis occur following trauma

Answer 34

if revascularisation fails

Question 35

what are some diagnostic indicators of pulpal necrosis

Answer 35

periapical radiolucency grey discolouration no response to sensitivity tests tenderness to percussion presence of sinus tracts

Question 36

what is the treatment for pulpal necrosis

Answer 36

primary endodontics internal bleaching extraction and prosthetic replacement

Question 37

when would unfavourable tooth positions occur

Answer 37

following displacement injuries

Question 38

what is the management to minimise risk of complications following displacement injuries

Answer 38

repositioning and splinting for 24 hours

Question 39

what is the treatment for minimal changes in tooth positioning

Answer 39

addition of composite removal of tooth tissue

Question 40

what is the treatment for significant alterations in apico-coronal tooth position

Answer 40

extra coronal restorations ortho repositioning

Question 41

what can occur in displacement injuries that means we need to intervene quickly

Answer 41

ankylosis

Question 42

why does infra-occlusion occur

Answer 42

anyklosis/ replacement root resorption resulting from injury

Question 43

what treatment is available for infra occluded teeth

Answer 43

not amendable to ortho repositioning

Question 44

what does treatment of infra occlusion usually depend on

Answer 44

prognosis of teeth degree of infra occlusion wishes of patient lip line

Question 45

what are examples of defects in hard and soft tissues following trauma

Answer 45

gingival lacerations/ abrasions alveolar fractures

Question 46

what is the management for adults with bone deficiencies

Answer 46

bone graft orthodontic extrusion therapy

Question 47

what is the management for adults with soft tissue deficiencies

Answer 47

mucogingical surgery connective tissue grafting frenectomies implants

Question 48

what is the management options for children with hard and soft tissue deficiencies

Answer 48

extractions coronectomies

Question 49

when should your follow ups continue for any of the displacement injuries

Answer 49

yearly up to five years

Question 50

what are potential difficulties with treatment of displaced teeth

Answer 50

alcohol related frequency psychopathology non-transfer of dental records UK

Question 51

what are long term complications of dental trauma

Answer 51

external cervical root resorption internal inflammatory root resorption external inflammatory resorption altered tooth position