Assessment, classification and management of crown fractures Flashcards
what percentage of school children experience dental trauma? (1)
25%
what percentage of damaged teeth go untreated? (1)
70%
What type of damage is most common in the primary dentition? (1)
Luxation
What type of damage is most common in the permanent dentition? (1)
Crown Fracture
What is the risk associated with having an overjet greater than 9mm? (1)
Doubles the likelihood of tooth trauma
falls account for what percentage of permanent tooth trauma? (1)
50%
Biking and skateboarding accounts for what percentage of permanent tooth trauma? (1)
17-35%
Sports account for what percentage of tooth trauma? (1)
14-25%
fights account for what percentage of tooth trauma? (1)
3%
What extra oral injuries would you look out for from someone who has just experienced dental trauma? (6)
- lacerations
- Haematomas
- Haemorrhage/CSF
- Subconjunctival haemorrhage
- Bony step deformities
- Facial/jaw fractures
Which intra oral features would you assess from someone who just experienced dental trauma? (4)
- lacerations on soft tissues
- Alveolar bone movement
- is the occlusion affected?
- are any other teeth affected?
How would you check for the presence of foreign bodies within wounds if you could not see with the naked eye? (1)
Soft tissue radiograph
tooth mobility may indicate? (3)
- displacement of tooth
- Root fracture
- Bone fracture (more than on mobile tooth)
what different tests are there to assess tooth damage? (3)
Thermal - ethyl chloride
electrical - electric pulp tester
percussion - duller note may indicate tooth fracture
what is meant by traumatic occlusion? (1)
when patient cant put teeth into occlusion normally
whats the purpose of a trauma sticker? (1)
Helps monitor the progress and status of a traumatised tooth for the duration of treatment.
How long should you continue using sensibility tests following an injury? (1)
2 years
why would you test an adjacent non-injured tooth as well as an injured tooth? (1)
To compare reactions and strengthen evidence of tooth sensitivity
what are the classifications of fractures? (6)
- enamel fracture
- Enamel-dentine fracture
- enamel-dentine-pulp fracture
- root fracture -apical 1/3 middle 1/3 coronal 1/3
- uncomplicated crown root fracture
- complicated crown root fracture
the prognosis of traumatised teeth depends on what? (5)
- Stage of root development
- Type of injury
- If PDL is damaged
- Time between injury and treatment
- Presence of infection
Ultimately what do you aim to achieve by emergency treatment? (5)
- Retain vitality of any damaged or displaced teeth
- Treat exposed pulp tissue
- reduction and immobilisation of displaced teeth
- Tetanus prophylaxis
- Consider antibiotics
what intermediate treatment would you consider? (2)
- +/- pulp treatment
* is a restoration required?
how could you manage an enamel fracture? what is the tooths prognosis of pulp necrosis? (4)
- bond fragment to tooth or simply grind sharp edges
- Take 2 periapical radiographs to rule out root fracture or luxation
- Follow up: 6-8 weeks, then 6 months, then 1 year
- 0% risk
how could you manage an enamel-dentine fracture? what is the tooths prognosis of pulp necrosis? (7)
- account for fragment
- Either bond fragment to tooth or place composite bandage
- Take 2 periapical radiographs to rule out root fracture or luxation
- radiograph any lip or cheek lacerations to rule out embedded fragment
- Sensibility testing and evaluate tooth maturity
- Definitive restoration
- Follow up 6-8weeks, 6 months, 1 year
- 5% risk
