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Paediatric Dentistry BDS3 > Dental Trauma 3 > Flashcards

Dental Trauma 3 Flashcards

1
Q

what are important considerations with soft tissue trauma

A

impact of injury on surrounding bone, neurovascular bundle and root surface
nature of trauma - separation/crushing

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2
Q

what is concussion

A

injury to tooth supporting structures without abnormal loosening or displacement of tooth

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3
Q

what are clinical findings of concussion

A

pain on percussion

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4
Q

what is the treatment for concussion

A

none

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5
Q

what is follow up for concussion

A

clinical and radiographic after 4 weeks then 1 year

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6
Q

what is subluxation

A

injury to tooth supporting structures with abnormal loosening but without tooth displacement

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7
Q

what are clinical findings of subluxation

A

increased mobility
tender to percussion
bleeding from gingival crevice may be present

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8
Q

what is treatment for subluxation

A

none
splint if excessive mobility or tenderness when biting

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9
Q

what is follow up for subluxation

A

2 weeks
12 weeks
6 months
1 year

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10
Q

how do you monitor concussion and subluxation

A

trauma stamp
sensibility tests
radiographs

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11
Q

what do you look for on follow up radiographs

A

root development
comparison with contralateral tooth
resorption

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12
Q

what is on the trauma stamp

A

sinus
colour
mobility
TTP percussion
ethyl chloride
EPT
radiograph

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13
Q

what is extrusion

A

an injury in which the tooth suffers axial displacement partially out of socket

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14
Q

what are the clinical findings of extrusion

A

tooth appears elongated
displaced palatally
tooth mobile
bleeding from gingival sulcus

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15
Q

how do you treat extrusion

A

reposition tooth by gently pushing back into socket under LA
splint

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16
Q

what is follow up for extrusion

A

2 weeks
1 month
2 months
3 months
6 months
1 year
annually for 5 years

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17
Q

what is lateral luxation

A

displacement of a tooth in a socket in a direction other than axially, accompanied by comminution or fracture or alveolar bone plate

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18
Q

what are the clinical findings of lateral luxation

A

tooth appears displaced in socket
tooth immobile
high ankylotic percussive tone
may be bleeding from gingival sulcus
root apex palpable in sulcus

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19
Q

what is lateral luxation treatment

A

reposition under LA
splint for 4 weeks
monitor

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20
Q

what happens if a tooth with incomplete root formation has lateral luxation

A

spontaneous revascularisation can occur
if necrotic pulp and inflammatory external resorption then endo treatment

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21
Q

what happens if a tooth with complete root formation has lateral luxation

A

necrotic pulp so start endo treatment
place corticosteroid antibiotic into canal or calcium hydroxide as intra canal medicament

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22
Q

what is follow up for lateral luxation

A

2 weeks
4 weeks - splint removal
2 months
3 months
6 months
1 year
annually for 5 years

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23
Q

what is intrusion

A

tooth forced into socket in axial direction and locked in bone

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24
Q

what is clinical findings with intrusion

A

crown appears shortened
bleeding from gingivae
ankylotic high, metallic percussion tone

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25
Q

how do you treat an intruded tooth with immature root formation

A

spontaneous repositioning
if no eruption within 4 weeks then ortho
monitor pulp
necrotic pulp = endo

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26
Q

how do you treat an intruded tooth with mature root formation

A

if <3mm then spontaneous repositioning
if no eruption within 8 weeks the surgical reposition and splint for 4 weeks or ortho reposition
if 3-7mm then surgical/ortho reposition
if >7mm then reposition surgically

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27
Q

how do you treat an intruded tooth with complete root formation

A

start endo treatment at 2 weeks

28
Q

what is follow up for intrusion

A

2 weeks
4 weeks
2 months
3 months
6 months
1 year
annually for 5 years

29
Q

what is avlusion

A

tooth totally displaced from socket

30
Q

what is clinical findings with avulsion

A

socket empty or filled with coagulum

31
Q

what are the critical factors for an avulsed tooth

A

extra alveolar dry time
extra alveolar time
storage medium

32
Q

what emergency advice do we give for avulsed teeth

A

ensure permanent tooth
hold by crown
place immediately into socket
rinse in milk/saline/saliva
bite on gauze to hold in place
seek immediate dental advice

33
Q

what do you store an avulsed tooth in

A

milk
HBSS
saliva
saline
water

34
Q

what factors influence management of avulsed tooth

A

maturity of root
PDL cells condition

35
Q

how do you manage an avulsed tooth with closed apex

A

clean injured area
verify tooth position and apical status
place splint
suture gingival lacerations
consider antibiotics and check tetanus
post op instructions
follow up

36
Q

at what extra alveolar dry time will the PDL cells likely be non-viable

A

> 60mins

37
Q

when do you start endo treatment on avulsed tooth with closed apex

A

2 weeks

38
Q

what medication is placed inside an avulsed tooth when doing RCT

A

calcium hydroxide up to 1 month
corticosteroid/antibiotic paste for 6 weeks

39
Q

what is follow up for avulsed teeth

A

2 weeks
4 weeks
3 months
6 months
1 year
annually for 5 years

40
Q

what is emergency treatment for open apex avulsed tooth

A

clean injured area
verify position
place splint
suture lacerations
consider antibiotics and check tetanus
provide post op instructions
follow up

41
Q

what happens to an avulsed open apex tooth if EAT >60 mins

A

PDL cells non-viable
ankylosis related root resorption

42
Q

what is the goal with open apex avulsed teeth

A

revascularisation

43
Q

what is follow up for open apex avulsed tooth

A

2 weeks
1 month
2 months
3 months
6 months
1 year
annually for 5 years

44
Q

when would you not replant an avulsed tooth

A

immunocompromised
very immature apex
EAT >90mins
very immature lower incisors

45
Q

what is alveolar fracture

A

fracture of alveolar bone which may or may not involve alveolar socket

46
Q

what are the clinical findings with alveolar fracture

A

complete alveolar fracture extending from buccal to palatal bone in maxilla and buccal to lingual bone in mandible
segment mobility and displacement with several teeth moving together
occlusal disturbance
gingival laceration

47
Q

how do you treat alveolar fracture

A

reposition any displaced segment
stabilise by splinting
suture gingival lacerations
monitor pulp condition of all teeth

48
Q

what is the follow up for alveolar fracture

A

monitor clinically and radiographically
4 weeks
6-8wks
4 months
6 months
1 year
annually for 5 years

49
Q

what advice do you give for alveolar fractures

A

soft diet for 7 days
avoid contact sport whilst splint in place
careful oral hygiene with use of chlorhexidine mouthwash

50
Q

when would you splint a tooth for 2 weeks

A

subluxation
extrusion
avulsion

51
Q

when would you splint a tooth for 4 weeks

A

intrusion
lateral luxation
root fracture - mid root and apical third
dento alveolar fracture

52
Q

when would you splint a tooth for 4 months

A

root fracture in cervical third

53
Q

what are the types of chairside splint

A

composite and wire
composite
orthodontic brackets and wire
acrylic
titanium trauma splint

54
Q

what are the types of lab made splint

A

vacuum formed
acrylic

55
Q

what is a composite and wire splint

A

stainless steel wire 0.4mm
passive
flexible

56
Q

when is an acrylic splint useful

A

when few abutment teeth

57
Q

what are the main post trauma complications

A

pulp necrosis and infection
pulp canal obliteration
root resorption
breakdown of marginal gingiva and bone

58
Q

what is pulp canal obliteration

A

progressive hard tissue formation within pulp cavity
gradual narrowing of pulp chamber and pulp canal

59
Q

what are the types of external root resorption

A

surface
inflammatory resorption
cervical
ankylosis

60
Q

what is internal root resorption

A

internal infection related inflammatory root resorption

61
Q

what is external surface resorption

A

superficial resorption lacunae repaired with new cementum
response to localised injury
not progressive

62
Q

what is external infection related inflammatory root resorption

A

non-vital tooth
initiated by PDL damage
indistinct root surface
happens rapidly

63
Q

how do you manage external infection related inflammatory root resorption

A

remove stimulus
endodontic treatment

64
Q

what is ankylosis related root resorption

A

initiated by severe damage to PDL and cementum
bone repair does not occur
severe luxation or avulsion
root remodels

65
Q

how do you treat ankylosis related root resorption

A

plan for loss

66
Q

what is internal infection related inflammatory root resorption

A

due to progressive pulp necrosis
can see symmetrical expansion of root canal walls and tramlines are indistinct

67
Q

how do you treat internal infection related inflammatory root resorption

A

remove stimulus and do endodontic treatment

Paediatric Dentistry BDS3 (8 decks)

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