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PAEDS FLASHCARDS > DETNAL TRAUMA > Flashcards

DETNAL TRAUMA Flashcards

1
Q

What is the most common TDI in the primary dentition?

A

Luxation injuries are the most common & more common in boys!

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2
Q

does dental trauma matter in the long run

A
  • yes, trauma is the most common cause of loss of permanent incisors in childhood
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3
Q

what is the most common complication of trauma

A

PULPAL NECROSIS resulting in long term restorative problems

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4
Q

what are the 3 peak times dental trauma can occur

A
  1. 2-4 years
  2. 8-10 years
  3. 14-16 years
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5
Q

what are the PREVENTION STRATEGIES for dental trauma incidences (3)

A
  • it can be difficult to manage a child from stopping trauma to teeth
  • increased incidence with INCREASED OVERJET
  • mouthguards
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6
Q

what is the main points of management for trauma

A

PROPER DX, TX PLANNING and follow-up are important to assure a favourable outcome

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7
Q

what are the 8 steps that we do first when presented with trauma

A
  • check for head injury
  • assess the dental/facial injury
  • does the story fit?
  • where are the bits?
  • do emergency dental treatment to STABILISE injnuries
  • clean up patient
  • review and treat or refer to specialist
  • DOCUMENT EVERYTHING
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8
Q

what are the 2 types of injury that may occur from a BLOW to the teeth

A

INJURIES TO THE TOOTH:
- CROWN fracture
- ROOT fracture
- these may be from impact against something hard ie the road or golf club etc

INJURIES TO THE SOCKET:
- tooth intact but displaced or loosened within its socket
- result of an impact with something softer ie fist elbow etc

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9
Q

what is the main problem with DENTAL INJURIES

A

it is that bacteria can invade pulp, so cover all exposed dentine quickly and monitor vitality of tooth

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10
Q

what is the main problem with DENTO-ALVEOLAR injuries

A

it is that any significant movement within the socket will almost certainly sever all the blood vessels entering the pulp via the apical foramen so the pulp horns become NECROTIC

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11
Q

List the 4 types of dental trauma

A
  • LUXATION
  • AVULSION
  • CROWN FRACTURES
  • ROOT FRACTURES
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12
Q

LUXATIONS IN THE PRIMARY TEETH CAN BE SPLIT INTO 4 SUB-GROUPS. WHAT ARE THEY:

A

(luxation is the most common injury to the primary teeth involving displacement of the teeth and the alveolar bone)

  • CONCUSSION
  • SUBLUXATION
  • INTRUSIVE LUXATION
  • EXTRUSIVE AND LATERAL LUXATION
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13
Q

LUXATIONS - what is concussion

A

concussion is an injury to the tooth without displacement or mobility of the tooth (OH needs to be stressed here as increased risk of bacterial entry)

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14
Q

LUXATIONS - what is subluxation

A

this occurs when the tooth is mobile but is not displaced. (OH needs to be stressed here as increased risk of bacterial entry)

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15
Q

When we test concussed/subluxated teeth what are the results?

A

these type of injured teeth are TTP, there is haemorrhage and oedema within the ligament, but gingival bleeding and mobility occur only if the teeth have ben SUBLUXATED!!!!

IF TOOTH MOBILE, DO NOT CHECK TTP IF RECENT INJURY. VITALITY CHECK 1 WEEK POST TRAUMA!

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16
Q

what is the management of concussion and subluxation(5)

A
  • periapical radiograph
  • soft diet for one week
  • advice to parents, possible sequelae
  • follow up
  • check immunization ie tetanus
17
Q

LUXATION - what is INTRUSIVE LUXATION

A
  • most common injury to upper primary incisors
  • newly erupted incisors often take the full force of ANY fall
  • usually a palatal and superior displacement of the crown
18
Q

what is the management of intrusive luxation

A
  • if the crown is visible with minor alveolar damage - leave the tooth to re-erupt
  • if the whole tooth is intruded - XLA
  • decision is solely based on the presentation of the injuries and assessment of the child

INCREASED SEVERITY = INCREASED RISK OF XLA!!!

19
Q

luxations - describe management of extrusive and lateral luxations

A
  • treatment is dependant on the mobility and extent of displacement
  • if there is excessive mobility, the tooth should be extracted
20
Q

luxations - what is the management of avulsion

A
  • avulsed primary teeth should NOT be replanted
  • lack of pt cooperation
  • may damage the developing permanent tooth
  • carer/parent may replant tooth - if stable and viable leave in situ
21
Q

what is avulsion (seperate from luxation)

A

this is a complete displacement of a tooth from its socket in the alveolar bone

22
Q

luxations - what happens if avulsion occurs in a permanent tooth

A
  • REPLANT IMMEDIATELY
  • to rinse or not to rinse?
  • bite gently on clean hanky/cloth
  • unable to replant - advice?
23
Q

FRACTURES OF THE PRIMARY INCISORS - what is the management of treating a CROWN fracture not involving the pulp

A

if possible restore with GI or comp resin

24
Q

what are the complications of crown/root fractures(3)

A
  • they are more likely to involve the pulp and extend BELOW the gingival margin
  • there may be multiple fractures in individual teeth
  • fracture not always immediately evident!
25
Q

what is the management of FRACTURES TO PRIMARY INCISORS (NOT crowns) - (4)

A
  • loose fragments should be removed
  • remaining tooth can be extracted at a later date
  • small pieces of root remaining in socket after a fracture may be SAFELY left in situ
  • ROOT FRACTURE - signs of pulpal necrosis, excessive mobility or sinus formation remove CORONAL proportion as root will resorb/exfoliate anyway.
26
Q

what are the SEQUELAE after trauma to primary teeth(4)

A
  • all traumatised teeth require follow up
  • difficult to accurately predict prognosis esp with permanent teeth so guarded prognosis!
  • reassure patient and parents
  • discuss with parents possible outcomes
27
Q

management of fractures to permanent teeth (5)

A
  • initial management matters!
  • time is of the essence
  • ensure injury is stabilised and reduce chance of infection!
  • get specialist help if needed
  • treat the uncomplicated crown fracture close to pulp, if no one available, stabilise trauma with a composite bandage. if pulp involved refer to be seen by a dentist SAME DAY

DOCUMENT (often legal cases)

28
Q

what is the possible damage to primary and permanent teeth due to trauma…. (6)

A
  • necrosis of the pulp of the primary tooth with grey discolouration and possible abscess formation
  • internal resorption of the primary tooth
  • ankylosis of the primary tooth (fused bone due to the root)
  • hypoplasia or MIH of successory teeth (adult teeth)
  • dilaceration of the crown or root
  • resorption of the permanent tooth gem
29
Q

MAIN AIMS OF MANAGING TRAUMA IN A KID….

A
  • the main aim of managing trauma to PRIMARY incisors is to prevent further damage to the developing permanent incisors
  • the main aim of managing trauma to PERMANENT incisors is the maintain or possible regain VITALITY OF THE DENTAL PULP.

PAEDS FLASHCARDS (10 decks)

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