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Paediatric Trauma Flashcards

1
Q

What is an enamel fracture?

A

This is where there is loss of enamel, no mobility, sensibility and TTP testing normal

we take 1 parallel PA

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2
Q

Tx for enamel fracture?

A

Do nothing/accpet

Smooth off edges

Flowable/composite

Rebond fragment

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3
Q

Follow up for enamel fracture?

A

6-8 weeks

1 year

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4
Q

What is enamel dentine fracture?

A

This is where there is loss of enamel + dentine, no mobility, sensibility and TTP testing normal

we take 1 parallel PA

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5
Q

Tx for ED fracture?

A

Account for fragment

rehydrate in saline for 20 mins

rebond

GIC over exposed dentine and comp restoration

If 0.5mm from pulp, liner, restore

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6
Q

Follow up for ED fracture?

A

6-8 weeks
1 year

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7
Q

What is EDP fracture?

A

Enamel dentine pulp fracture - pulp is involved, not TTP, no mobility, normal sensibility but sensitive to stimulus due to pulp exposure

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8
Q

Tx for EDP fracture?

A

<1mm and 24 hrs = pulp cap

> 1mm >24hrs partial/full pulpotomy and restore

or if NV or bleeding wont stop then pulectomy

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9
Q

Follow up for EDP fracture?

A

6-8 weeks
3 months
6 months
1 year

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10
Q

What is a complicated crown root fracture?

A

This is where there is fracture of crown and root which involves pulp and as a result there is a mobile fracture, tooth is TTP, pos response and MOBILE FRAGMENT

XEAYS - 1 PARALLEL PA 2X OTHER

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11
Q

Tx for complicated crown root fracture?

A

temporise by bonding mobile fragment to adjacent non mobile

then tx:

  • remove fragment and restore (pulp exposure will depend on size and time –> may need RCT)

Surgical/ortho extrusion of non mobile fragment and restore

RCT

XLA

Decoronate

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12
Q

Follow up for complicated crown root fracture?

A

1 week

6-8 weeks

3 months

6 months

1 year

yearly for 5

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13
Q

what is an uncomplicated crown root fracture?

A

This is where there is fracture of crown and root which DOES NOT INVOLVE THE pulp and as a result there is a mobile fracture, tooth is TTP, pos response and MOBILE FRAGMENT

XEAYS - 1 PARALLEL PA 2X OTHER

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14
Q

What is the tx for uncomplicated crown root fracture?

A

Temp = stabilise mobile fragment

remove fragment and restore (cover exposed dentine with GUC)

RCT if needed

Surgical/rotho extrusion

XLA

Decorate for implant

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15
Q

What is a root fracture?

A

This is where the root fractures at either:

apical 1/3rd
mid 1/3rd
coronal 1/rd

best prognosis if apical 1/3rd

coronal segment may be mobile and displaced, may be TTP, may have bleeding, pulp test may be negative

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16
Q

Tx for root fracture?

A

Reposition any displacements and check with PA

Stabilise with passive flexible splint for 4 weeks (up to 4 months for coronal fracture)

no endo at emergency visit but can initiate 7-10 days later or in primary teeth monitor

in mature teeth may need to remove mobile coronal fragment and consider post and core

17
Q

What types of healing in root fracture?

A

CALCIFIED TISSUE HEALING

CT HEALING

BONE + CT HEALING

NON HEALING

18
Q

What is a concussion injury?

A

This is where both supporting structures are injured and the tooth is TTP but no mobility. no displacement or mobility

19
Q

What is tx for concussion injury?

A

Nothing - reassure pt monitor pulp for 1 year

20
Q

What is follow up for concussion?

A

4 weeks
6/8 weeks
1 year

21
Q

What is a subluxation injury?

A

This is where there is injury to tooth supporting structure, there is mobility, bleeding TTP, but no displacement

may be non vital

22
Q

What is tx for subluxation?

A

No tx needed usually

for pt comfort or if excess mobility then splint for 2 weeks with passive flexible splint

monitor for 1 yerar

23
Q

Recall for subluxation?

A

2 weeks - splint
3 months
6 months
1 year

24
Q

What is extrusive luxation?

A

This is where tooth is displaced out socket, there is partial or total seperation of PDL, tooth appears elongated, increased mobility, negative pulp test

INC PDL SPACE APICALLY AND LATERALLY

TOOTH NOT IN SOCKET, LOOKS LONGER INICISALLY

25
Q

How do we tx extrusive lunation?

A

reposition gently by pushing it back into socket under LA

stabilise with passive flexible splint 2 weeks

monitor pulp

if necctoridc endo

26
Q

Recall for extrusive lunation?

A

2 weeks (splint)
4 weeks
2 months
3 months
6 months
1 year
yearly for 5

27
Q

What is lateral luxation?

A

this is where tooth displaced buccal/palatally and there is tear and crush injury to PDL, tooth immobile, ankylotic, widened PDL space

28
Q

How do we tx lateral luxation?

A

reposition and splint - 4 weeks

monitor pulp

29
Q

Recall for lateral luxation?

A

2 weeks
4 weeks
2 months
3 months
6 months
1 year
yearly for 5

30
Q

What is intrusive luxation?

A

Tooth driven into alveolar process and there is crush injury to PDL, immobile, ankylotic, likely negative

PDL not visible

ACJ apical

31
Q

What is tx for intrusion?

A

Immature :

up to 7mm = spontaneous (if not after 4 weeks then ortho or there will be ankylosis)

> 7mm = ortho or surgical

Mature:

< or equal to 3mm = spontaneous
3-7mmm = ortho
>7m surgical

splint 4 weeks passivee flexible

32
Q

Recall for intrusive luxcation?

A

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

33
Q

do we prescribe antibiotics?

A

PDL exposed in avulsion and contaminated by oral cavity, environment or storage medium so recommended to prevent infection by prescribing amoxicillin or pen V

34
Q

Advice afterr avulsion?

A

avoid playing in contact sports
maintain soft diet for 2 weeks
brush teeth with soft brush after each meal
CHX 0.18% mouth rinse twice day for 2 weeks

35
Q

Follow up for avulsion

A

2 weeks
4 weeks
2 months
3 months
6 months
year
yearly for 5 years

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