Revision-Orthodontic first aid Flashcards
Pt presenting complaint
“Wire sticking out distally from molar tube/band”
Which are the possible causes and how should it be managed?
Pt presenting complaint
“Wire sticking out mesial to molar”
Which are the possible causes and how should it be managed?
Pt presenting complaint
“Bracket has detached from tooth”
Which are the possible causes and how should it be managed?
Pt presenting complaint
“Band loose”
Which are the possible causes and how should it be managed?
Pt presenting complaint
“Teeth feel loose”
Which are the possible causes and how should it be managed?
Pt presenting complaint
“Dentist fractures tooth during extraction leaving root fragment”
How should it be managed?
- Take X-ray to investigate size of fragment
- If large and/or will interfere with planned tooth movements, refer patient for removal of fractured portion
- If small and/or does not interfere with tooth movements, keep under radiographic observation
Pt presenting complaint
“Appliance component missing? Inhaled or ingested”
how should it be managed?
- If airway obstructed, call ambulance and try to remove obstruction
- If there is a risk that the component has been inhaled then refer the patient to hospital for a chest X-ray and subsequent management (give patient another similar component to aid radiologist when examining films)
- If there is a danger that the component is >5 cm and has been swallowed then seek the advice of the local hospital. If >6 days previously, object has probably passed through patient’s system
Pt presenting complaint
“Bonded retainer detached”
How should it be managed?
Pt presenting complaint
“Bonded retainer partially detached”
Which are the possible causes and how should it be managed?
- If remainder not distorted then re-bond to remaining teeth
- If remainder distorted then remove and place new bonded retainer
Incident occurs
What do you do?
Which are the types of Permanent teeth injuries?
Concussion
- The tooth is tender to touch or tapping; it has not been displaced and does not have increased mobility.
- Sensibility tests are likely to give positive results.
Tx:
- No treatment is needed.
- Monitor pulpal condition for at least one year.
Subluxation
- The tooth is tender to touch or tapping and has increased mobility; it has not been displaced.
- Bleeding from gingival sulcus may be noted.
- Sensibility testing may be negative initially indicating transient pulpal damage.
- Monitor pulpal response until a definitive pulpal diagnosis can be made.
Tx:
- Normally no treatment is needed, however a flexible splint to stabilize the tooth for patient comfort can be used for up to 2 weeks.
Extrusion:
- The tooth appears elongated and is excessively mobile.
- Sensibility tests will likely give negative results.
- Increased periodontal ligament space apically.
Tx:
- Reposition the tooth by gently re-inserting It into the tooth socket.
- Stabilize the tooth for 2 weeks using a flexible splint.
- In mature teeth where pulp necrosis is anticipated or if several signs and symptoms indicate that the pulp of mature or immature teeth became necrotic, root canal treatment is indicated.
Lateral luxation
- The tooth is displaced, usually in a palatal/lingual or labial direction.
- It will be immobile and percussion usually gives a high, metallic (ankylotic) sound.
- Fracture of the alveolar process present.
- Sensibility tests will likely give negative results
- The widened periodontal ligament space is best seen on eccentric or occlusal exposures.
Tx:
- Reposition the tooth digitally or with forceps to disengage it from its bony lock and gently reposition it into its original location.
- Stabilize the tooth for 4 weeks using a flexible splint.
- Monitor the pulpal condition.
- If the pulp becomes necrotic, root canal treatment is indicated to prevent root resorption.
Avulsion
Tx
