s10-finals+midterms-Trauma

Question 1

What are the 3 key prognostic factors in dental trauma?

Answer 1

Time elapsed, stage of tooth development, proper diagnosis.

Question 2

Which teeth are most commonly affected by traumatic injuries?

Answer 2

Permanent maxillary central incisors.

Question 3

What is the first-aid protocol for an avulsed tooth?

Answer 3

Rinse with saline, replant immediately, or store in milk/HBSS.

Question 4

How do crown infractions appear clinically?

Answer 4

Craze lines in enamel without loss of tooth structure.

Question 5

What distinguishes uncomplicated from complicated crown fractures?

Answer 5

Pulp exposure (complicated) vs. no pulp exposure (uncomplicated).

Question 6

Define “crown-root fracture.”

Answer 6

Fracture involving both enamel/dentin and cementum/root structure.

Question 7

What radiographic feature indicates a vertical root fracture?

Answer 7

J-shaped or halo radiolucency around the root.

Question 8

Which luxation injury shows “apical displacement into alveolar bone”?

Answer 8

Intrusive luxation.

Question 9

What characterizes avulsion?

Answer 9

Complete displacement of the tooth from its socket.

Question 10

Why is sensibility testing unreliable immediately post-trauma?

Answer 10

Nerve damage causes false negatives; vascular damage precedes neural destruction.

Question 11

How does Laser Doppler Flowmetry (LDV) measure pulp vitality?

Answer 11

Detects blood flow (flux) using scattered light and perfusion units (PU).

Question 12

What is the primary limitation of pulse oximetry in traumatized teeth?

Answer 12

Cannot be used through restorations; requires isolation from gingival blood flow.

Question 13

How many radiographs are needed to diagnose root fractures?

Answer 13

At least three at different angles.

Question 14

When is CBCT indicated in dental trauma?

Answer 14

Suspected vertical root fractures, intrusive luxation, or complex fractures.

Question 15

What radiographic view best detects apical root fractures?

Answer 15

Periapical radiograph with steep vertical angle.

Question 16

What is the emergency treatment for uncomplicated crown fractures?

Answer 16

Bonding with composite or reattachment of fragment.

Question 17

When is direct pulp capping indicated in crown fractures?

Answer 17

Small pulp exposure (<1mm) within 24 hours, immature apex.

Question 18

What is the treatment for complicated crown fractures after 48 hours?

Answer 18

Pulpotomy (immature apex) or root canal treatment (mature apex).

Question 19

How are uncomplicated crown-root fractures managed?

Answer 19

Fragment reattachment or extraction if non-restorable.

Question 20

What is the worst prognosis for root fractures?

Answer 20

Middle third fractures due to difficulty stabilizing segments.

Question 21

How are non-displaced middle-third root fractures treated?

Answer 21

RCT on both segments + rigid post stabilization.

Question 22

What is the treatment for displaced middle-third root fractures?

Answer 22

RCT on coronal segment; monitor apical segment (extract if necrotic).

Question 23

How long should splinting last for extrusive luxation?

Answer 23

2 weeks with a flexible splint.

Question 24

What repositioning method is used for lateral luxation?

Answer 24

Firm pressure + flexible splinting for 2-4 weeks.

Question 25

What is the priority in intrusive luxation for teeth with open apices?

Answer 25

Allow spontaneous eruption if ≤7mm intrusion; reposition if no movement in 3 weeks.

Question 26

How is intrusive luxation managed in mature teeth (>17 years)?

Answer 26

Surgical/orthodontic repositioning within 3 weeks for >3mm intrusion.

Question 27

What storage medium is preferred for avulsed teeth?

Answer 27

Hank's Balanced Salt Solution (HBSS) > milk > saline.

Question 28

What is the replantation protocol for avulsed teeth with closed apex (<60 mins dry time)?

Answer 28

Rinse, replant, splint flexibly for 1-2 weeks.

Question 29

How should open-apex avulsed teeth be treated before replantation?

Answer 29

Soak in doxycycline/minocycline solution.

Question 30

What defines "inflammatory tissue ingrowth" in root fractures?

Answer 30

Infected granulation tissue causing resorption and non-union.

Question 31

How should avulsed teeth with >60 mins dry time be treated?

Answer 31

Remove PDL, soak in citric acid/fluoride, RCT extra-orally, then replant and splint.

Question 32

What is the splinting duration for avulsed teeth with open apices?

Answer 32

2 weeks with flexible splint.

Question 33

Why is long-term Ca(OH)₂ used in avulsion cases?

Answer 33

To prevent/treat inflammatory resorption via antibacterial action.

Question 34

What healing pattern shows calcified tissue between root fragments?

Answer 34

Calcific union (most favorable but rare).

Question 35

What is "fibrous union" in root fractures?

Answer 35

Healing with PDL-like tissue; slight mobility but stable.

Question 36

Why is inflammatory tissue ingrowth the worst healing outcome?

Answer 36

Causes infected resorption, leading to inevitable tooth loss without intervention.

Question 37

What causes pulp necrosis after luxation injuries?

Answer 37

Severance of apical neurovascular supply.

Question 38

What is "pulp space obliteration"?

Answer 38

Calcific metamorphosis of pulp chamber/canal due to trauma.

Question 39

How does revascularization work in immature traumatized teeth?

Answer 39

Stem cells from apex regenerate pulp tissue when infection is controlled.

Question 40

What protects roots from resorption under normal conditions?

Answer 40

Pre-cementum and predentin layers.

Question 41

What two conditions are required for root resorption to occur?

Answer 41

1. Loss of protective layer (pre-cementum/predentin) 2. Inflammation on exposed surface.

Question 42

What is "surface resorption" (repair-related)?

Answer 42

Transient, self-limiting resorption that heals spontaneously.

Question 43

How is inflammatory resorption managed?

Answer 43

Eliminate pulp infection via RCT + long-term Ca(OH)₂/Ledermix.

Question 44

What characterizes replacement resorption (ankylosis)?

Answer 44

Bone fuses to root, causing tooth to resorb and be replaced by bone.

Question 45

Can replacement resorption be reversed?

Answer 45

No; progresses inevitably. Management: decoronation or extraction.

Question 46

What is the #1 early complication of dental trauma?

Answer 46

Inflammatory resorption (infection-related).

Question 47

What late complication leads to "submergence" of the tooth?

Answer 47

Ankylosis (replacement resorption).

Question 48

When is decoronation indicated?

Answer 48

For ankylosed immature teeth to preserve alveolar bone dimensions.

Question 49

What follow-up interval checks pulp vitality post-trauma?

Answer 49

3 weeks, 3 months, 6 months, 1 year, then annually.

Question 50

What radiographic sign indicates pulp necrosis?

Answer 50

Periapical radiolucency or arrested root development.

Question 51

When should RCT be initiated after intrusive luxation?

Answer 51

Immediately for mature teeth; within 7-10 days for immature teeth if no revascularization.

Question 52

What antibiotic is used for avulsed teeth with open apices?

Answer 52

Doxycycline or minocycline (soaked for 5 mins pre-replantation).

Question 53

How is a horizontally fractured root with great mobility managed?

Answer 53

Extract coronal segment; orthodontically extrude apical segment for restoration.

Question 54

What is the key difference between concussion and subluxation?

Answer 54

Subluxation shows increased mobility; concussion has tenderness only.

Question 55

How are concussion/subluxation injuries treated?

Answer 55

Occlusal adjustment ± flexible splinting (1-2 weeks).

Question 56

Why is LDV more reliable than pulse oximetry in trauma?

Answer 56

LDV detects blood flow directly; pulse oximetry fails through restorations/isolated teeth.

Question 57

What CBCT view detects axial root fractures?

Answer 57

Rectal axis (axial plane) for vertical fractures.

Question 58

What is Emdogain's role in trauma management?

Answer 58

Promotes PDL regeneration and prevents ankylosis in avulsion/replantation.

Question 59

What is the prognosis for apical root fractures?

Answer 59

Excellent (asymptomatic, vital fragment, no treatment needed).

Question 60

When is surgical extrusion indicated for crown-root fractures?

Answer 60

Fracture below alveolar crest with sufficient root length (emergency option).