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DG2016 - CK 2 > Trauma > Flashcards

Trauma Flashcards

(186 cards)

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1
Q

What percentage of all schoolchildren experience dental trauma?

A

25%

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2
Q

What is the most common injury to permanent teeth?

A

uncomplicated crown fracture/enamel dentine fracture

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3
Q

What characteristic double the incidence of accidental trauma?

A

overjet >9mm

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4
Q

What history should be taken regarding the injury?

A
  • when, where, how
  • any other symptoms
  • lost teeth/fragments
  • investigate laceration for missing fragment
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5
Q

What medical history should be taken post injury?

A
  • congenital and acquired heart anomalies
  • immunosuppression
  • consult physician
  • vaccination status - tetanus
    these conditions are not contraindications to treatment but appropriate additional abx may need to be given
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6
Q

What extra oral examinations should be undertaken post injury?

A
  • lacerations
  • haematomas
  • haemorrhage
  • subconjunctival haemorrhage
  • bony step deformities
  • mouth opening
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7
Q

What intra oral examinations should be undertaken post injury?

A
  • soft tissue: penetrating wounds, foreign bodies
  • alveolar bone
  • occlusion: traumatic occlusion demands urgent treatment
  • teeth
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8
Q

What 3 things may tooth mobility indicate?

A
  • displacement
  • root fracture
  • bone fracture
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9
Q

What 3 things can transillumination show post injury?

A
  • fracture lines in teeth
  • pulpal degeneration
  • caries
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10
Q

What 3 things can tactile test with probe look for post injury?

A
  • horizontal fractures
  • vertical fractures
  • pulpal involvement
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11
Q

What special investigations can be carried out following injury?

A
  • sensibility tests: thermal & electrical
  • percussion
  • radiographs: additional vertical angle to see root fractures
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12
Q

What 8 things are documented on a trauma stamp/chart?

A
  • mobility
  • displacement
  • TTP
  • colour
  • sinus/tender in sulcus
  • thermal
  • electric (EPT)
  • radiograph
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13
Q

For how long after an injury should sensibility testing be done?

A

5 years
- temp loss of sensibility is a frequent finding during post-traumatic healing, especially post luxations

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14
Q

What are 6 indications of loss of vitality?

A
  • PDL widening
  • arrested root development (though not always)
  • TTP (slightly)
  • slight tenderness in buccal sulcus
  • poor response to sensibility testing
  • discolouration
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15
Q

What are 4 indications that show obvious loss of vitality?

A
  • periapical radiolucency
  • infection
  • pain
  • inflammatory resorption
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16
Q

The prognosis of crown and root fractures can depend on which 5 things?

A
  • age of child: mature/immature tooth
  • type of injury
  • combination of 2 different types of injuries in same tooth will be more detrimental - negative synergistic effect
  • time between injury and treatment
  • presence of infection
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17
Q

What are 4 aims of emergency management treatment?

A
  • try and retain vitality by protecting exposed dentine
  • treat exposed pulp tissue
  • reduction and immobilisation of displaced teeth
  • tetanus prophylaxis if indicated
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18
Q

What are 2 aims of intermediate management treatment?

A
  • +/- pulp treatment
  • restoration: minimally invasive
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19
Q

What are 4 aims of permanent management treatment?

A
  • apexification
  • root filling +/- root extrusion
  • gingival and alveolar collar modification if required
  • coronal restoration
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20
Q

What is the definition of infraction?

A

incomplete enamel fracture without tissue loss

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21
Q

What is the definition of enamel fracture?

A

a fracture confined to the enamel with loss of tooth structure

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22
Q

What is the definition of enamel-dentine fracture?

A

a fracture confined to enamel and dentine with loss of tooth structure, but not involving the pulp

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23
Q

What is the definition of uncomplicated fracture?

A

no pulpal involvement

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24
Q

What investigations should be done for crown fractures?

A
  • PA + soft tissue exam
  • evaluate size of pulp chamber and stage of root development
  • sensibility testing
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25
What material should be used as a liner for fractures within 0.5mm of pulp?
calcium hydroxide
26
What are the 2 treatment options for crown fractures?
- rebond fragment, rehydrate in water or saline for 20 mins prior to rebonding - composite dressing
27
How often should sensibility tests be carried out after trauma?
1 month, 3 months, 6 months, 1 year then yearly for 5 years
28
What clinical test should be carried out after trauma to monitor tooth?
trauma stamp
29
What should be examined on radiographs in order to monitor tooth after trauma?
- root development - width of canal and length - comparison with other side - internal and external inflammatory resorption
30
What is the pulp survival rate for open and closed concussion?
open - 95% closed - 85%
31
What is the pulp survival rate for open and closed subluxation?
open - 80% closed - 50%
32
What is the pulp survival rate for open and closed extrusion?
open - 60% closed - 20%
33
What is the pulp survival rate for open and closed lateral luxation?
open - 65% closed - 15%
34
What is the pulp survival rate for open and closed intrusion?
open - 0% closed - 0%
35
What is the definition of enamel-dentine-pulp fracture?
a fracture involving enamel and dentine with loss of tooth structure and exposure of the pulp
36
What is the definition of a complicated fracture?
involving the pulp
37
How should a enamel-dentine-pulp fracture be assessed?
- PA - evaluate like uncomplicated crown fracture
38
What factors does treatment depend upon for a enamel-dentine-pulp fracture?
- size of exposure - time since exposure prognosis depends on: associated luxation injuries
39
What is the treatment for a tiny exposure and within 24 hours of trauma for enamel-dentine-pulp fracture?
- direct pulp cap with calcium hydroxide - hermetic seal (composite)
40
What is the treatment for a large exposure or more than 24 hours since trauma for enamel-dentine-pulp fracture?
- pulpotomy - partial (Cvek) or full coronal: with Biodentine, white MTA - hermetic seal (composite)
41
What is the treatment for a large exposure with no vital tissue remaining in the coronal portion after enamel-dentine-pulp fracture?
- pulpectomy (open apex) - calcium hydroxide, then MTA/biodentine to produce apical stop and then obturate - pulpectomy and conventional root treatment in closed apex tooth
42
Which treatment is being described? - LA and rubber dam - pulp tissue (2-3mm) excised with diamond bur - normal bleeding stops with moist cotton wool - rinse gently with sterile saline - apply biodentine/calcium hydroxide dressing to pulp - hermetic seal with composite
partial pulpotomy
43
Which treatment is being described? - after doing a partial pulpotomy, if no bleeding/uncontrollable bleeding proceed to this treatment - excised all pulp in chamber with excavator/round bur - normal bleeding stops with moist cotton roll - rinse gently with sterile saline - apply biodentine/calcium hydroxide dressing to pulp - hermetic seal with composite - rebonding a fragment can still be done after rehydration and after the pulp has been treated
full coronal pulpotomy
44
What is the success rate of a partial pulpotomy?
97%
45
What is the success rate of a full coronal pulpotomy?
75%
46
What are 6 advantages of MTA?
- sets in a wet environment - good sealing properties - easy to visualise radiographically - not soluble - doesn't interact with other materials - some antibacterial properties
47
Which 2 radiographs can be taken to investigate root fractures?
- PA - upper standard occlusal from at least 2 angles
48
What is the treatment for an undisplaced, not mobile root fracture?
soft diet and monitor vitality
49
What is the treatment for a displaced and mobile root fracture?
- reposition - splint
50
How long should a tooth be splinted following a root fracture in the apical/middle third?
flexible splint for 4 weeks
51
How long should a tooth be splinted following a root fracture in the coronal third?
flexible splint for 4 months
52
Which type of root fractures require longer splinting for stability and take longer to heal?
coronal third fracture
53
What are 3 potential outcomes for a healing root fracture injury?
- calcified tissue union across fracture line - connective tissue - calcified and connective tissue
54
What is a potential outcome for a non-healing root fracture injury?
- granulation tissue (usually associated with loss of vitality)
55
What is the splinting time for a subluxation?
passive-flexible 2 weeks
56
What is the splinting time for an extrusion?
passive-flexible 2 weeks
57
What is the splinting time for a luxation?
passive-flexible 4 weeks
58
What is the splinting time for an avulsion?
passive-flexible 2 weeks
59
What is the splinting time for an apical/middle third root fracture?
passive-flexible 4 weeks
60
What is the splinting time for a coronal third fracture?
passive-flexible 4 months
61
What is the splinting time for a dento-alveolar fracture?
passive-flexible 4 weeks
62
What size wire should be used for splinting?
<0.4mm, labial placement
63
What is the definition of crown-root fractures not involving the pulp?
fracture involving enamel, dentine and cementum with loss of tooth structure, but not exposing the pulp
64
What is the definition of crown root fracture involving the pulp?
a fracture involving enamel, dentine and cementum with loss of tooth structure and exposure of the pulp
65
What are the treatment options for crown root fractures?
- extract coronal portion: 1.root-fill, extrude root and restore, 2.root fill if possible then cover root with mucoperiostial flap and retain, this maintains height and width of alveolus - extract whole tooth and restore space
66
What are 5 requirements for extrusion?
- good OH, low caries rate - sufficient adjacent teeth - eventual position - crown/root ratio not <50:50 - will 4-6mm of rapid extrusion over 4-6 weeks bring the fractured surface coronal to the biological width? - some gingiva and bone removal often required after extrusion
67
What is the most common primary teeth trauma?
luxation
68
What is the peak incidence age of primary traumas?
2-4 years
69
What percentage of injury in the primary dentition are enamel cracks, enamel dentine fractures and enamel dentine pulp fractures?
7-13%
70
What percentage of injury in the primary dentition are crown root fractures?
2%
71
What percentage of injury in the primary dentition are root fractures?
2-4%
72
What percentage of injury in the primary dentition are luxations?
62-69%
73
What percentage of injury in the primary dentition are avulsions?
7-13%
74
What percentage of risk is there of risk of damage to the permanent tooth?
50%
75
A duller note with percussing tooth may indicate what?
root fracture
76
What type of radiographs can be used to assess post injury?
- intra oral - anterior occlusal - lateral pre-maxilla - OPG - soft tissue radiograph - CBCT
77
What information does a trauma stamp/chart document?
- mobility - displacement - occlusion - colour - sinus/tender in sulcus - radiograph - TTP - vitality
78
What are the 9 classifications of dental trauma?
- enamel fracture: uncomplicated - enamel-dentine fracture: uncomplicated - enamel-dentine-pup fracture: complicated - crown-root (pulp involved) - root fracture - alveolar fracture - concussion/subluxation - luxation: lateral, intrusive, extrusive - avulsion
79
What advice should be given to all post injuries?
- soft diet for 10-14 days - brush teeth with soft toothbrush after every meal - topical chlorhexidine by parent 2x daily for one week - after initial treatment, review after a week and then 1, 3, 6 monthly taking radiographs if possible 6 monthly - intrusion requires review 1 week then with diagnosis 4 week, 2 month, 6 month, 1 year - radiograph initially then 6 monthly
80
After treatment, how often should patients attend for review of tooth?
- 1 week after treatment - 1 monthly - 3 monthly - 6 monthly
81
Intrusion injuries require how many reviews?
- 1 week after treatment - 4 weeks with X-rays - 2 monthly - 6 monthly - 1 year
82
How often should radiographs be taken to assess tooth post injury?
6 monthly
83
What are the treatment guidelines for enamel fractures and enamel-dentine fractures?
- smooth sharp edges - restore compomer/composite
84
What are the treatment options for enamel-dentine-pulp fractures?
- RCT - extract
85
What are the treatment options for crown-root fractures and root fractures?
- extract coronal fragment - fragments that aren't obvious, should be left to resorb physiologically
86
What are the treatment guidelines for alveolar fractures?
- reposition segment, splint to adjacent teeth 3-4 weeks - teeth may need to be extracted after alveolar stability has been achieved
87
What is the treatment guideline for a concussion/subluxation?
observation
88
At what age does 65% pulp necrosis and 84% premature tooth loss occur as a complication post concussion/subluxation?
aged 4+
89
What are the treatment decisions based upon following a lateral luxation?
- degree of displacement - mobility - occlusal interference
90
What percentage of cases following lateral luxation realign spontaneously within 1 year?
95%
91
What is being assessed when taking a radiograph following lateral luxation?
increased periodontal ligament space apically
92
What is the treatment guidelines for no occlusal interference following lateral luxation?
allow to position spontaneously
93
What is the treatment guidelines for an occlusal interference following lateral luxation?
extract
94
What is an indication as to no collision with the permanent tooth bud following a lateral luxation?
- tooth would appear shorter on radiograph - crown would be pushed palatally, root would be pushed buccally therefore avoid permanent tooth
95
What is an indication as to a collision with the permanent tooth bud following a lateral luxation?
- tooth would appear longer on radiograph - crown would be pushed buccally, root would be pushed palatally therefore colliding with permanent tooth
96
What are the treatment guidelines for an intrusion?
- allow spontaneous eruption - follow up: 1 week then radiographs 4 weeks, 2 months, 6 months, 1 year
97
When assessing radiographic findings post intrusive luxation, what would the following indicate? - when the apex is displaced toward or through the labial bone plate the apical tip can be visualised and tooth appears shorter than the unaffected contralateral tooth
no collision with permanent tooth bud
98
When assessing radiographic findings post intrusive luxation, what would the following indicate? - when the apex is displaced toward the permanent tooth germ, the apical tip cannot be visualised and the tooth appears longer
collision with permanent tooth
99
Which injury is the most likely to cause injury to the permanent successor?
intrusion
100
What are the treatment guidelines for extrusion?
- significant: extract - mild can be left
101
What are the treatment guidelines for avulsion of a primary tooth?
- radiograph to confirm - do not replant - risk of: aspiration, damage to permanent tooth
102
What are 3 long term effects of injured primary tooth?
- discolouration - infection - delayed exfoliation
103
What are 3 long term effects of injured permanent successors?
- enamel defects 44% - abnormal tooth/root morphology 8% - delayed eruption 1%
104
What age range is most likely to have trauma to the permanent successor following injury?
under 4
105
What may reddish colour immediately following injury indicate?
haemosiderin in tubules may regress/remain and maintain vitality
106
What may brown/black colour in the following weeks after injury indicate?
pulp breakdown products in tubules non-vital
107
What may yellow/opaque colour in the following months after injury indicate?
pulp calcification
108
What is the treatment for primary dentition for non vital tooth with sinus of periapical pathology?
RCT or extract
109
What is the treatment for primary dentition for non vital tooth without sinus or periapical pathology?
leave and review
110
If following injury, primary tooth does not resorb normally, XLA must be done to avoid what?
permanent successor erupting ectopically
111
A potential long term defect to a permanent successor following injury could be hypo mineralisation. How would this present?
white/yellow spot, normal thickness of enamel
112
A potential long term defect to a permanent successor following injury could be hypomineralsation and hypoplasia. How would this present?
yellow/brown with missing enamel
113
What is the treatment for crown dilacerations?
surgical exposure, ortho realignment, improve appearance
114
What is the treatment for root dilaceration/angulation/duplication?
combined surgical and ortho
115
What is the treatment for arrest of root development?
RCT/XLA
116
What is the treatment for odontome?
surgical removal
117
What is the treatment for undeveloped tooth germ?
may sequestrate spontaneously or require removal
118
Premature loss of a primary tooth can result in delayed eruption of 1 year due to what?
thickened mucosa - take X-ray is greater than 6 month delay compared to contralateral tooth - surgical exposure and ortho may be required if abnormal morphology
119
Which type of PDL injury is the following? - injury to the tooth supporting structures without increased mobility or displacement of the tooth, but with pain to percussion
concussion
120
Which type of PDL injury is the following? - injury to the tooth supporting structures resulting in increased mobility, but without displacement of the tooth, bleeding from the gingival sulcus confirms the diagnosis
subluxation
121
What is the treatment for a subluxation?
- occlusal relief - flexible splint 2 weeks
122
Which clinical testing should be carried out for concussion, subluxation, extrusion and lateral luxation injuries?
trauma stamp
123
What sensibility testing should be carried out for concussion, subluxation, extrusion and lateral luxation injuries and at what intervals?
- thermal and electrical - at time of injury - 1 month, 3 months, 6 months, 1 year then annually for 5 years
124
What should be assessed on radiographs following concussion, subluxation, extrusion and lateral luxation injuries?
- root development - width of canal and length - comparison with other side - internal and external inflammatory resorption
125
Which type of PDL injury is the following? - partial displacement of the tooth out of its socket
extrusion
126
Which type of PDL injury is the following? - displacement of the tooth other than axially. Displacement is accompanied by fracture of either the labial or the palatal/lingual alveolar bone
lateral luxation
127
What is the treatment for a lateral luxation?
- reposition under LA - flexible splint 4 weeks
128
What is the treatment for an extrusion?
flexible splint 2 weeks
129
What is the 5 year pulp survival percentage for an open and closed apex post concussion?
open - 100% closed - 96%
130
What is the 5 year pulp survival percentage for an open and closed apex post subluxation?
open - 100% closed - 85%
131
What is the 5 year pulp survival percentage for an open and closed apex post extrusion?
open - 95% closed - 45%
132
What is the 5 year pulp survival percentage for an open and closed apex post lateral luxation?
open - 95% closed - 25%
133
What is the 5 year pulp survival percentage for an open and closed apex post intrusion?
open - 40% closed - 0%
134
What is the 5 year pulp survival percentage for an open and closed apex post avulsion/replantation?
open - 30% closed - 0%
135
What is the management of intrusion injuries with open apex?
- allow re-eruption without intervention - if no re-eruption within 4 weeks, start orthodontic repositioning - monitor to see if root canal needed
136
What is the management of intrusion injuries with closed apex?
- depending on the degree of intrusion: - <3mm: allow re-eruption without intervention, if no re-eruption within 4 weeks, reposition surgically and splint for 2 weeks or reposition orthodontically - 3-7mm: reposition surgically or orthodontically - >7mm: surgically reposition, flexible splint 4 weeks
137
What is the 5 year resorption percentage rate for open and closed apex post concussion?
open - 1% closed - 3%
138
What is the 5 year resorption percentage rate for open and closed apex post subluxation?
open - 1% closed - 3%
139
What is the 5 year resorption percentage rate for open and closed apex post extrusion?
open - 5% closed - 7%
140
What is the 5 year resorption percentage rate for open and closed apex post lateral luxation?
open - 3% closed - 38%
141
What is the 5 year resorption percentage rate for open and closed apex post intrusion?
open - 67% closed - 100%
142
What is the 5 year resorption percentage rate for open and closed apex post avulsion/replantation?
frequent
143
What sensibility tests should be done for an intrusion injury and at what intervals?
- thermal and electrical - at time of injury, 1 month, 3 months, 6 months for an average of 2 years
144
Which traumatic injury is the following? - the tooth is completely displaced out of its socket. Clinically the socket is found empty or filled with a coagulum
avulsion
145
What is the treatment for a avulsion injury with an open apex?
replant and splint for 2 weeks - root canal treatment should be avoided unless there is evidence of pulp necrosis
146
What is the treatment for an avulsion injury with a closed apex?
replant and splint for 2 weeks - initiate root canal treatment within 2 weeks
147
What first aid advice should be given for avulsion injuries?
- hold by crown - rinse root in milk/saline/saliva (max 10 secs) to wash off any foreign debris - either: replant into socket; patients bites on gauze and goes to dentist OR place into storage medium and go to dentist - do not let the tooth get dry
148
What are 4 storage mediums for an avulsion in order of preference?
- milk - patient saliva - normal saline - HBSS
149
Best outcomes are achieved if replantation is done within within time frame?
15 mins
150
Extra-alveolar dry time post avulsion of over 5 mins leads to what?
significant root damage
151
Extra-alveolar dry time post avulsion of 30 mins leads to what?
most PDL cells are non-viable
152
Extra-alveolar dry time post avulsion of over 1 hour leads to what?
no vital PDL cells remain
153
What is the critical extra-alveolar time (how long out the mouth even if tooth has been in storage medium)?
6 hours max
154
What are 3 critical factors for replantation success?
- extra alveolar dry time - extra alveolar time - type of storage medium
155
Which class is the following for an avulsed tooth? - PDL cells most likely viable. Tooth has been replanted immediately or less than 15 mins
1
156
What class is the following for an avulsed tooth? - PDL cells may be viable but compromised. Tooth has been in a storage medium and total EADT less than 60 mins
2
157
Which class is the following for an avulsed tooth? - PDL cells likely non-viable. Total EADT more than 60 mins regardless of having been in a medium or not
3
158
What is the treatment for a replantation with a closed apex where the tooth has been replanted immediately or within 15 mins?
- clean with saline, water or chlorhex - verify correct position clinically and radiographically - leave tooth (if slightly malpositioned, correct with digital pressure) - give LA (no evidence to support no vasoconstrictor) - if in wrong socket or rotated then correct within 48 hours - passive and flexible splint, labial surface for 2 weeks - if associated alveolar fracture - 4 weeks splinting - initiate RCT within 2 weeks - give systemic abx/check tetanus status
159
If there is an associated alveolar fracture post avulsion injury, what is the splinting time?
4 weeks
160
RCT should be initiated within which time frame of a closed apex avulsion injury?
within 2 weeks
161
What is the ideal flexible splint size?
< 0.4mm
162
What is the treatment for a replantation with a closed apex where the tooth has been in a storage medium and EADT <60 mins OR EADT > 60 mins?
- rinse visible contamination on root surface with stream of saline - remove debris by agitating in a storage medium or saline soaked gauze - leave tooth in storage medium whilst getting history - give LA - irrigate socket with saline - examine socket, remove coagulum with stream of saline, if fracture then reposition with suitable instrument - reposition with slight digital pressure, verify position clinically and rad - passive and flexible splint - 2 weeks - if associated alveolar fracture - 4 weeks splinting - initiate RCT within 2 weeks - give systemic abx and check tetanus status
163
What is the treatment for a replantation with an open apex where the tooth has been replanted immediately or within 15 mins?
- clean injured area - verify position clinically and rads - leave tooth (if slightly malpositioned, correct with digital pressure) - give LA - if in wrong socket then correct within 48 hours - passive and flexible splint for 2 weeks - if associated alveolar fracture, splint for 4 weeks - if no revascularisation occurs then start RCT soon as pulp necrosis/infection identified - give system abx and check tetanus status
164
What is the treatment for a replantation with a open apex where the tooth has been in a storage medium and EADT <60 mins OR EADT > 60 mins?
- rinse visible debris on root surface with stream of saline or agitating in a storage medium - leave tooth in storage medium whilst getting history - give LA - irrigate socket with saline - examine socket, remove coagulum with stream of saline, if a fracture then reposition with suitable instrument - reposition with slight digital pressure, verify position clinically and rads - passive and flexible splint for 2 weeks - if associated alveolar fracture, 4 weeks splint - if no revascularisation occurs then start RCT as soon as necrosis/infection identified - give systemic abx/check tetanus status
165
What are 3 benefits of replantation?
- restore aesthetics, function whilst maintaining alveolar contour, width and height - keep future treatment options open - decision to replant is always the correct one, even if extra oral time is over 60 mins
166
Which abx would be given for an avulsion injury?
penicillin
167
Which abx would be given for an avulsion injury if penicillin allergy or under 12 years of age?
doxycycline
168
What treatment would be done for a closed apex post avulsion injury and RCT is indicated?
- calcium hydroxide within 2 weeks of replantation, left for 1 month then RCT OR - corticosteroid or corticosteroid/Ab placed immediately after replantation and left for 6 weeks then RCT
169
What treatment would be done for an open apex post avulsion injury and RCT is indicated?
- RCT if pulp necrosis and infection seen at follow up - specification procedure - MTA/biodentine apical plug then backfill with GP - regenerative endodontics - keeping calcium hydroxide in canal if progressive resorption
170
If there is pulp necrosis/infection following avulsion in an open apex, then which process will be rapid in children?
infection related resorption
171
What is the review cycle for patients with an open apex post avulsion injury?
- 1 month, 2 month, 3 month, 6 months, 1 year then annually for 5 years
172
Which type of injury is the following? - a fracture of the alveolar process, may or may not involve the alveolar socket
dentoalveolar fracture
173
What is the treatment for a dentoalveolar fracture?
- reposition under LA - apical lock may be present - flexible splint for 4 weeks - abx
174
Which type of resorption is the following? - damage to PDL which subsequently heals - non-progressive
external surface resorption
175
Which type of resorption is the following? - damage to PDL initially, maintained and propagated by necrotic pulp tissue via dentinal tubules - progressive - root surfaces indistinct, tramlines of root canal intact
external infection related resorption
176
What is the treatment for an external infection related resorption?
- pulp extirpation - mechanical and chemical irrigation, calcium hydroxide - change calcium hydroxide every 3 months to try and halt resorption - obturate when bone repair is visible radiographically - if progressive resorption then change calcium hydroxide every 6 months and plan ahead for prosthetic replacement
177
Which type of resorption is the following? - initiated by non-vital pulp - progressive - tramlines of root canal indistinct - root surfaces intact
internal infection related resorption
178
Which type of resorption is the following? - initiated by severe damage to the PDL and cementum, normal repair does not occur, bone fused directly to dentine - progressive, tooth gradually resorbed as it is now part of bone remodelling - diagnosis: loss of PDL and lamina dura - treatment: nil
ankylosis related resorption
179
Which post injury complication is the following? - commoner in open apex teeth with severe luxation - common also in root fracture teeth - indicates some vital pulp in canal - progressive hard tissue formation within pulp cavity - gradual narrowing of pulp chamber and pulp canal - total or partial obliteration - treatment: conservative
pulp canal obliteration
180
What damage may occur to permanent successor after an intrusion injury to a primary tooth during apposition?
hypoplasia
181
What damage may occur to permanent successor after an intrusion injury to a primary tooth during calcification?
hypocalcification
182
What damage may occur to permanent successor after an intrusion injury to a primary tooth during root formation?
dilaceration
183
What percentage is the risk of damage to permanent successor following trauma to primary teeth?
50%
184
What is the initial patient management following a trauma to primary teeth?
- reassure - history - examination - photographs - diagnosis - emergency treatment - advise parent of 50% risk to permanent successor damage - further treatment and review
185
What extra-oral examination should be undertaken for a primary trauma?
- laceration - haematoma - haemorrhage/CSF - subconjuctival haemorrhage - bony step deformities - mouth opening
186
What intra-oral examination should be undertaken for a primary trauma?
- soft tissue - alveolar bone - occlusion - teeth

DG2016 - CK 2 (10 decks)

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