Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CCD2 > Trauma > Flashcards

Trauma Flashcards

(65 cards)

Start Studying
1
Q

What are some injuries to the hard tissues and pulp?

A
  • Infraction
  • Enamel
  • Enamel-dentine
  • Enamel-dentine-pulp
  • Root
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is infraction?

A

An incomplete fracture (crack) of the enamel without loss of tooth substance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is an enamel fracture?

A

A fracture with loss of tooth substance confined to the enamel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is an enamel-dentine fracture and what is it also called?

A

A fracture with loss of tooth substance confined to enamel and dentine but not involving the pulp.
Also called an uncomplicated crown fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is an enamel-dentine-pulp fracture?

A

A fracture involving enamel and dentine and exposing the pulp.
AKA as a complicated crown fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a crown root fracture?

A

A fracture involving enamel, dentine and cementum
The pulp may or may not be involved
No pulp involvement - uncomplicated crown root fracture
Pulp exposed - complicated crown root fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a root fracture?

A

A fracture involving dentine, cementum and the pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can root fractures be further classified?

A

Location - horizontal/vertical
Displacement of the coronal fragment - displaced or non-displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some injuries to the periodontal tissues?

A

Concussion
Subluxation
Extrusion
Lateral luxation
Avulsion
Intrusion
Alveolar fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is concussion?

A

An injury to the tooth supporting structures without abnormal loosening or displacement of the tooth, but with marked reaction to percussion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is subluxation?

A

An injury to the tooth supporting structures with abnormal loosening, but without displacement of the tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is extrusive luxation?

A

Displacement of the tooth into the alveolar bone. This injury is accompanied by comminution or fracture of the alveolar socket.
As the apex has been pushed into the socket the neurovascular bundle has been crushed and the PDL cells have also been crushed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is avulsion?

A

Complete displacement of the tooth out of its socket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What clinical special investigations can you use in trauma?

A

Mobility - grade I/II/III
Transillumination - curing light from palatal aspect to see infraction lines
Percussion - is the tooth tender on percussion (TTP?)
What does it sound like when percussed? - normal/high
Colour - Normal? Blue/grey? Pinkish?
Sensibility tests - only in traumatised permanent teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What radiographs do you take at the initial trauma visit?

A

PA + USO
2 x PA
OPT only if possible bony fractures
Assess root development stage
Assess presence/absence of root fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why don’t we do sensibility tests on deciduous teeth?

A

Unreliable because the child may be anxious or in pain and there are poorly myelinated nerve fibres in an immature tooth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the root development stages?

A

1 = <2/3
2 = >2/3
3 = complete (apex open)
4 = complete (apex closed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What factors do you take into account for prognosis of a traumatised tooth?

A

Root development stage
Combination injuries
Previous TDI
Severity of injury (response to sensibility test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some of the responses of the PDL to injury?

A

Surface resorption
Infection related (inflammatory) resorption
Replacement resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the main prognostic factors of PDL resorption?

A

Maturity of tooth (open apex and closed apex)
Type of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is surface resorption?

A

Physiological and can be pathological
Arrests quickly as stimulus is removed so is not transient and can see post orthodontic treatment
May see in relation to very minor trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What happens in crushing injuries?

A

Normal circumstances are Bone-PDL-Cementum
Fibroblasts stop osteoblasts from coming into the tooth
Cementoblasts help maintain integrity of the PDL

In injury destruction of PDL and fibroblasts and cementoblasts
These cells will mediate regeneration of the PDL
(most vulnerable to crushing injuries = intrusion in comparison to extrusion - tearing injury with intact cells around)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is replacement resorption?

A

Death of PDL so bone is in direct contact with the tooth and you get ankylosis (osteoclasts being able to get to tooth) and tooth is involved in the remodelling process and tooth is resorbed and replaced by bone. = ankylosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you identify ankylosis?

A

No mobility - no PDL
Ankylotic sound (cracked teacup)
Infraocclusion - tooth stuck and left behind, alveolar bone grows around it and carries the teeth around it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is inflammatory related resorption?
Toxins diffuse through dentinal tubules which compromises the PDL causing inflammatory resorption of bone and PDL around the tooth. Associated radiolucency Not progressive if RCT eliminates source of infection
26
What are factors affecting periodontal healing?
Type of injury - crushing of PDL is worst Maturity - blood supply to periodontal ligament
27
What are factors affecting pulpal healing?
Type of injury - worst crushing (of apical foramen) Maturity - blood supply to pulp Concomitant fracture - fracture as well as a luxation injury etc
28
What are the differences between replacement and inflammatory resorption?
Replacement - death of PDL, no radiolucency and progressive Inflammatory - death of pulp, radiolucency and able to arrest
29
What is the most common primary tooth injury?
Luxation - displacement and damage to PDL
30
What are aims of treatment when treating trauma?
Prevent further damage to permanent successor, treat pain, restore function and aesthetics.
31
What does treatment depend on?
Behaviour, parental choice, MH, type of injury
32
Does the early loss of a primary incisor have an effect on speech or occlusion?
No
33
How do you manage subluxation/concussion?
Soft diet, analgesics, monitor
34
How do you manage lateral luxations in primary teeth?
Leave if they are stable, no interference with occlusion and can undergo spontaneous repositioning. Or extract is significantly extruded/interfere with occlusion
35
How do you manage extrusions in primary teeth?
Usually interfere with occlusion and become non-vital so extract
36
How do you manage intrusions in primary teeth?
Lateral radiograph - see relationship of primary tooth to permanent successor Leave unless: Clear interference with permanent successor Infection Failure to re-erupt (within 3-6 months)
37
How do you manage avulsion in primary teeth?
DO NOT reimplant
38
How do you manage an uncomplicated crown fracture in primary teeth?
Leave, smooth, composite
39
How do you manage a complicated root fracture?
Extraction Pulpotomy Pulpectomy
40
How do you manage a root fracture in a primary tooth?
If stable - leave and monitor If unstable - extract coronal segment and leave apical segment
41
How do we extract injured primary teeth?
LA, sedation, GA
42
What is the sequelae of dental trauma?
Discolouration, loss of vitality and damage to permanent successor
43
What does a grey colour of tooth usually mean?
Probably haemorrhage of tooth, usually happens quickly with subsequent gradual resolution, not a sign of loss of vitality.
44
What are signs of loss of vitality in primary teeth?
Chronic abscess, periapical pathology, other signs - pain, mobility, discolouration
45
What are some signs of damage to permanent successor?
White or brown discolouration with/without hypoplasia Dilaceration of crown Dilaceration of root Odontome like formation Root duplication Partial or total failure of root development Failure of tooth development
46
What is a dilaceration?
Displacement of formed hard tissue in relation to developing root, abrupt change in direction of root. Results in delayed or non eruption
47
What are treatment options for uncomplicated fractures?
Composite crown or reattach fragment
48
What are general considerations for complicated enamel dentine fractures?
Time since fracture occurred Degree of contamination Degree of damage Other injury (luxation) Stage of root development
49
Treatment options for immature teeth with complicated fractures?
Pulp capping - small exposure that was recent and kept clean Partial pulpotomy Pulpectomy
50
What is the technique for a Cvek pulpotomy?
LA and isolation Remove 2mm pulpal tissue Haemostasis Apply non setting CaOH Apply hard setting lining Restore
51
What do you do for complicated fractures in terms of the tooth's apex?
Closed - pulpectomy Open - apexification
52
What is apexification?
Method of inducing apical closure through the formation of mineralised tissue in the apical pulp region of a non vital tooth with an open apex.
53
What are some problems with apexification?
No increase in root dimensions Final root filling is difficult Root is predisposed to fracture
54
How do we do apexification?
When the apex is open and pulp necrotic Establish working length (1-2mm short of the apex) Chemo mechanical preparation Clean walls gently with large files Sodium hypochlorite Dress with CaOH Reassess and redress 3 monthly Obturate definitively when hard apical barrier formed (usually 9-12 months)
55
What is the prognosis of apexification?
75-96% forms a hard tissue apical barrier High risk of cervical root fracture Apex open <2/3 of root complete - 75% Apex open >1mm root length complete 25%
56
What are potential problems with crown root fractures?
Isolation for endodontics, impressions, crowns
57
Crown root fracture treatment options
Supragingival restoration Surgical exposure of fracture site Surgical extrusion Orthodontic extrusion REFER these cases
58
Treatment options for root fractures
Undisplaced/stable fracture - no splint Displaced/unstable fracture - flexible splint - 4 weeks
59
How do we diagnose root fractures?
Clinically - mobility increased, extrusion/lateral luxation of crown Radiographic - radiographs from two angles in vertical plane eg parallelling technique and anterior occlusal
60
Why reposition teeth?
Occlusion - protect from occlusal interference Aesthetics Patient comfort
61
How do we reposition?
LA Manual and gentle Or manipulate position by biting
62
How do we splint?
Give LA Choose light orthodontic wire and cut to correct length - should extend from midline of teeth adjacent to luxated tooth Bend wire so it sits passively on teeth Cement to support teeth Place composite on luxated tooth Reposition Cement into position
63
Treatment of extrusion and lateral luxation
Reposition tooth Physiological splint for 3-4 weeks Antibiotics, chlorhexidine
64
What time and extra oral medium guarantees unfavourable healing in avulsion?
Extra alveolar time - 60 mins Extra alveolar medium - 60 mins Extra alveolar dry time - 30 minutes
65
What are disadvantages of reimplanting after avulsion?
Infraocclusion Gingival contour Multiple visits Tooth will be lost

CCD2 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions