Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pedo 1 > Trauma > Flashcards

Trauma Flashcards

1
Q

What is always the first thing you do when a pt comes in with physical trauma?

A

History and examination

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

True or false.. all injuries should be treated immediately

A

False.

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

What are seven things you should inquire when obtaining the history of the injury?

A

Date and time of injury

Where and how injury occurred

Date of last tetanus inoculation

Other medical history, allergies, medicine being taken

The pt should be assessed for nausea, vomiting, etch.

Complete dental hx can help the dentist learn of previous injuries to teeth

The pts complains and experiences after injury, pain to thermal changes, pain to closing mouth, etc. can be helpful

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

A force strong enough to fracture, intrude, or avulse a tooth is also strong enough to…

A

Result in cervical spine or intracranial injury.

The pt should be assessed for nasuea, vomiting, drowsiness, or possible cerebral sinus fluid leaking from ears or nose (skull fracture)

Complete dental history can help dentist learn of previous injuries to teeth

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

True or false… repeated injuries to the teeth are uncommon in children

A

False. They are not uncommon

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

As part of the extraoral exam, you should check and describe observed injuries. Name 8 things you may find.

A

Facial fractures

Lacerations

Contusions

Swelling

Abrasions

Hemorrhage/drainage

Foreign bodies - asphalt on face and teeth

TMJ deviation/asymmetry

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

The clinical intraoral exam should be conducted after…

A

The teeth in the area of injury have been cleaned of debris

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

A traumatized tooth may be in a state of shock and as a result may…

A

Fail to respond to the accepted methods of testing pulp vitality

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

What should you include in your radiographic examination of a traumatic injury?

A

Traumatized tooth, surrounding teeth, and sometimes of opposing arch

Look for root fracture and pulp expsoure, size of pulp chamber, open or closed apex.

If fractured tooth fragmement is missing, check soft tissues

If mandible was hit, TMJ deviation, or bruising in FOM, take panorex to check for jaw or TMJ fracture

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

Another value of radiographs is that it provides a record of the tooth immediately after injury. Frequent, periodic radiographs reveal…

A

Evidence of continued pulp vitality or adverse changes that take place within the pulp or the supporting structures

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

True or false… if the fracture goes below the crest of the bone its hopeless

A

True

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

If a tooth is intruded, what is the treatment?

A

Extraction. Don’t want to risk hitting the permanent tooth because it can damage it.

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

What is the most common type of crown fracture?

A

Class 2

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

Describe the 5 classes of crown fractures.

A

Class 1 - simple fracture of the crown involving little or no dentin

Class 2 - extensive fracture of the crown involving considerable dentin but not the dental pulp

Class 3 - extensive fracture of the crown with an exposure of the dental pulp

Class 4 - loss of the entire crown

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

What is a class5, 6, 7, 8, 9 fracture?

A

5 - total loss of tooth (avulsion)

6 - fracture of the root with or without loss of crown structure

7 - displacement of tooth with neither crown or root fracture

8 - fracture of crown en masse and its displacement

9 - traumatic injuries of primary teeth

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

What are you going to do and in what order for traumatic injuries?

A

Soft tissue management

Pulp therapy

Repositioning

Stabilization

Restoration

Extraction

Medication/prescription

Referral

Record all treatment and rationale

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

What is typically the first thing you do to treat emergency injuries?

A

Treat soft tissue first

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

Since injuries are considered dirty wounds, always check what?

A

Check that tetanus inoculation is current. Check with child’s physician if uncertain

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

True or false… you should always suture a torn labial frenum.

A

False.. sometimes do sometimes dont

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

What is a complication that can happen when the lower lip is lacerated and then closed with sutures?

A

Mucoceles may form

Sometimes its better to leave it alone so a mucocele isn’t created. You dont want to suture any glands closed

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

What is the treatment of a class 1 fracture (no dentin)?

A

May only need smoothing off or bonded resin, however, without exception a thorough examination should be completed, sometimes hidden problems

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

True or false… it is always advisable to restore a class 2 fractured tooth with a crown on the first visit

A

False. Best not to manipulate tooth anymore then necessary.

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

What is typically the best immediate treatment for a class 2 fractured tooth?

A

A temporary cover of dentin can be accomplished easily without too much additional trauma to tooth. This is often the treatment of choice.

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

True or false… the temporary resin can be left on when final restoration is finished

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the most common fracture in permanent teeth?

A

Class 2 fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

In a significant class 2 fracture, what do you cover exposed dentin with?

A

Ca(OH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When you have to extract a primary tooth due to injury, what do else do you do?

A

Use a pedo partial to replace lost teeth.

Reassure parents that you are trying to save the permanent tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the reactions of the tooth to trauma?

A

Pulp hyperemia

Internal hemorrhage

Tooth color alteration

Calcific metamorphosis of dental pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is pulpal hyperemia?

A

Difficult to determine the initial pulpal response and in predicting the long-range reaction of the pulp, congestion of blood in the pulp chamber can often be seen in exam, color often appears reddish.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is an internal hemorrhage?

A

Hyperemia and increased pressure causes the rupture of capillaries and the escape of RBCs with subsequent breakdown and pigment formation in the tubules. Color change is evident in 1-3 after injury. Color change may lighten. Rarely goes back to white.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does a dark-grey discoloration of a tooth mean? What about light grey-yellow?

A

Dark grey discoloration - nonvital pulp and possibly necrotic

Light grey-yellow - vital pulp with canal obliterated

32
Q

What is calcific metamorphosis of pulp?

A

Crowns that have undergone this reaction may have a yellowing, opaque color. primary teeth that have turned yellow will usually undergo normal root resorption. Permanent teeth will often be retained indefinitely but in later years may become infected because of obliterated root

33
Q

In what case will internal hemorrhaging not cause color change?

A

If the blood is reabsorbed before gaining access to dentinal tubules

34
Q

What happens in more severe cases of internal hmorrhaging? Is it reversible?

A

Pigment formation in dentinal tubules. Color change is evident within 2-3 weeks after injury. Some of the change is reversible but some color will remain.

35
Q

Does the pulp remain vital in internal hemorrhaing?

A

Pulp may remain vital, but if color change remains dark-grey likelyhood of vitality is low

36
Q

A frequently observed reaction to trauma is the partial or complete obliteration of the pulp chamber and canal. This is called ___

A

Calcific metamorphosis of dental pulp

37
Q

Teeth that have undergone calcific metamorphosis may have what color?

A

Yellowish-opaque color

38
Q

True or false… primary teeth with calcific metamorphosis usually will have normal root resorption

A

True

39
Q

True or false.. permanent teeth that have undergone calcific metamorphosis will usually be retained indefinitely.

A

True. They must be followed because they are a potential focus of infection. Especially if root canal is totally obliterated.

40
Q

True or false.. teeth that have undergone calcific metamorphosis are less likely to experience infection

A

False. More likely

41
Q

If trauma caused the primary tooth to be shoved in front of the permanent teeth, and the lateral radiograph shows broken alveolar buccal plate of bone. What should you do?

A

Don’t splint them! Don’t want to risk hitting the permanent teeth. Extract the primary tooth

42
Q

What is the most important thing with direct pulp exposures

A

Most important is to seal and protect pulp tissue from oral fluids

43
Q

___ is the first bioactive base/liner that delivers long-term benefits and better care due to the releasing of calcium, phosphate, and fluoride ions

A

Activa

44
Q

When should you consider a pulpotomy?

A

Pulp exposure in immature permanent tooth (apex is large)

Small exposure but pt didnt seek treatment for several hours or days after injury

Insufficient crown remaining to hold a temporary restoration

Coronal pulp inflammation is not widespread

Deeper acces is not needed to help retain the restoration

45
Q

When should you do a deeper pulpotomy?

A

If health of pulp is questionable. Otherwise do a shallow pulpotomy

46
Q

A successful pulpotomy on an injured tooth allows the pulp tissue in the root canal to…

A

Maintain its vitality and allows the apical portion to continue (apexification)

If not… hermetically sealing of tooth with open apex is very difficult and infludes apical surgery

47
Q

What is apexification?

A

Therapy to stimulate root growth and apical repair in immature teeth with pulpal necrosis

This will make it easier to RCT later down the road

48
Q

What is internal resorption?

A

Destructive process thought to be caused by odontoblasts cancer action

May be observed radiographically in the pulp chamber or canal within a few weeks or months following injury

Destruction action may progress slowly or rapidly

If caught soon enough it may be able to be stopped with endodontic procedures

49
Q

What causes external root resorption? What is external root resorption?

A

Trauma with damage to the periodontal structures.

The reaction starts form the outside. The pulp may not become involved.

Resorption usually continues unabated until root structure is gone. Usually seen in sever trauma shwich there has even some degree of displacement of tooth

50
Q

True or false.. there is a strong relationship between the type of injury to the tooth and the reaction of the pulp tissue and surrounding tissue

A

False

51
Q

Why should you always take radiographs of traumatized teeth?

A

One reason is because you will use it to compare against radiographs a few months later

52
Q

A severe blow to the tooth causing displacement may sever the ___. What happens if the blow is less severe?

A

Apical vessels. Causes necrosis

A less severe blow that doesn’t cause displacement can also cause damage to apical vessels which may eventually cause pulpal necrosis

53
Q

A tooth injury that causes coronal fracture as opposed to displacement has a better pulpal prognosis. Why?

A

Because you dont sever the blood supply in a strictly coronal fracture.

54
Q

What is ankylosis? How does it relate to trauma?

A

A condition caused by injury to the PDL and subsequent inflammation which is associated with invasion of osteoclastic cells (resulting in irregularly resorbed areas on the PDL surface leading to MECHANICAL LOCK or fusion between alveolar bone and the root

It is another reaction observed after trauma to anterior primary and permanent teeth.

55
Q

What is an issue with ankylosis?

A

Adjacent teeth continue to erupt, whereas the ankylosed tooth remains fixed in relation to surrounding structures.

56
Q

What is turner’s tooth?

A

The presence of small, pigmented hypoplastic areas on permanent teeth due to damage of the primary teeth

57
Q

What should you NOT do with intruded primary teeth?

A

Do not reposition or splint primary teeth!!! Leave them alone or extract them

58
Q

Which has a poorer prognosis.. intruded permanent teeth or primary teeth?

A

Intruded permanent teeth have a poorer prognosis than primary teeth. The tendency for the injury to be followed by rapid root resorption, pulpal necrosis, ankylosis.

59
Q

What is the treatment for an intruded permanent tooth with closed apex and only intruded 3mm?

A

Let tooth erupt without intervention. Watch! May need to pull down with Orthodontics

60
Q

What do you do to teeth that are intruded or extruded more than 7mm?

A

Reposition tooth surgically and stabilize 4-8 weeks with a flexible splint (if not flexible it can cause ankylosis)

Pulp will become nectrotic. RCT started 2-3 weeks after stabilization. Fill with calcium hydroxide initially to stop external resorption

61
Q

In immature permanent intruded/extruded teeth, what has the best success?

A

Spontaneous eruption

If doesn’t erupt within 2-4 weeks, orthodontically repositon

62
Q

Extrusive luxation of a permanent tooth usually results in pulpal ___

A

Necrosis

63
Q

What is a risk with replantation of an avulsed tooth?

A

Slow or rapid external root resorption

64
Q

What are advantages of replantation?

A

Prolonged retention is achieved

Replanted tooth can serve as space maintainer to help guide in surrounding teeth

Replantation procedure has a huge psychological component.

Can last 5-10 years or just months

Most common age is 7-9. 3 times more frequent in boys

65
Q

True or false.. primary teeth are replanted.

A

False. Don’t want to risk hitting the underlying permanent tooth

66
Q

Should the mom place the tooth back in immediately or wait to have the dentist do it?

A

Have the mom wash it briefly under water then repositon immediately.

If repositioning is impossible, keep it in a storage medium.

67
Q

Of avulsed teeth, those replanted within __ minutes, 90% showed no discernible evidence of resorption 2 or more years later.

A

30

68
Q

About 3% of teeth replanted more than 2 hours after injury showed ___

A

Root resorption

69
Q

Which avulsed teeth are better implanted, open apex or closed apex?

A

Open apex.

In closed apex, endo pulpotomies with calcium oh should be done within a few days

70
Q

What is the most favorable medium to store avulsed teeth in? What shouldnt you use?

A

Milk

Don’t use tap water cause its hypotonic and leads to cell lysis (but still better than nothing (dehydration))

71
Q

Once an avulsed tooth is replanted, what should be done?

A

Use a splint to stabilize it during at least the first week of healing.

72
Q

What are the ideal criteria of a splint used to stabilize an avulsed tooth?

A

Not too stiff!! Can cause ankylosis!

Easily fabricated directly

Placed passively

Shouldn’t cause gingival irritation

Shouldn’t interfere with occlusion

Should be easily cleaned

Should not traumatized teeth

It should allow an approach for endo therapy

Should be easily removed

73
Q

Splinting times for less severe luxation is ___

Splinting times for severe subluxation (lateral displaced, fractured alveolus) is ___

A

1-2 weeks

4-6 weeks

74
Q

Oral burns can cause various degrees of ___. A common cause of oral burns is ___

A

Microstomia

Electrical trauma

75
Q

What is the treatment of choice for oral burns?

A

Prosthetic appliance to prevent contracture of healing tissue and create normal-appearing coommisure (helps prevent microstomia)

76
Q

What happens if you dont use a prosthetic appliance with oral electrical burns?

A

Mouth can close up. It can be 2/3rds the size of normal mouth

Pedo 1 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions