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Peds Final > Trauma > Flashcards

Trauma Flashcards

(68 cards)

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1
Q

Signs of intracranial Pressure

A 
Loss of consciousness
Nausea and vomiting
Dizziness
Headache
Lethargy or irritability
Memory loss
Pupil size and reaction to light
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2
Q

Occlusal view for primary teeth

A

Occlusal plane
Gentle bite to stabilize
Outside edge should be at incisors

60 degrees through bridge of nose

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3
Q

2 week radiographic evidence

A

Pulpal necrosis

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4
Q

3 week radiographic

A

Inflammatory resorption

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5
Q

6 week radiographic

A

Replacement resoprtion ankylosis

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6
Q

Short term reaction of teeth to trauma

A 
Pulpal hyperemia (pulpitis)
Internal hemorrhage
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7
Q

Long term reactions of teeth to trauma

A

Pulpal necrosis
Pulp canal obliteration
Inflammatory resorption
Replacement resorption

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8
Q

Pulpitis internal hemorrhage

A

May lead to cold sensitivity

This is an immediate response

May be transient q

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9
Q

Pulp canal obliteration and pulpal necrosis

A

These are long term responses

Both ar irreversible

PCO causes yellow discoloration

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10
Q

Replacement resoprtion

A

Direct union of bone and root

Resorption of root and replacement with bone

Direct results of loss of vital PDL

Lack of mobility and dull percussion sound

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11
Q

2 types of injuries

A

Injuries to the tooth =fractures

Injuries to the PDL=luxation

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12
Q

Goals of fracture

A

Temp cover up

Establish follow up plan

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13
Q

Goals of luxation

A

Resportion and stabilize

Establish follow up plan

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14
Q

Class I fracture

A

Limited to enamel

Restore perm with composite

Ignore primary

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15
Q

Class II fracture

A

Fracture includes enamel and dentin

Pulp is not exposed

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16
Q

Class II primary tooth

A

Composite/GI

Then monitor for symptoms

Definitively restore with composite/GI

3-4 week follow up

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17
Q

Class II fractures Permanent Teeth

A

Bond fragment if available
Composite blind aid

6-8 weeks clinical and radiographic exam

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18
Q

Class III Fractgure

A

Involves enamel and dentin and pulp is exposed

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19
Q

Class III fractures primary teeth options

A

Partial pulpotomy
Pulpotomy
Pulpectomy
Extraction

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20
Q

Class III primary teeth usually comes down to

A

Behavior

Partial pulpotomy
Extraction

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21
Q

Class III primary teeth follow up

A

1 week clinical exam

6-8 weeks clinical radiographic exam

1 year clinical and radiographic exam

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22
Q

Class III fractures permanent young tooth

A

Young tooth with open apex or closed apex

Direct pulp cap
Partial pulpotomy (Cvek technique)
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23
Q

Class III fractures permanent mature tooth

A

Mature tooth with closed apex

Pulpectomy

Direct pulp and partial are also options

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24
Q

Cvek Partial pulpotomy

A

Single tooth isolation

Access the pulp chamber to a depth of 1-2 mm

Extend to allow access keep in dentin

Bleeding is good

Medicaments

Condense a sufficient thickness of dry calcium hydroxide powder to fill preparation at least 1 mm in depth

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25
If no bleeding
Tooth may be necrotic and pulpectomy is indicated
26
Class III fractures permanent teeth
Restoration can occur after success of Cvek has been determined Typically after 6-8 weeks follow up Strip crown or composite buildup
27
Chin trauma
Posterior crown fracture Mandibular consular fractures Cervical spine injury
28
Luxation injuries
``` Concussion Subluxation Extrtusive luxation Lateral luxation Intrusive luxation Avulsion ```
29
Concussion
An injury to the tooth-supporting structures without abnormal mobility or displacement of the tooth
30
How can you tell concussion
Tender to percussion
31
Primary teeth Concussion
No emergency treatment | Monitor for symptoms
32
Subluxation
An injury to the tooth supporting structures with increased mobility but without displacement of the tooth May have bleeding from gingival sulcus
33
Subluxation primary tooth
No emergency tooth shoul tighten back up Same with permanent -can consider splinting for 2 weeks
34
Extrusion
A partial displacement of the tooth out of its socket Looks long May be mobile
35
Minor extrusion primary
<3 mm Reposition but dont splint Spontaneous alignment
36
Extrusion severe primary
Extract
37
Extrusion permanent teeth
Reposition with digital pressure Flexible splint for 2 weeks Rx chlorhexidine mouth rinse
38
Extrusion follow up closed apex
Likely pulp necrosis Remove pulp and fill with CaOH when indicated Complete gutta percha fill in 2 months if no inflammatory resorption
39
Lateral luxation
A displacement of the tooth in a direction other than a i ally Usually immobile This is accompanied by fracture of the alveolar socket
40
Lateral luxation primary teeth retrusion
If no occlusal interference then allow spontaneous repositioning With occlusal interference resportion (but do not splint) or extract Severe protrusion -extract
41
Lateral luxation permanent teeth
Reposition with digital pressure Flexible splint for 4 weeks Rx chlorhexidine mouth rinse
42
Lateral luxation closed apex
Likely pulp necrosis remove pulp and fill with CaOH when indicated Complete gutta percha fill in 2 months if no inflammatory resorption
43
Intrusive luxation
A displacement of the tooth into the alveolar bone Tooth is immobile This injury is accompanied by comminution or fracture of the alveolar socket
44
Intrusion primary tooth if displaced labially
Then allow spontaneous re eruption
45
Intrusion if tooth displacement into tooth bud
Extract
46
Injuries to developing teeth
``` Discoloration Enamel hypoplasia Crown or root dilaceration Arrested development Disturbance in eruption ```
47
Greatest risk to developing teeth
Ages 1-3
48
Intrusion permanent teeth Open apex
Up to 7mm- spontaneous eruption More than 7 mm: ortho or surgical repositioning
49
Intrusion permanent teeth closed apex
Up to 3 mm; spontaneous eruption 3-7 mm ortho or surgical reposition More than 7 mm surgical reposition If repositioned splint with flexible splint for 4 weeks
50
Intrusion follow up for closed apex
Remove pulp and fill with CaOH within 2-3 weeks Complete gutta percha fill in 2 months if no inflammatory resoprtion
51
Avulsion
A complete displacement of the tooth out of its sockets
52
Primary avulsion
NEVER re-implant
53
Avulsion permanent tooth ultimate goal
PDL healing without root resorption
54
Avulsion percent tooth most critical factor
Maintain an intact and viable PDL on the root surface
55
Avulsion of permanent tooth
EVERY MINUTE COUNTS Whoever is holding tooth is the person to put it back Flexible splint for 2 weeks
56
Avulsion of permanent tooth medication
Systemic antibiotics Chlorhexidine rinse Ibuprofen
57
Transport media
HBSS Milk Saline Saliva Avoid water
58
Management of root surface
Maintain PDL cell vitality Don’t handle surface Gently remove persistent debris
59
Management of the socket
If clot present use saline irrigation Do not curette socket Reposition alveolar bone Manually compress bony plates after replantation
60
Management of soft tissue
Tightly suture any soft tissue lacerations particularly in the cervical region
61
Splinting
Use fish line/acid etch resin Maint splint up to 2 weeks longer if excessive mobility
62
Home care
No biting on splinted they No sports Soft diet for 2 weeks Good oral hygiene
63
After removing splint
Asses need for RCT follow up should happen a t 4 weeks 3 months 6 months 1 year and yearly thereafter
64
Closed apex avulsion
Remove pulp fill with CaOH within 7-10 days Splint 2 weeks Complete gutta percha fill in 2-12 months
65
Immature permanent tooth avulsion
Best prognosis if replanted within 20 minutes Replant and splint as with mature teeth
66
Revascularization technqieu
Stimulate bleeding through apex Place MTA on top of clot Allow continued root development and root wall thickening
67
What to do when the tooth becomes ankylosed
Maintain it as long as possible
68
For permanent teeth if the apex is closed and you expect the blood supply is severed
Depending on the severity of the injury Do the pulpectomy

Peds Final (7 decks)

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