Flashcards in Trauma- Restoration Deck (19):
What are the treatment options for an enamel dentine fracture?
1. Composite buildup with GIC liner
2. Crown reattachment
What do you use as the cement in crown re attachment?
T/F you also need a GIC liner in the crown reattachment?
What are the options for discoloured non vital teeth?
Non vital bleaching
Why do non vital teeth become discoloured?
Hb and tissue breakdown products diffuse through the dentine tubules
What are the indications to non vital bleaching?
Well condensed GP
No clinical or radiological signs of Periapical disease
What do you need for non vital bleaching?
37% phosphoric acid
Bleaching agent eg sodium perforate of HP acid
Non setting CaOH
How do you perform non vital bleaching?
1. Take pre op PA and colour shade of tooth
2. Rubber dam and access GP
3. Remove 1mm of GO down to level of dento gingival level
4. 1mm cement over GP
5. Etch pulp and wash
6. Place bleaching agent soacked cotton wool into chamber
7. Place dry cotton wool over and seal.
8. Repeat at weekly intervals to a mad of 10 until tooth over bleached slightly but if no changes after third try abandon
9. Place non setting CaOH in chamber for 2 weeks and seal
Restore with white GP and composite
What is the purpose of placing the cement over the GP?
To prevent bleach seeping out and inducing cervical resorption
What is the purpose of placing CaOH in the chamber prior to final restoration?
This is to calm down any inflammation that may have occurred in pdl
How do you perform vital bleaching?
Chair side and night guard
What are the options for displaced teeth?
When can auto transplant be considered?
Reposition an ectopic tooth
Replacement of an un-restorable tooth with a redundant member of the dentition
What are the 6 stages to auto transplant?
1. Asses donor site
2. A traumatically extract donor tooth
3. Prepare recipient site
6. Root terra transplant tooth if req
What is usually given prior to auto transplant surgery?
Prophylactic AB usually penicillin as this has shown to reduce root resorption
What does assessment of donor tooth and recipient site entail?
Donor tooth: clinical and radiograph analysis and caries assessment and dimensions measured. Ideally 2/3 root complete (open apex), not too curved at apex as likely to become damaged in the process
Recipient site: radiograph and clinically. Look at space
How does xla a tooth for autotransplant differ?
1. Severe gingival fibres first
2. Forceps only on crown
What do you need to be careful with when splinting the transplanted tooth?
Not splint for too long as this will lead to possibility of ankylosis
Usually paint for three weeks only