Trauma To Primary Teeth

Question 1

How would you treat a crown fracture in the primary dentition?

Answer 1

E - smooth sharp edges/flowable
ED - restore/bandage with composite or compomer
EDP - endo or extract

Question 2

Treatment of a crown & root fracture

Answer 2

Extract coronal fragment

Question 3

Treatment of alveolar bone fracture

Answer 3

Reposition
Splint 3-4wks
*Only case where splint is used in primary dentition

Question 4

Treatment of concussion & subluxation

Answer 4

Observation

Question 5

Treatment of lateral luxation

Answer 5

Radiograph
No occlusal interference - allow to position spontaneously
Occlusal interference - extract
Interfering with adult tooth germ - extract

Question 6

Where does the adult tooth germ sit in relation to the primary teeth?

Answer 6

Above & palatal

Question 7

You have taken a PA radiograph of a tooth with a lateral luxation injury. How can you determine if the displaced tooth is effecting the adult tooth germ?

Answer 7

Apical tip appears shorter than that of the contralateral tooth - displaced buccally, away from the tooth germ

Apical tip is indistinct & tooth appears elongated compared to contralateral tooth - displaced palatally, towards the tooth germ

Question 8

Treatment of intrusion

Answer 8

Root displaced labially, away from tooth germ - leave to erupt, if no progress after 6 months, extract

Root displaced palatally, towards tooth germ - extract

Question 9

Treatment of extrusion

Answer 9

Extract

Question 10

Treatment of avulsion

Answer 10

Radiograph to confirm

Do not replant

Question 11

What long term effects can occur due to trauma in primary teeth (Affecting the primary teeth)?

Answer 11

Discolouration
Discolouration & infection
Delayed exfoliation

Question 12

What long term effects can occur in permanent teeth when trauma to the primary dentition has occurred?

Answer 12

Enamel defects (44%)
Abnormal tooth/root morphology (8%)
Delayed eruption (1%)
Ectopic position
Arrest in tooth formation
Complete failure of tooth formation
Odontome formation

Question 13

What is an odontome?

Answer 13

A benign tumour of odontogenic origin

Question 14

What enamel defects can occur in permanent teeth as a result of trauma to the primary dentition?

Answer 14

Hypomineralisation - White/yellow spot, normal enamel thickness
Hypoplasia - yellow/brown areas, reduced enamel thickness

Question 15

Treatment of hypomineralisation

Answer 15

Leave
Mask with composite
Localised removal and restoration with composite
External bleaching

Question 16

Treatment of hypoplasia

Answer 16

Restore with composite

Porcelain veneer when gingival level stabilised (16yrs+)

Question 17

Why does delayed eruption of permanent successors occur when there is premature loss of a primary tooth?

Answer 17

Thickened mucosa
Delayed eruption of about 1yr
Radiograph if greater than 6 month delay
Surgical exposure & ortho may be required

Question 18

What is the most common trauma affecting primary teeth?

Answer 18

Luxation