Traumatic Dental Injuries PRIMARY

Question 1

what is the most prevalent truamatic injury in primary dentition

Answer 1

luxation
62-69%

Question 2

trauma pt management steps

Answer 2

1. reassurance
2. trauma history
3. trauma examination
4. diagnosis
5. emergency tx
6. important information
7. further tx
8. review

Question 3

important information to tell parents regarding care of injured teeth to optimise healing

Answer 3

analgesia
soft diet 10-14 days
brush teeth with soft brush every meal
chew with molars, cut food small
chlorohexidine 0.12% 2x day for week
warn of reinfection signs

Question 4

what does a trauma stamp assess

Answer 4

mobility
colour
TTP
sinus
percussion note
radiograph

Question 5

types of hard tissue and pulp trauma

Answer 5

enamel
enamel + dentine
enamel + dentine + pulp
crown-root fracture
root fracture

Question 6

types of supporting tissues trauma

Answer 6

concussion
subluxation
lateral luxation
intrusion
avulsion
alveolar fracture

Question 7

concussion

Answer 7

symptoms - tooth tender to touch, not displaced, normal mobility, no bleeding

tx - observation

Question 8

subluxation

Answer 8

symptoms - tender to touch, increased mobility, not displaced, bleeding

tx - observation

Question 9

lateral luxation

Answer 9

tooth displaced in palatal/lingual or labial direction

tx -
minimal/no occlusal interference - repositions spontaneously
severe displacement = reposition with splint 4 weeks, XLA

Question 10

intrusion

Answer 10

tooth displaced through labial bone plate, or impinge on permanent tooth bud

tx - allow spontaneously reposition

Question 11

extrusion

Answer 11

partial displacement of tooth out of socket

tx
not occlusal interference = spontaneous reposition
excessive mobility or extruded > 3mm = XLA

Question 12

avulsion

Answer 12

tooth completely out of socket

tx - do not implant

Question 13

alveolar fracture

Answer 13

fracture involving alveolar bone and may extend to adjacent bone

tx - reposition segment, stabilise with adjacent uninjured teeth for 4 weeks
may need XLA after alveolar stability achieved

Question 14

enamel fracture

Answer 14

smooth sharp edges

Question 15

enamel dentine fracture

Answer 15

cover exposed dentine with GI
lost tooth structure restored with composite

Question 16

enamel dentine pulp fracture

Answer 16

partial pulpectomy
extract

Question 17

crown root fracture

Answer 17

remove loose fragment and determine if crown can be restored

restorable =
- no pulp exposure = cover exposed dentine with GI
- pulp exposure = pulotomy or endo

unrestorable =
- extract loose fragments, dont dig

Question 18

root fracture

Answer 18

coronal fragment not displaced = no tx
coronal fragment displaced but not excessively mobile = spontaneous reposition

coronal fragment displaced, excessively mobile and interfering with occlusion =
- XLA only loose fragment
- reposition with splint