What is included in a trauma stamp?
investigations (8)
- sinus
- colour
- mobility
- TTP
- percussion note
- ethyl chloride test (ECL)
- electric pulp test (EPT)
- radiograph
What should be looked at during trauma review appointments?
significant findings
- continuation of root formation
- loss of pulp vitality
- breakdown of the perdiodontal ligament
- resorption (types and process)
- types of root fracture healing
Which trauma type has the poorest prognosis?
- intrusion
- avulsion/replantation
What is the % incidence of resorption after 5 years for open apex intrusion and avulsion cases?
67%
What is the % incidence of resorption after 5 years for closed apex instrusion and avulsion cases?
100%
List in order best to worst prognosis of dental trauma types.
concussion
subluxation
extrusion
lateral luxation
intrusion
avulsion
What is the % incidence of resorption after 5 years for open apex concussion and subluxation?
1%
What is the % incidence of resorption after 5 years for closed apex concussion and subluxation?
3%
What is the % incidence of resorption after 5 years for open apex extrusion?
5%
What is the % incidence of resorption after 5 years for closed apex extrusion?
7%
What is the % incidence of resorption after 5 years for open apex lateral luxation?
3%
What is the % incidence of resorption after 5 years for closed apex lateral luxation?
38%
Name the 4 types of resorption.
- external surface
- external inflammatory
- internal inflammatory
- replacement resorption (ankylosis)
What is external surface resorption?
- damage to PDL which heals
- non-progressive
What is external inflammatory resorption?
- damage to PDL
- progressive
How can external inflammatory resorption be diagnosed?
radiograph shows:
* root surfaces indistinct
* tramlines of root canal intact
What is the managemet of externnal inflammatory resorption?
- pulp extirpation
- mechanical debridement and chemical irrigation
- non-setting calcium hydroxide 4-6 weeks
- obturate
What is internal inflammatory resorption?
- initiated by non-vital pulp
- progressive
How can internal inflammatory resorption be diagnosed?
- tramlines of root canal indistinct
- root surfaces intact
What is the management for internal inflammatory resorption?
- pulp extirpation
- mechanical debridement and chemical irrigation
- non-setting calcium hydroxide 4-6 weeks
- obturate
What is replacement resorption (ankylosis)?
- initiated by severe damage to PDL
- normal repair does not occur
- bone fused directly to dentine
- progressive
- tooth gradually resorbed as it is now part of bone remodelling
How can replacemet resorption (ankylosis) be diagnosed?
loss of PDL and lamina dura
What are the types of root fracture healing?
(4)
- calcified tissue
- granulation tissue
- osseous tissue
- non-healing (granulation tissue detected as black mass round fracture line on radiograph)
