Trauma

Question 1

Trauma Incidence

Answer 1

• 45% of 12 yrs old children with OJ > 9mm had visible damage to increased incisor
• More effect of OJ in females than males
• 50% children need tx following trauma.

Question 2

How does trauma Present?

Answer 2

• Prior tx
• During tx
• After tx

Question 3

Prior treatment

Answer 3

• Acute trauma : needing immediate ortho input ( intrusion , extrusion, lateral luxation, root resorption, Dilaceration
• Non acute - Noticed during ortho assessment influencing treatment planning. ( Evidence of trauma, Composite restoration/ RCT present,
  Root resorption, Lost incisor space maintained or lost .

Question 4

During treatment

Answer 4

• Acute
• Medium term

Question 5

After treatment

Answer 5

• Longterm sensibility / radiograph check

Question 6

Consequences of trauma

Answer 6

• Internal and external root resorption
• Loss of vitality
• Ankylosis
• loss of tooth
• pulpal calcification
• Root fracture

Question 7

Consent for Ortho tx trauma

Answer 7

• Informed valid consent

Question 8

How does pre treatment trauma effect therapist

Answer 8

• History taking : when did it happen? Any immediate treatment undertaken? Long- term follow up? Good documentation
• Pre assessment: Colour, swelling, mobility/ position ,vitality, palpitation, precussion,
  -Radiographs : Root resorption, PA pathology, loss of lamina dura, obliteration of pulp

Question 9

If you know the risk?

Answer 9

• Pre tx - Clinical, radiograph
• Investigate suspicious teeth before tx
• Record / document finding accurately
• Inform patient/ parent/ GDP of finding
• Consider effect/ delay on active ortho tx
• Arrange necessary tx

Question 10

Timing of treatment - Post trauma observation period

Answer 10

• 3 months - No pulpal injury - only crown
  12 months - Root fracture, intrusion, extrusion replanted

Question 11

Minimising risk before tx

Answer 11

• Reveiw morphology of root before tx
• Use light and short acting force < 70 gms
• Avoid cortical bone

Question 12

Review for minimising risks

Answer 12

• 3 months Clinically
• 6 months radiographs

Question 13

Factors count for Loss of tooth due to trauma

Answer 13

• Aethetic
• Space loss
• Crowding/ spacing
• Pontics

Question 14

Working with Pontics

Answer 14

• Pontic cribbing 7’s
• Prosthetic teeth archwire ss

Question 15

Mouthguard

Answer 15

-70% consultant recommment
- 3 kinds - Stock, mouth , custom made
- Cutom formed pressure laminated are best one

Question 16

Trauma teeth how to plan

Answer 16

• Traumatised teeth are common
• Liaison with dental carer vital
• Keep good record and valid consent
• Risk management
• Can be moved successfully