Trauma I

Question 1

What is the biggest urgency in pediatric dentistry?

Answer 1

Dental trauma

Question 2

Dental trauma prognosis depends on …

Answer 2

The time that has passed until it

is treated

Question 3

Most affected teeth for dental trauma are..?

Answer 3

The upper central incisor (for both primary and permanent dentition)

Question 4

Trauma primary dentition?

Answer 4

Complete teeth or with physiological reabsorptions

Question 5

Trauma mixed dentition? (2)

Answer 5

• Permanent teeth with open or closed apex.
There are also primary teeth.
• Problem: The alveolar bone is still growing and we must
preserve it.

Question 6

Trauma etiology primary dentition? (2)

Answer 6

• when the child starts walking

- games

Question 7

Trauma etiology permanent dentition? (4)

Answer 7

• Sports
• More risky games
• Car accidents
• Bikes

Question 8

Underlying factors for dental trauma? (2)

Answer 8

Protrusion:

• big overjet
• class II 1st division)

Question 9

Frequency of dental trauma (3)?

Answer 9

Maximum peak at 12-15 months in primary dentition

7-11 years in permanent dentition

Question 10

After dental trauma you should go to the ER if…? (4)

Answer 10

• Loss of balance
• Vomits
• Absence of attention
• Bewilderment

Question 11

To diagnose dental trauma - General history? (4)

Answer 11

• How, when, where?
• Adjacent lesions of the face (soft tissues, bone lesions) ears,
neck, TMJ,…
• Previous traumas and their treatments
• Previos treatments of the actual trauma

Question 12

To diagnose dental trauma - extraoral exploration? (6)

Answer 12

• Face ( lips, soft tissues, malar bone,
nasal area , orbit…)
• TMJ ( deviations, asymmetries, clicks)
• Refer to other specialists
• Soft tissues
• Arches
• Dental crowns
    - palpation
    - percussion

Question 13

To diagnose dental trauma - tests? (3)

Answer 13

• X-ray
• Thermal tests
• Electrical tests

Question 14

To diagnose dental trauma - Main test? (4)

Answer 14

• X-ray
• 3 periapical x-rays
• 1 occlusal x-rays
• Occlusal xray only if we suspect the presence of strange objects

*andreassen guidelines

Question 15

To diagnose dental trauma - Electrical tests? (2)

Answer 15

• vital tests*

* We will NOT do it the day of the trauma : false positives and negatives

Question 16

FACTORS TO TAKE INTO ACCOUNT FOR dental trauma? (4)

Answer 16

1. • Kind of trauma
2. • If there is pulp affectation or not
3. • State of the ápex (open or closed) and the root (reabsorption)
4. • Time that has passed from the moment of the trauma

Question 17

What must you always do for dental trauma treatment? (2)

Answer 17

• Always clean the area with saline solution

* Always use topical and local anesthesia

Question 18

What is sometimes necesary for relocations, reimplantations etc?

Answer 18

Previous medications: benzodiazepines

Question 19

General treatment of soft tissues in mouth after dental trauma?

Answer 19

Suture soft tissues (tongue, mucosa etc)

Question 20

What to do after the treatment of dental trauma? (2)

Answer 20

• Remember the importance of the oral hygiene.
• Rinses with clorhexidine for 7-10 days.
• Sometimes a soft diet is needed

Question 21

Dental trauma medications? (4)

Answer 21

• Antibiotics (always)
• analgesics and antiinflammatories
• antitetanic vaccine
• Use of splints

Question 22

Dental trauma medications: antibiotics? (2)

Answer 22

• Amoxicillin oral via. : 40 – 50 mg / kg / day in 3-4 intakes (at least 4 days)
• If allergies: Azithromycin / clindamycin

Question 23

Dental trauma medications: Analgesic and antiinflammatoires?

Answer 23

Ibuprofene : 10 -20 mg / kg / 8 hours ( or paracetamol )

Question 24

Dental trauma medications: Antitetanic vaccine?

Answer 24

1 reminder dose (if there is reasonable doubt that is necessary)

Question 25

Dental trauma medications: splits? (3)

Answer 25

• When there is mobility on the trauma it is necessary to inmobilize the teeth with splints • The most commonly used in pediatric dentistry are the wire splints • We may also use: titanium chain (expencsive) or glass fiber

Question 26

Characteristics of splints? (3)

Answer 26

• 1º-Easy (to put, to remove, to wear) • 2º-Not harmful for the occlusion or the soft tissues • 3º- Stable: They must include at least 2 teeth on each side of the affected tooth

Question 27

Andreassen check up guidlines? (5)

Answer 27

- 1- 2 weeks (confirm diagnosis, remove splint, pulp treatments,…) - 4 weeks ( remove splints, pulp treatment) - 3, 6, 12 months (internal and external reabsorptions , ankylosis) - 5 years ( complications : external reabsorptions **counting from the moment of the trauma

Question 28

Types of complications for traumas? (4)

Answer 28

- Reabsroptions (internal & external) - Ankylosis and delay of eruption - alterations of the enamel - dilaceration

Question 29

Trauma complications: Reabsorption? (2)

Answer 29

* Internal reabsorptions: The first that appear | * External reabsorptions: The most severe

Question 30

Trauma complications: Ankylosis and delay of eruption? (2)

Answer 30

* Because of traumas of great intensity( luxations ) | * Delay of eruption of permanent tooth because of very premature loss or extraction of the primary

Question 31

Trauma complications: Enamel alterations and dilacerations? (2)

Answer 31

• Because of traumas of great intensity( luxations ) • The buccal surface of the permanent incisor is affected (Turner tooth)

Question 32

Classification of traumas? (4)

Answer 32

- Andreassen classification - Confirmed by WHO - Trauma on the hard dental tissues - Trauma on the periodontal tissues

Question 33

Trauma on hard dental tissues? (5)

Answer 33

- ENAMEL FRACTURE - DENTIN-ENAMEL FRACTURE - DENTIN-ENAMLE-PULP FRACTURE - CROWN ROOT FRACTURE - ROOT FRACTURE

Question 34

Trauma of the periodontal tissues? (6)

Answer 34

- CONTUSION - SUBLUXATION - INTRUSIVE LUXATION - EXTRUSIVE LUXATION - LATERAL EXTRUSION - AVULSION

Question 35

What type of dental trauma lesion is most common in primary dentition?

Answer 35

``` periodontal lesions (luxations) ```

Question 36

What type of dental trauma lesion is more common with permanent dentition?

Answer 36

dental lesions | dental fractures