Permanent Trauma

Description

First Year Dentistry Mind Map on Permanent Trauma, created by sanna pathy on 16/04/2020.
sanna pathy
Mind Map by sanna pathy, updated more than 1 year ago
sanna pathy
Created by sanna pathy over 4 years ago
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Resource summary

Permanent Trauma
  1. Crown Fracture
    1. Enamel #
      1. Composite bandage/restoration
        1. Review
          1. 6-8wks, 1yr
          2. Bond tooth fragment
          3. Enamel-dentine #
            1. Composite bandage
              1. Definitive composite restoration
                1. If close to pulp, place indirect pulp cap (setting CaOH)
                2. Review
                  1. 6-8wks, 1yr
                  2. Bond tooth fragment
                  3. Enamel-dentine-pulp #
                    1. Closed apex
                      1. RCT
                        1. Extirpate within 7-10 days
                      2. Open apex
                        1. >24hrs
                          1. Extirpate within 7-10 days + bandage
                            1. wait 6m for apex to close
                              1. RCT
                              2. MTA plug
                                1. RCT
                            2. <24hrs
                              1. Direct pulp cap
                                1. Very small exposure
                                  1. Partial pulpotomy
                                    1. Setting CaOH (or MTA/Biodentine
                                2. Review
                                  1. 6-8wks, 1yr
                              2. Periodontium Injury
                                1. Advice
                                  1. Soft diet
                                    1. Keep tooth clean
                                      1. Chx MW (0.1%)
                                        1. Painkillers
                                        2. Concussion
                                          1. = TTP+ but not displaced or mobile
                                            1. No treatment
                                              1. Review
                                                1. 4wks, 6-8wks, 1yr
                                              2. Subluxation
                                                1. = TTP+ & mobile but not displaced
                                                  1. 2wk flexible splint
                                                    1. Review
                                                      1. 2wks
                                                        1. 4wks, 6m, 6-8wks, 1yr
                                                      2. Avulsion
                                                        1. EADT >60mins = Poor prognosis
                                                          1. Ankylosis + replacement resoprtion will occur
                                                            1. Infraposition
                                                          2. Closed apex
                                                            1. RCT
                                                              1. Extirpate within 7-10 days
                                                            2. Re-implant
                                                              1. If dirty - wash for 10s in cold water/saline
                                                                1. Best done immediately
                                                                  1. Storage - saliva, hank's solution, milk
                                                                  2. Open apex
                                                                    1. No RCT
                                                                      1. Hope for revascularisation
                                                                    2. 2wk flexible splint
                                                                      1. Amoxicillin 3xday, 5 days
                                                                        1. Check tetanus
                                                                          1. Review
                                                                            1. 2wks
                                                                              1. 4wks, 3m, 6m, 1yr, yearly
                                                                              2. Complications
                                                                                1. Ankylosis
                                                                                  1. Pulp necrosis
                                                                                    1. Root resorption
                                                                                  2. Extrusion
                                                                                    1. Reposition
                                                                                      1. 2wk flexible splint
                                                                                        1. Review
                                                                                          1. 2wks
                                                                                            1. 4wks, 6-8wks, 6m, 1yr, yearly for 5yrs
                                                                                            2. Complications
                                                                                              1. No pulp revascularisation
                                                                                                1. likely with closed apex
                                                                                                2. Root resorption
                                                                                                3. = tooth displaced occlusally
                                                                                                4. Intrusion
                                                                                                  1. Reposition
                                                                                                    1. Closed apex
                                                                                                      1. <3mm
                                                                                                        1. Spontaneous
                                                                                                          1. No movement in 2-4wks -> Surgical or Ortho
                                                                                                          2. 3-7mm
                                                                                                            1. Surgical or Ortho
                                                                                                            2. >7mm
                                                                                                              1. Surgical
                                                                                                              2. RCT
                                                                                                                1. Extirpate within 7-10 days
                                                                                                              3. Open apex
                                                                                                                1. <7mm intrusion
                                                                                                                  1. Spontaneous
                                                                                                                    1. No movement in 2-4wks -> Ortho
                                                                                                                    2. >7mm
                                                                                                                      1. Surgical or Ortho
                                                                                                                  2. 4wk flexible splint
                                                                                                                    1. = tooth displaced apically + alveolar #
                                                                                                                      1. Review
                                                                                                                        1. 2wks
                                                                                                                          1. 4wks
                                                                                                                            1. 6-8wks, 6m, 1yr, yearly for 5yrs
                                                                                                                            2. Complications
                                                                                                                              1. Pulp necrosis
                                                                                                                                1. Root resorption
                                                                                                                                  1. Ankylosis
                                                                                                                                2. Lateral luxation
                                                                                                                                  1. = tooth displaced non-axially e.g. labial or palatal + alveolar #
                                                                                                                                    1. Reposition
                                                                                                                                      1. 4wk flexible splint
                                                                                                                                        1. Review
                                                                                                                                          1. 2wks
                                                                                                                                            1. 4wks
                                                                                                                                              1. 6-8wks, 6m, 1yr, yearly for 5yrs
                                                                                                                                          2. Aveolar Process Fracture
                                                                                                                                            1. = section of alveoalr bone # with group of teeth mobile together
                                                                                                                                              1. Reposition
                                                                                                                                                1. 4wk flexible splint
                                                                                                                                                  1. Review
                                                                                                                                                    1. 4wks
                                                                                                                                                      1. 6-8wks, 6m, 1yr, 5yr
                                                                                                                                                      2. Suture any gingival lacerations
                                                                                                                                                      3. Root Fracture
                                                                                                                                                        1. = horizontal or oblique # through root
                                                                                                                                                          1. Middle or Apical third #
                                                                                                                                                            1. 4wk flexible splint
                                                                                                                                                            2. Cervical third #
                                                                                                                                                              1. 4m flexible splint
                                                                                                                                                                1. Worse prognosis
                                                                                                                                                                2. Reposition coronal part if displaced
                                                                                                                                                                  1. Review
                                                                                                                                                                    1. 4wks, 4m
                                                                                                                                                                      1. 6-8wks, 6m,1yr, yearly for 5yrs
                                                                                                                                                                      2. Complications
                                                                                                                                                                        1. Pulp necrosis
                                                                                                                                                                          1. RCT up to # line
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