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21128061
CDH trauma PDL injuries
Description
First Year Dentistry Mind Map on CDH trauma PDL injuries, created by sanna pathy on 03/03/2020.
No tags specified
cdh
dentistry
first year
Mind Map by
sanna pathy
, updated more than 1 year ago
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Created by
Zainab Patel
almost 5 years ago
Copied by
sanna pathy
over 4 years ago
2
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Resource summary
CDH trauma PDL injuries
Primary teeth
PDL injuries (UNDER 3 TRAUMAS, be worried about central incisor)
Concussion
Subluxation
Features
Mobile
TTP +ve
Treatment
None
Extrusion
Features
V Mobile
TTP +ve
Elongated on radiographs
Treatment
Minor extrusion <3mm
Reposition/ spontaneously align itself
Good co-operation
Reposition and flexible splint 2 weeks
Follow up
1-2 wks, 6 wks, 6 month
1 YEAR, THEN 1 YEAR TILL SUCCESSOR
Severe extrusion >3mm
XLA
Lateral luxation
Clinical features
Non-mobile
TTP
Very displaced
High metallic ankylotic sound
Treatment
Spontaneous repositioning if not in occlusion
Repositioning
XLA
Intrusion
Clinical features
Not mobile
High metallic ankylotic sound
Treatment
Spontaneous re-eruption
If displaced towards labial plate
Follow up
1 wk, 3-4 wk (R), 6-8 wk (R), 6mnths (R), 1 yr(R),
1 YEAR, THEN 1 YEAR TILL SUCCESSOR
XLA
Follow up
1 wk, 1yr
Alveolar fracture
Treatment
Flexible splint 4 weeks
Follow up
1 wk, 4wk (R), 6-8wk (R), 1yr (R)
1 YEAR, THEN 1 YEAR TILL SUCCESSOR
GA often indicated so refer
Avulsion
Review
1 YEAR, THEN 1 YEAR TILL SUCCESSOR
6mnth, 1 year
DO NOT VITALITY TEST
Permenant teeth
PDL injuries (RESORPTION, LOSS OF VITALITY & TRANSIENT APICAL BREAKDOWN)
Concussion
Features
TTP +ve
Positive pulp
Treatment
General trauma advice
Follow-up
4wks, 6wks, 1 year
Subluxation
Features
TTP +ve
Mobile
Positive or negative pulp
Treatment
None usually
Flexible splint 2wk
Extrusion
Features
TTP +ve
V Mobile
Negative pulp
Treatment
Reposition & splint 2 wks
Types
Flexible acrylic splint
No wire needed
Flexible wire splint
Follow up
2 wk (R), 4 wk (R), 6-8 wk (R), 6mnths (R), 1 yr(R) & yearly for 5 yr (R)
5 year survival
95% open apex
45% closed apex
Lateral luxation
Features
Non-mobile
TTP +ve
Visually displaced
Negative pulp
High metallic ankylotic sound
Treatment
Splint 4 weeks
If pulp is necrotic RCT
Reposition under LA fingers/ortho NO forceps
5 year survival
Open apex
95%
Closed apex
25%
Intrusion
Clinical features
Not mobile
Negative pulp
High metallic ankylotic sound
Treatment
Open apex <3mm
Spontaneous eruption
Open Apex 3-6mm
Orthodontic repositioning
Flexible splint 2 weeks then check if there needs to be surgical (forceps) repositioning
RCT 2-3 weeks later
Completed root formation
Surgical (foreceps) repositioning
Flexible splint 4 weeks
RCT 2-3 weeks later
Endo
Necrotic pulp
Avulsion
Treatment (clean saline, irrigate, replant, tetanus)
Open apex
Tooth already re-implanted
Flexible splint 2 wks
Tetracycline 2ds for 7 days
EADT <60 mins
Flexible splint 2 wks
Tetracycline 2ds for 7 days
Follow up
2 wk (R), 4 wk (R), 3 month (R), 6mnths (R), 1 yr(R) & yearly for 5 yr (R)
EADT >60 mins
Poor prognosis
Flexible splint 4 wks
Tetracycline 2ds for 7 days
Closed apex
Tooth already re-implanted
Flexible splint 2 wks
Tetracycline 2ds for 7 days
RCT 7-10 days AFTER re-implantation & BEFORE splint removal
EADT <60 mins
Flexible splint 2 wks
Tetracycline 2ds for 7 days
RCT 7-10 days AFTER re-implantation & BEFORE splint removal
EADT >60 mins
Flexible splint 4 wks
Poor prognosis
Tetracycline 2ds for 7 days
RCT 7-10 days AFTER re-implantation & BEFORE splint removal
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