21184897
Description
Mind Map by sanna pathy, updated more than 1 year ago
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CDH Trauma Pulp
- Permenant teeth
- Enamel-dentine-pulp
fracture
- Treatment
- Open apex
- 0.5mm exposure and within 24 hours
- Direct pulp cap
- Material
- 1a) Pulp cap with MTA or CA(OH)2
- 1b) GIC
- 1c) Composite
- 1a) Pulp cap with MTA or CA(OH)2
- Material
- Direct pulp cap
- Large exposure OR >24 hours
- Pulpotomy
- 1a) Remove coronal pulp
- 1b) Arrest bleeding
- 1c) Apply MTA or Ca(OH)2
- 1d) GIC
- 1e) composite resin
- 1a) Remove coronal pulp
- Pulpotomy
- If pulpotomy doesn't work
- Pulpectomy
- Need to apexify (open apex),
either using Ca(OH)2 OR MTA
- Can also use regenerative
endo technique if open
- 1a) clean out and extirpate
- 1b) Triple antibiotic mixture in canal for 2 weeks
- 1c) Small needle 2mm past WL
to make apical tissues bleed
into tooth
- 1d) Get haemostats
- 1e) Seal up GIC
- 1a) clean out and extirpate
- Need to apexify (open apex),
either using Ca(OH)2 OR MTA
- Pulpectomy
- 0.5mm exposure and within 24 hours
- Closed apex
- Young people with
closed apex >48hrs
- Pulpotomy
- Pulpotomy
- Older patients with closed apex
- RCT
- RCT
- Young people with
closed apex >48hrs
- Open apex
- Treatment
- Uncomplicated crown-root fracture
- Treatment
- Emergency
- Stabilise loose segment to the adjacent teeth
- Stabilise loose segment to the adjacent teeth
- Remove the fragment & restore
- 1a) locate fracture line
- 1b) remove mobile fragment
- 1c) Disinfect & suture any lacerations
- 1d) GIC
- 1e) Composite resin
- 1a) locate fracture line
- Remove the fragment and restore
with gingivectomy +- osteoplasty
- Remove the fragment &
extrude orthodontically
- Emergency
- Treatment
- Root fracture
- Treatment
- Coronal third/Cervical root fractures
- If the root fracture is near the cervical area of
the tooth stabilization is benificial for a longer
period of time (up to 4 months).
- Endo?
- If displaced make sure you
reposition before you splint
- If really bad (into gingival tissues)
- Extract whole tooth
- Extract coronal portion
- Extrude surgically with
orthodontist & post crown
- Extrude surgically with
orthodontist & post crown
- Extract whole tooth
- If the root fracture is near the cervical area of
the tooth stabilization is benificial for a longer
period of time (up to 4 months).
- Apical & mid-root fractures
- Endo?
- Non-mobile & non-displaced
- Soft diet, keep an eye on vitality
- Soft diet, keep an eye on vitality
- Mobile
- Flexible splint
for 4 weeks.
- Flexible splint
for 4 weeks.
- If displaced make sure you
reposition before you splint
- Endo?
- Coronal third/Cervical root fractures
- 20% get pulp necrosis
- Do endo if there is
no vitality and PAP
still after 3 months
- Cam do endo to the fracture
line then allow the rest to
resorb
- Cam do endo to the fracture
line then allow the rest to
resorb
- Treatment
- Alveolar fractures
- Treatment
- 1a) Manual repositioning or repositioning using forceps of the
displaced segment.
- 1b) Stabilize the segment with
flexible splinting for 4 weeks.
- 1a) Manual repositioning or repositioning using forceps of the
displaced segment.
- Treatment
- Complicated crown-root fracture
- Treatment
- Emergency
- Stabalise to adjacent teeth
- Stabalise to adjacent teeth
- Remove fragment and restore if supragingival
- With pulpotomy (immature
apices) or pulpectomy
- With pulpotomy (immature
apices) or pulpectomy
- Remove the fragment and restore with
gingivectomy +/- osteoplasty + RCT and post
- Remove the fragment and extrude
orthodontically + RCT and post
- Emergency
- Treatment
- Enamel-dentine-pulp
fracture
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