Trauma 1
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Questions and Answers

Which statement best reflects the challenge in analyzing the long-term outcome of healing for dental traumas?

  • Randomized studies on trauma victims are easily performed.
  • Clinical observational studies are not reliable for analyzing long-term outcomes.
  • Ethical reasons make it difficult to perform randomized studies on trauma victims. (correct)
  • Most treatment procedures used for dental traumas are evidence-based.

    • What is the estimated proportion of 18-year-olds who have sustained injury to their teeth?

  • 40%
  • 10%
  • 30%
  • 20% (correct)

    • What is the proportion of traumatic dental injuries that cause permanent damage to the teeth?

  • 1/3 (correct)
  • 2/3
  • 1/4
  • 1/2

    • What is the recommended approach for future research on dental traumas?

    <p>Rely on experimental animal studies supported by clinical observational studies.</p> Signup and view all the answers

    What type of radiograph is recommended for lower incisors in dental injuries?

    <p>Parallel periapical radiograph</p> Signup and view all the answers

    Which type of examination is best for evaluating dental trauma?

    <p>CBCT</p> Signup and view all the answers

    Where is the cold test most effective for sensibility tests?

    <p>Incisal 1/3</p> Signup and view all the answers

    How many signs and symptoms are required for a necrotic pulp diagnosis?

    <p>At least three</p> Signup and view all the answers

    What can be affected in a complicated crown fracture?

    <p>Enamel, dentin, and pulp</p> Signup and view all the answers

    What is the preferred repair option for an uncomplicated crown fracture with good approximation of tooth fragments?

    <p>Dentin bonding</p> Signup and view all the answers

    What increases the reattachment strength of a tooth fragment before bonding?

    <p>Rehydrating</p> Signup and view all the answers

    What is required for successful vital pulp therapy?

    <p>Coronal seal and appropriate capping material</p> Signup and view all the answers

    What are the biologic consequences of complicated crown fracture in the first 24 to 48 hours?

    <p>Moderate inflammation and pulpal proliferation, with necrosis possible without treatment.</p> Signup and view all the answers

    What is used in direct capping for complicated crown fracture to cause chemical amputation of the blood coagulum and remove damaged pulp cells, dentin chips, and debris?

    <p>Sodium hypochlorite (NaOCl)</p> Signup and view all the answers

    What is the main benefit of Calcium Hydroxide as a capping material for vital pulp therapy?

    <p>It inhibits bacterial proliferation</p> Signup and view all the answers

    Why is Mineral Trioxide Aggregate (MTA) not recommended any longer in anterior teeth?

    <p>It causes staining of the remaining crown</p> Signup and view all the answers

    Which pulp-capping material exhibits superior color stability compared to MTA after 6 months?

    <p>Biodentine</p> Signup and view all the answers

    What is the action of Calcium Hydroxide (Ca(OH)2)?

    <p>Inhibition of bacterial proliferation and effect on endotoxins</p> Signup and view all the answers

    What material induces favorable effects on reparative process during vital pulp therapy and could be considered as an alternative to ProRoot MTA?

    <p>Biodentine</p> Signup and view all the answers

    What is the follow-up period recommended for complicated crown fracture in vital pulp therapy?

    <p>6-8 weeks and 1 year</p> Signup and view all the answers

    What is the fifth most prevalent disease or injury after permanent caries, tension-type headache, iron-deficiency anemia, and age-related and other hearing loss?

    <p>Traumatic dental injuries</p> Signup and view all the answers

    Which age groups experience two peaks in incidence of dental trauma?

    <p>Ages 2 to 4 and 8 to 14</p> Signup and view all the answers

    What is the noted risk factor for dental trauma among children and teenagers?

    <p>Severe overjet (8 mm or more)</p> Signup and view all the answers

    Which study found that adolescents with a history of trauma had 4.85 times greater odds ratio for additional trauma?

    <p>Ramos-Jorge ML et al., 2008</p> Signup and view all the answers

    What is recommended for a comprehensive examination after dental trauma?

    <p>Several angles of radiographs</p> Signup and view all the answers

    What are significant public health problems that dental teams should be familiar with for identifying victims of all ages?

    <p>Violence and abuse</p> Signup and view all the answers

    Which teeth are most likely to be involved in traumatic injuries?

    <p>Central upper incisors (40-60%)</p> Signup and view all the answers

    Which age group experiences the two peaks in incidence of dental trauma?

    <p>Ages 2 to 4 and 8 to 14</p> Signup and view all the answers

    What is the most likely tooth to be involved in traumatic injuries?

    <p>Central upper incisors</p> Signup and view all the answers

    What are the significant public health problems that dental teams should be familiar with for identifying victims of all ages?

    <p>Violence and abuse</p> Signup and view all the answers

    What type of symptoms after a dental injury can indicate more serious injuries?

    <p>Headache and nausea</p> Signup and view all the answers

    What does adherence to the International Association of Dental Traumatology (IADT) guidelines for treating dental trauma lead to?

    <p>Better outcomes with lower complication rates</p> Signup and view all the answers

    What is the prevalence and incidence of dental trauma among adolescents?

    <p>High prevalence</p> Signup and view all the answers

    What is the recommended approach for schoolchildren with untreated dental injuries?

    <p>Early orthodontic intervention</p> Signup and view all the answers

    What is necessary for diagnosing dental trauma?

    <p>Clinical exam and radiographic exam</p> Signup and view all the answers

    What are the common signs of more serious injuries after a dental trauma?

    <p>Behavioral changes and unexplained irritation</p> Signup and view all the answers

    What type of radiographs are recommended for a comprehensive examination after dental trauma?

    <p>Both intraoral and extraoral radiographs</p> Signup and view all the answers

    What increases the risk of dental trauma in children and teenagers?

    <p>Severe overjet</p> Signup and view all the answers

    What can untreated dental injuries in schoolchildren impact?

    <p>Eating and enjoying food, smiling and showing teeth, overall quality of life</p> Signup and view all the answers

    Study Notes

    • IADT Radiographic examination recommends min. 4 radiographs for every dental injury: 1 maxillary occlusal radiograph, 1 parallel periapical radiograph of lower incisors, and potentially more for mandibular teeth injuries.

    • Radiographic examinations aim to investigate injuries, conclude on possible injuries, and look for more injuries.

    • CBCT is best evaluation for dental trauma but requires immediate access and consideration of the ALARA principle.

    • Cold test is most effective on incisal 1/3 for sensibility tests; false negatives common soon after injury.

    • Necrotic pulp diagnosis requires at least two signs and symptoms.

    • Dental trauma crown injuries can be uncomplicated or complicated, affecting enamel, dentin, and pulp.

    • Uncomplicated crown fracture: most common dental injury, with minimal biologic consequences, requires sensitivity tests, radiographic evaluation, and esthetic repair.

    • Esthetic repair options include dentin bonding or Ca(OH)2 base, with dentin bonding preferred with a good approximation of the tooth fragments.

    • Rehydrating a tooth fragment before bonding increases reattachment strength, according to a study with bovine teeth.

    • Complicated crown fracture: involves enamel, dentin, and pulp, requires sensitivity tests, radiographic evaluation, vital pulp therapy, and consideration of biologic consequences.

    • Vital pulp therapy success requirements: capping of healthy pulp, bacteria tight coronal seal, and appropriate capping material.

    • Biologic consequences of complicated crown fracture in the first 24 to 48 hours: minimal inflammation and pulpal proliferation, with necrosis possible without treatment.

    • Complicated crown fracture direct capping: uses 5% NaOCl in a cotton pellet, causing chemical amputation of the blood coagulum and removing damaged pulp cells, dentin chips, and debris.

    • Dental trauma is a neglected condition that could rank fifth among the world's most frequent acute/chronic diseases and injuries. (Petti S et al., 2018)

    • Traumatic dental injuries are the fifth most prevalent disease or injury after permanent caries, tension-type headache, iron-deficiency anemia, age-related and other hearing loss, and preceding migraine and genital herpes. (Petti S et al., 2018)

    • Adherence to the International Association of Dental Traumatology (IADT) guidelines for treating dental trauma leads to better outcomes with lower complication rates. (Bücher K et al., 2013)

    • Dental trauma has two peaks in incidence: ages 2 to 4 and 8 to 14. (Andersen & Ravn, 1972; HayrinenöImmonen et al., 1990)

    • Children and teenagers with severe overjet (8 mm or more) have a higher risk of dental trauma, but early orthodontic intervention is not well proven to reduce the risk. (Forsberg & Tedestam, 1993)

    • The prevalence and incidence of dental trauma among adolescents is high. A prospective cohort study found that those with a history of trauma had 4.85 times greater odds ratio for additional trauma. (Ramos-Jorge ML et al., 2008)

    • Violence and abuse are significant public health problems, and dental teams should be familiar with diagnostic tools and surveys for identifying victims of all ages. (Thompson LA et al., 2013)

    • Schoolchildren with untreated dental injuries are more likely to experience an impact on eating and enjoying food, smiling and showing teeth, and overall quality of life. (Ramos-Jorge J et al., 2014)

    • Central upper incisors (40-60%), lateral upper incisors (20-30%), and lower incisors (20-30%) are the most likely teeth to be involved in traumatic injuries. (Traumatic Injuries)

    • Fact finding, clinical exam, and radiographic exam are necessary for diagnosing dental trauma. (Traumatic Injuries)

    • CNS symptoms after a dental injury, such as headache, nausea, vomiting, behavioral changes, and unexplained irritation, can indicate more serious injuries. (Traumatic Injuries)

    • Radiographs are necessary immediately after a dental trauma to assess the situation, decide on appropriate treatment, and have a baseline for comparison. (Traumatic Injuries)

    • Several angles of radiographs are recommended for a comprehensive examination after dental trauma. (IADT)

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