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What is pulp testing?
If teeth are mobile, the vascular blood supply may have been disrupted. Extreme tooth mobility leaves little chance that the blood supply has not been damaged, and pulpal necrosis will likely develop. Response to test will determine necrosis of tooth.
Examples of pulp testing done in an emergency?
- Electric(vitality) pulp test: placing a electrode on the injured tooth then passed an electrical current through the tooth
- The current is increased until the patient feels a sensation on the tooth.
- Limited help with this since acute phase and not a normal anatomy.
- Thermal testing is better for an acute phase situation, but can also be misleading.
- Test a non-traumatized tooth first (baseline)
- -Quick response to heat = inflammation
- -No response = necrosis
- -Pain stops when cold is removed = normal response
- -Prolonged reaction to cold after removed = further assessment
- Follow up after healing for 7-10 days will provide better assessment.
- Laser Doppler Flowmetry = real-time measurement of RBC flow in minute vessels called Perfusion.
What does soft tissue injuries consist of?
- Often associated with facial trauma:
- tears of gingival tissue and displacement of teeth
- Lips commonly involved with punctures caused by bite injuries
How should one address soft tissue injuries?
- Wounds should be rinsed with saline and gently debrided with gauze and mild soap to remove any foreign objects and dead or damaged tissue.
- Appropriate sutures may be needed for repair
- May be necessary to refer pt to plastic or oral surgeon for complex suturing
What does the defense system provide?
Examples of human defense system?
- ▪Anatomic barriers: Epithelium and an ideal dentition
- ▪Normal oral flora: Bacteria that discourage colonization
- ▪Immune system: Cellular and humoral components
- ▪Saliva: Immunoglobins
(defense system)Anatomic barriers ?
epithelium and normal dentition
(defense system) Normal oral flora?
(bacteria that discourage colonization)
(defense system) Immune system
(cellular and humoral)
What age do children usually injure their teeth? which teeth?
- Children younger than 3 years
- Most frequently primary teeth maxillary incisors
Different types of crown fractures? what do they represent?
Crown fractures are categories of traumatic dental injuries from Class I to IV.
Crown fracture Class I?
involves just Enamel
Crown fracture Class II?
includes Enamel and Dentin
Crown fracture Class III?
Involves Enamel, Dentin, and pulpal tissue
Crown fracture Class IV?
Complete loss of the clinical crown