The failure of a pulp to respond immediately after an

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The failure of a pulp to respond immediately after an accident is not an indication for endodontic therapy. Instead, emergency treatment should be completed, and the tooth should be retested at the next follow-up visit. Vitality test By cold, hot or by etecffic pulp tester. Very important point that the child come immediately after trauma and doesn’t I give response to vitalit y test because the tooth is in shock. Reexamination in the next visit after 6weeks If the child doesn’t give a response mean the tooth is died. In children the electric pulp tester is controversy because it needs cooperation and arelaxed 'child. When the child come
Lec 5 lubna AL Malah from the 1st time because of anxiety the child will give false response. RADIOGRAPHIC EXAMINATION The examination of traumatized teeth cannot be considered complete without a radiograph of the injured tooth, the adjacent teeth, and sometimes the teeth in the opposing arch. It may even be necessary to obtain a radiograph of the soft tissue surrounding the injury site in search of a fractured tooth fragment. The relative size of the pulp chamber and canal should be carefully examined. Irregularities or an inconsistency in the size of the chamber or canal compared with that of adjacent teeth may be evidence of a previous injury. This observation is important in determining the immediate course of treatment. In young patients the stage of apical development often indicates the type of treatment, just as the size of the coronal pulp and its proximity to the area of fracture influence the type of restoration that can be used. A root fracture as a result of the injury or one previously sustained can be detected by a careful examination of the radiograph. However, the presence of a root fracture may not influence the course of treatment, particularly if the fracture line is in the region of the apical third. Teeth with root fractures in this area rarely need stabilization, and a fibrous or calcified union will usually result.
Lec 5 lubna AL Malah If teeth have been discernibly dislocated, with or without root fracture, two or three radiographs of the area at different angles may be needed to clearly define the defect and aid the dentist in deciding on a course of treatment. Another value of the radiograph is that it provides a record of the tooth immediately after the injury. Frequent, periodic radiographs reveal evidence of continued pulp vitality or adverse changes that take place within the pulp or the supporting tissues. In young teeth in which the pulp recovers from the initial trauma, the pulp chamber and canal will decrease in size coincident with the normal formation of secondary dentin. After a period of time, an inconsistency in the true size or contour of the pulp chamber or canal compared with that of adjacent teeth may indicate a developing pathologic condition.

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