Cut slide ni!!

3)Fall from motorbike

Way of patient accident
-***Alleged : definition
4)PHOTOGRAPH IN TRIGGER 1
-Describe: This is clinical photograph of 16 years old student shows upper and lower lip, upper gingiva and teeth.
Teeth presence for the maxilla are 13 to 23,for the mandible are 33 to 43. For the 11,it is fractured ,pin point
bleeding on pulp area(exposed pulp),bleeding at cervical area .
-pinpoint bleeding on pulp area : Exposed pulp (why,treatment)
TRIGGER 2
Upon history taking, the patient is taking daily s/c injection for his medical problem. You also noticed a tobacco
odour from his clothes
On examination,he has a swollen upper lip
5) Comprehensive history taking and examination- (ALL part which includes complaints, hpc, pmh, pdh, sh,
etc)
16(D)
d)Upper # tooth
-Endo+crown/extraction(which one is suitable,the tooth can be safe or not(supra or
explain the tx and why!!!!)

sub),

Trauma
3)he alleged fall from motorbike
Way of patient accident
The patient only broke half of his cusp of
anterior tooth 11.
How?
Patient could be face-down when he fall

 4)PHOTOGRAPH IN TRIGGER 1
This is clinical photograph of Fazli, 16 years old
male student that shows upper and lower lip,
upper gingiva and teeth.
Teeth presence for the maxilla are 13 to 23,for
the mandible are 33 to 43.
11: half cuspal fracture that may involve enamel,
dentine and pulp horn, that also has evidence of
pin point bleeding on pulp area(exposed pulp),
also bleeding at swollen mesial cervical line area
of 11 .

Pinpoint bleeding on pulp area :

Exposed pulp (but it could be vital)
In patients with open apices, it is
advantageous to preserve pulp vitality by a
partial pulpotomy. This treatment is also the
choice in young patients with completely
formed teeth. Calcium hydroxide compounds
are suitable pulp capping materials. In
patients with mature apical development,
root canal treatment can be the treatment of
choice.
IADT Guidelines For The Management Of Traumatic Dental Injuries: 1. Fractures And Luxations Of Permanent Teeth, Dental
Traumatology 2012; 28.

 16(D) Upper # tooth

-Endo+crown/extraction(which one is
suitable, the tooth can be safe or not (supra or
sub), explain the treatment and why!!!!)
Savable *
no need to extract in this case

In young patients with immature, still developing teeth, it is

advantageous to preserve pulp vitality by pulp capping or partial
pulpotomy. Also, this treatment is the choice in young patients with
completely formed teeth. Calcium hydroxide is a suitable material to be
placed on the pulp wound in such procedures.
In patients with mature apical development, root canal treatment is
usually the treatment of choice, although pulp capping or partial
pulpotomy also may be selected
IADT Guidelines For The Management Of Traumatic Dental Injuries: 1. Fractures And Luxations Of Permanent Teeth, Dental
Traumatology 2012; 28.

Pulp Capping or Partial Pulpotomy

Treatment of exposed vital pulp in which the pulpal wound is sealed
with dental material, eg MTA or calcium hydroxide, to faciltate the
formation of reparative dentine and maintenance of a vital pulp.
Indications for permanent tooth partial pulpotomy
1. Tooth has no history of spontaneous pain.
2. Tooth has acute minor pain that subsides with analgesics.
3. Tooth has no discomfort to percussion, no vestibular
swelling and no mobility.
4. Radiographic examination shows normal appearance of
periodontal attachment.
5. Pulp is exposed during caries removal or subsequent to
recent trauma.
6. Tissue appears vital.
7. Bleeding from the pulp excision site stops with isotonic
saline irrigation within 2 minutes.

Torabinejad, 4th ed.

Review Article: Partial Pulpotomy For Immature Permanent Teeth, Its Present And Future, Cheng D. Fong, Martin J. Davis, Pediatr Dent 24:29-32,
2002

-provisional filling
-etch/composite bonding
technique

-Pulp: widened
-Superficial part removed to
depth 2-3mm

Calcium hydroxide
High pH irritate healthy pulp tissue 2nd dentine at exposed pulp

Direct Pulp Capping or

Root Canal Treatment

Pulp vitality
Radiographic evidence
Cost
Time
Success rate
Patients acceptibility