Ext's, and Space Maintenance

Question 1

what are need for a pediatric extraction?

Answer 1

• curette
• elevator
• ant/post forceps
• -150S/151S

Question 2

what instruments are contratindicated for extractions for kids?

Answer 2

cowhorns

*or any instrument that could damage perm successor

Question 3

what do you reflect the tissue with?

Answer 3

currette

Question 4

what does elevetion protect against?

Answer 4

prevents root fracture

-use finger rest and support mandible

Question 5

for anterior primary teeth, what type of leverage do you use most?

Answer 5

rotaitonal movement mroe than buccolingual movement

Question 6

for post primary teeth, what type of leverage do you use most?

Answer 6

buccolingual movement

Question 7

what could cause aspiration during ext of primary tooth?

Answer 7

• poor visibility
• proportionally large tongue in children
• unexpected movements

Question 8

how do you prevent aspiration in kids during exts?

Answer 8

• head control

- use gauze as a throat screen

Question 9

what are the complications with root fracture?

Answer 9

• aggressive retrieval can damage perm tooth
• common sense approach (if visible and mobile take it out, if not let resorb)
• will usually resorb
• notify parent

Question 10

what happens if a perm tooth is extracted during the ext of a primary tooth?

Answer 10

immediately reimplant

Question 11

when should ext be done in a long or colex procedure?

Answer 11

at the end

Question 12

what are the post-op instrucitons for pedo ext?

Answer 12

• firm pressure
• motrin prn pain
• numb lip precautions
• expectations (space maintenace required?)

Question 13

what is always the best space maintainer?

Answer 13

natural tooth

Question 14

what is the goal of space maintanence?

Answer 14

to prevent loss of arch length, width, and perimeter by maintaining the relative position of the existing dentition

Question 15

generally, do we do space maintenance for ant teeth?

Answer 15

no

Question 16

when is space maintenance univerally indicated?

Answer 16

posterior

Question 17

premature loss in the primary dentition generally does what to the successor?

Answer 17

delays eruption of the successor

*appliances must be monitored, adjusted, potentially replaced for longer periods

Question 18

if it is getting close to normal exfoliation, ext primary tooth in the mixed dentition doees what to the successor

Answer 18

accelerates eruption

• most after age 8
• 6 months for every mm

Question 19

most space loss in the mixed dentition occurs within ___ months

Answer 19

6

Question 20

when is space maintenance unnecessary?

Answer 20

if the perm first molars are erupted and in occlusion and primary second molars remain

Question 21

what are the indications of band and loop appliances for space maintenance?

Answer 21

• unilateral loss of primary first molar before eruption of perm first molar or primary second molar
• bilateral loss of primary molar before the eruption of the perm incisors

Question 22

what are the contraindications of band and loop appliance?

Answer 22

eduntulous space is more than one tooth

Question 23

what are the indications of a LLHA?

Answer 23

• bilateral tooth loss AFTER eruption of perm incisors in mandib
• edentuous span more than one tooth in mandib

Question 24

what are the contraindications for LLHA?

Answer 24

perm incisors unerupted

Question 25

what are the indications of a nance appliance and a TPA?

Answer 25

• bilateral tooth loss in maxilla
• edentulous span more than one tooth in maxilla

*do not have to wait for perm incisors

Question 26

what is the controversy with nance vs TPA?

Answer 26

TPA is cleaner but some think it allows tooth movement

Question 27

what is a space maintainer used if there is loss of primary second molar before eruption of perm first molar?

Answer 27

distal shoe