Final Exam Flashcards
When does the maxilla grow, and how does it happen?
- Intramembranous Ossification
- Sutural apposition & surface remodeling
- Moves out from under cranium- downward and forward
How does the mandible grow?
- Chin?
- Condyle?
- Ramus?
Endochondral & Intramembranous
- Chin - downward & forward
- Condyle - upward & backward
- Ramus - grows away from chin
Developmental Milestones:
- Tooth buds appear?
- Major development of face?
- Fusion of palatal shelves?
- Deciduous teeth begin to calcify?
- Reflexes develop?
- Permanent teeth begin to calcify?
- 6th week
- 3-6th week
- 7-8th week
- 14th week (or 16th week)
- 14-32nd week
- Birth
What are the time lines for the formation and eruption of primary teeth?
Review chart
What are the different anomalies in the mouth of the newborn?
- Inclusion Cysts
- Epstein’s pearls
- Bohn’s nodules
- Dental-lamina cysts
- Natal & Neonatal Teeth
- Predeciduous teeth
- Primary teeth
- Eruption hematoma
- What inclusion cyst is found on the midpalatal raphe?
- Buccal & lingual aspects of dental ridges?
- Crests of alveolar ridge?
- Epstein’s pearls
- Bohn’s nodules
- Dental-lamina cysts
What’s the difference between natal teeth and neonatal teeth?
- Natal teeth - present at birth
- Neonatal teeth - erupt within 30 days of birth
What are predeciduous teeth?
- Supernumerary teeth, defective, mobile
- Incidence 1 in 4000
- Risk for aspiration, removal is generally recommended
Describe the characteristics of primary teeth that erupt prematurely?
- Normal primary teeth
- Incidence 1 in 2000
- Should not be extracted (if possible)
- Radiograph helpful
What is the eruption sequence of primary teeth?
ABDCE
What is the eruption sequence for maxillary and mandibular permanent teeth?
- Maxillary - 6-1-2-4-5-3-7-8
- Mandibular - 6-1-2-3-4-5-7-8
What’s the rule of 6 regarding flouride supplements?
- Less than 6 months - No Flouride
- More than 0.6ppm - No Flouride
- More than 16 years - No Flouride
- Dosage changes at 6 months, half of 6 (3 years) and at 6 years
What is the Tanaka Johnson formula?
- mandibular incisor length/2 + 11 (max or 10.5 mandibular)
What’s the prevalence of diastemas in 6,9 and 14 year olds?
- 6 (ugly duckling) - 44-97%
- 9 - 33-46%
- 14 - 7-20%
What are the etiologies for diastemas?
- Normal
- Space, small teeth, supernumary
- Habit, malocclusion
- Frenum - may be effect, rather than cause
What’s the treatment for diastemas?
After eruption of the permanent canines, based on diagnosis of cause
What’s the standard protocol for X-rays?
- No “standard” prescription
- Order radiographs only if diagnostic yield is expected to effect care
What do you consider when giving X-rays?
- Age of patient/cooperation
- Oral hygiene
- Position of teeth
- Patient history
- Clinical exam
- Caries risk assessment
What is the SLOB rule?
Same Lingual, Opposite Buccal
When do you place a protective liner?
When all the decay is gone and there is no exposure
When do you place an indirect pulp cap?
Leave some of the decay and seal it, with the intention to come back and fix it after tertiary dentin has formed
When do you do a pulpectomy?
On a non-vital tooth
When would you perfrom an apexification?
Non vital, permanent immature tooth
Do you perform apexifications on primary teeth?
NO
What is apexogenesis?
The vital tooth used to keep it to continue to develop
What’s the website for trauma of teeth?
Dental Trauma guide.org
When do you splint for 2 weeks or 4 weeks?
- 2 weeks - subluxation, extrusion, intrusion, alvusion
- 4 weeks - lateral luxation, delayed avulsion
What do you do with avulsed primary teeth?
Do not re-implant them!
What is the order from better to worse of tooth transport medium?
- Biospan (best, but hardly used)
- Hank’s
- Milk
- Saliva
- Saline
- Water
How do you make splints?
- Small ortho wire, or monofilament fishing wire and composite
- Try to include 2 other non-affected teeth on either side
- Must allow for movement or risk of akylosis
If the alveolus is not involved, how long do you have to splint for?
2 weeks - no alveolus
4 weeks if alveolus is involved
What is a shallow pulpotomy called?
Cvek pulpotomy
What do you do in a partial pulpotomy due to trauma, in which the inflammed pulp needs to be removed, just the first couple millimeters?
Cvek Pulpotomy
What’s the goal for doing Cvek pulpotomies?
Apexogenesis - to keep the permanent tooth
What are some features of childs mandible vs adults?
- Mandibular forament located below the occlusal plane
- Bone is less dense = quick onset
- Ramus is shorter and narrower anteroposteriorly
What is the most common problem regarding local anesthetics in children?
Self trauma - lip biting
How do you calculate the mg of a cartridge of lidocaine?
1.8mL x 20 mg/mL = 36mg
What is the maximum dosage/weight for lido and septo?
- Lidocaine 2% - max dose - 4.4mg/kg (2mg/lb)
- Septocaine 4% - max dose - 7mg/kg
Absolute max dose
- Lido 2%- 300mg
- Septo 4%- 500mg
What is the correct way to document anesthetics in the clinic?
- 36mg lido 2% with 0.018mg epi (or)
- 36mg lido 2% with 1:100,000 epi
Describe the Brodsky’s scale?
Tonsil coverage of posterior oro-pharynx
- 0 - in fossa
- +1 - <25%
- +2 - >25%<50%
- +3 - >50%<75%
- +4 - >75%
How do you estimate what the systolic blood pressure should be, because pulse and respiratory rate decrease with age, while blood pressure increases?
90+(2 x age) = systolic
