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Paediatrics > FPM > Flashcards

FPM Flashcards

1
Q

what percentage of 11 year olds have caries affecting the FPM?

A

50%

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2
Q

Caries in the occlusal surface of 6’s accounts for how much caries in children?

A

90%

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3
Q

Why are FPM so prone to caries?

A

they erupt at a young age and they often go un noticed and enamel defects are common

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4
Q

What do you need to take before deciding treatment options for FPM?

A

clinical exam

radiographic exam

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5
Q

What are the three main treatment options for FPM of poor prognosis?

A

Extract
retain
Keep until ideal time

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6
Q

What factors would influence treatment choice for FPM?

A

Patient
Dental
Orthodontic

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7
Q

What patient factors must you consider?

A 
Medical
symptommatic
behavioura
motivation
OH
Cost
pt prefernce
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8
Q

What dental factors would influence your treatment choice for FPM?

A

extent of lesion
presence and condition of remaining dentition eg are 8’s presnt and position of 5
is the enamel prone to furrther breakdown
vitality
stage of develpment/dental age

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9
Q

Which orthodontic factors would influcence your decsion re FPM?

A

malocclusion: this will influence timing of xla
hypodontia
make sure you have an orthodontic input

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10
Q

What is the ideal situation if the 6’s are extracted?

A

mesial migration of 7’s to replace 6’s and then if 8’s are present they will complete the dental arch

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11
Q

What are the advantages of XLA FPM?

A

immediate resolution of symptoms
once off procedure
space created could be used to alleviate crowding in buccal segments, reduce overjet and create space for 8’s to come through

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12
Q

What are the disadvanatges to xla FPM?

A

loss of permanent tooth
may need GA or RA
need to deal with the consequences of late or early extrcations
pt may need ortho after which prolongs treatment time and complexity

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13
Q

When is the ideal time to xla FPM?

A

When the root bifurcation of the 7’s are forming which is usallt around 9 yrs

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14
Q

WHat happens if you extract the FPM too early?

A

the 5 will escape distally

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15
Q

What happens if you xtarct the FOM too late?

A

the 7 tips rather then moving mesially

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16
Q

under which circumstance would could you maintain the FPM?

A

it must be restorable

17
Q

What factors must you take into account of you were going to restore the FPM?

A 
extent of lesion
qulaity of enamel
moisture control
pateint co operation
symptoms
caries risk
18
Q

What are the options for FPM with deep caries?

A

Indirect pulp cap
direct pulp cap
partial pulpotomy
pulpectomy

19
Q

WHen would you do an indirect pulp cap and what would you use?

A

deep caries with no pain

removal caries from periphery and leave some over the centre t avoid pulpal exposure
place CaOH or GIC over the pulpal area and then go back into the tooth after 6 months once some repative dentine has been laid down

20
Q

When would you do a direct pulp cap?

A

this is not advised

21
Q

Why are partial pulpotomies succesful in young perm teeth and how would you perform one?

A

because they have increased vascularisation

LA and Rubber dam
remove all caries and inflamed pulp usually about 2mm until healthy pulp is found

22
Q

What is the most likely treatment that will be carried out on a FPM that is still vital and has deep caries?

A

indrict pulp cap

23
Q

How effective are RCT’s/pulpectomy in YPD?

A

not very
this is because apices immature
long term success is 36% Peretz et al 1997

committing child to life long maintenance

24
Q

What is the best treatment option for non vital FPM?

A

EXTRACT

25
Q

What would be the purpose of maintain a FPM?

A

This is to maintain when futrue loss is planned

26
Q

How can you maintain FPM?

A

SSC

GIC, RMGIC

27
Q

What are the advantages of using SSC to maintain?

A 
prevents further breakdown since full coverage
relieves sensitivity
longevity
quick and inexpensive
single visit
28
Q

What are the disadvantages of using SSC to temporise FPM?

A

Expensive
LA may be required
occlusion affcted
need to monitor eription of 7

29
Q

WHat are the advantages of mainting the FPM with GIC?

A

fluoride release
easy to place
tolerant to moisture contamination

30
Q

What are the disadvantages to mantaing the FPM with GIC?

A

poor physical properties

no full coverge so wont help with further breakdown

Paediatrics (31 decks)

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