Further Treatment Planning

Question 1

What did the dundee cariology study find in terms of statistical significance?

Answer 1

The relationship between the observation of a clear band of dentine is statistically considered to be HIGHLY SIGNIFICANT.

Question 2

What % of hall crowns succeeded in the DDH study with a clear band of dentine?

Answer 2

97.3%

Question 3

What did the dundee cariology study find in terms of NOT statistical significance?

Answer 3

The relationship between depth of carious lesion and outcome is statistically considered to be NOT SIGNIFICANT (as long as there is a clear band of dentine).

Question 4

When will occlusal reequilibration occur after the placement of a hall crown?

Answer 4

4-6 weeks.

Question 5

Why can you not place hall crowns on opposing teeth?

Answer 5

Mouth will not be able to re equilibrate adequately which can lead to THEORETICAL TMJ PAIN + UNCOMFORTABLE PATIENT.

Question 6

Can you place multiple crowns in the same visit?

Answer 6

CAN PLACE MULTIPLE CROWNS IN THE SAME VISIT BUT THEY MUST NOT BE ADJACENT (NEIGHBORS) OR OCCLUDE ON TOP OF EACH OTHER.

Question 7

What is SDF?

Answer 7

clear, odourless, metallic-taste liquid that will stain most oxidizable surfaces black upon exposure to light due to the formation of a silver oxide layer

Question 8

What does S in SDF contain and what are its 3 effects?

Answer 8

• Effects on bacteria.- Hydroxyapatite doping- Collagen degradation inhibition

Question 9

What does the F in SDF do (2 effects)?

Answer 9

• Mineral formation (fluoroapatite - reduced degradation of hard tissues in acid). - Collagen degradation inhibition.

Question 10

What can you put after applying SDF?

Answer 10

Potassium iodide. Supposed to prevent the blackening effect by binding the free silver ions yet this DOESNT OCCUR.

Question 11

Indications for SDF (6)

Answer 11

• Patients at high risk of developing caries (xerostomia or severe early childhood caries).- Pre-cooperative children (very young children).- Treatment challenged by behavioral or medical conditions.- Patients with several carious lesions that may not all be treated in one visit.- Difficult to treat dental carious lesions (ex. root caries).- Patients without access to dental care.

Question 12

Contraindications for SDF?

Answer 12

• Silver allergy- Pain - Irreversible pulpitis or periapical periodontitis→Spontaneous, severe, constant pain or wakening child at night- Infection→Swelling of soft tissues, abscess or fistula- Patient refusing treatment or unable to cope- Unable to isolate tooth & maintain control over oral environment

Question 13

4 things you must do before placing SDF

Answer 13

• Will have already have agreed to the treatment plan- Ensure they know and the parent knows that the lesion will go dark/ black- Ensure the child has safety glasses on and an apron- Warn your nurse it will stain anything it touches!

Question 14

4 steps to the placement of SDF?

Answer 14

1. Isolation with cotton rolls, dry tooth with air2. Dispense a minimal amount of SDF into a dish3. Using a micro-brush, apply the SDF solution on to the carious lesion and agitate for 1 minute4. Remove excess SDF following procedure completion

Question 15

What was the % acceptability of SDF in children who did not require GA for treatment?

Answer 15

27% (vs 73% unacceptable).

Question 16

What was the % acceptability of SDF in children who otherwise required GA for treatment?

Answer 16

69% (vs 31% unacceptable).

Question 17

What is the concentration of SDF?

Answer 17

38%

Question 18

What is the off license use of SDF?

Answer 18

arresting caries

Question 19

In what lesions does GI not work?

Answer 19

Proximal lesions (only use in occlusal lesions).