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Pedo 1 > Lecture 6 > Flashcards

Lecture 6 Flashcards

1
Q

Lower permanent first molars tend to ___

Upper permanent firs molars tend to ___

A

Tip and drift mesially

Remain upright but drift mesial (around palatal root?)

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2
Q

What is the primary objective of pulp therapy in the primary dentition?

A

Prevent or eradicate infection and to maintain the integrity and health of the teeth and their supporting tissues

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3
Q

What are the other objectives of pulp therapy?

A

Prevent space loss and malocclusion

Aid in mastication

Preserve the primary tooth in the case of hypodontia

Prevent possible speech problems

Maintain esthetics (more important for parent)

Prevent aberrant tongue habits

Prevent potentially damaging psychosocial effects (getting bullied)

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4
Q

Primary molars can last ___ years if they are kept well

A

30-40

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5
Q

Which has a larger margin of error, second or first primary molars?

A

Second

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6
Q

What are some materials used for protective liners?

A

GLUMA (5% gluteraldyhyde and 35% HEMA. Useful as desensitized, cavity disinfectant, a resetting agent and an adhesion promoter.

Glass ionomer

RMGI

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7
Q

You can do an indirect pulp cap when the tooth has ___ or ___, when the deepest carious dentin is not removed to avoid a pulp exposure.

A

No pulpitis

Or reversible pulpits

Success rate depends most significantly on the diagnosis

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8
Q

True or false.. it is ok to leave affected dentin and infected dentin.

A

False. You may leave affected denting but you must remove all infected dentin

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9
Q

True or false… you may do an indirect pulp cap when there is radiographic evidence of pathologic external or internal root resorption or other pathologic changes

A

False

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10
Q

True or false.. you can do indirect pulp caps on teeth with reversible pulpitis

A

True

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11
Q

True or false.. MTA or calcium hydroxide can stimulate dentin formation

A

True

Primary teeth heal up better than permanent teeth

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12
Q

When is a protective liner indicated?

A

In a tooth with normal pulp when all caries is removed for a restoration. Protective liner can be placed in the deep areas of prep to minimize injury to pulp and promote pulp tissue healing and minimize post op sensitivity

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13
Q

What are some materials used for an indirect pulp cap?

A

Calcium hydroxide (GI or reinforced ZOE should be placed over it)

ZOE

MTA

RMGI

GI cement

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14
Q

Why must you place GI or ZOE over calcium hydroxide?

A

Calcium hydroxide has high solubility, making a poor seal and low compressive strength. ZOE/GI provides a better seal preventing microleakage

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15
Q

What materials are used in direct pulp caps?

A

Calcium hydroxide

MTA

(Remember that GI or ZOE should be placed over it)

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16
Q

If you are going to do a pulpotomy, what should you do before you excavate the careis?

A

Prepare the tooth for full coverage

17
Q

What are some matierals used in a pulpotomy?

A

Formocresol - devitaliztion/fixation

Ferric sulfate and chlorhexidine - preservation

MTA - regeneration

Filling - ZOE(IRM)

*although the medicaments and materials may change, the access opening technique will remain the same

18
Q

If you see that the coronal pulp doesn’t bleed or doesn’t stop bleeding, should you do a pulpotomy?

A

No, this means the inflammation has gone beyond coronal pulp, do a pulpectomy

19
Q

What are the indications for a pulpectomy?

A

Primary tooth with irreversible pulpits or necrosis

Roots should exhibit minimal or no resorption

20
Q

What materials are used in a pulpectomy?

A

ZOE

Iodoform paste - bacteriocidal, resoorbable

Although eh medicaments and materials may change, the access opening teachniques will remain the same

21
Q

What are some contraindication to pulp therapy in primary teeth?

A

Close to exfoliation

PA abscess formation with swelling and drainage unless the tooth deemed important

Cellulitis (just extract it)

Unrestorable tooth

Medically complex pedo pts (transplants, cancer, immunosuppression)

22
Q

What are the most important primary teeth to save?

A

Second primary molar prior to eruption of primary first molar (spacing issue)

This is really the only tooth you’d do pulp therapy on

23
Q

Especially in young permanent teeth with immature roots, the pulp is integral to continue ___

A

Apexogenesis

24
Q

True or false… a tooth without a vital pulp cannot remain clinically functional

A

False

25
Q

True or false… symptomatic or asymptomatic irreversible pulpitis is incapable of healing

A

True

26
Q

In permanent teeth, ___ and ___ tests may be helpful in diagnosing the pulp etiology

A

Electric pulp tests and thermal tests

27
Q

What are the signs and symptoms of irreversible pulpitis or necrosis?

A

Hx of spontaneous unprovoked toothache

Sinus tract

Soft tissue inflammation not resulting from gingivitis or periodontitis

Excessive mobility not associated with trauma or exfoliation

Furcation/apical radiolucency

Radiographic evidence of internal/external resorption

28
Q

What are the signs and symptoms of reversible pulpitis?

A

Provoked pain of short duration relieved by OTC analgesics

Pain caused by brushing or upon the removal of the stimulus and without signs or symptoms of irreversible pulpitis

29
Q

Any planned treatment should include consideration of what 4 things?

A

The patients medical history

The value of each involved tooth in relation to the child’s overall development

Restorablility of the tooth

30
Q

Post operative clinical assessment generally should be performed every ___ months

A

6

31
Q

Radiographic evaluation of primary tooth pulpotomies should occur at least once every ___ because…

A

Year

Success rate diminishes over time

32
Q

True or false… glass ionomer cements or reinforces ZOE restorative materials has the additional advantage of inhibitory activity against carcinogenic bacteria

A

True

33
Q

True or false… pulpotomy has been shown to have higher success rates than indirect pulp caps

A

False. Indirect pulp caps have better success rates than pulpotomies

34
Q

True or false… direct pulp capping of a carious pulp exposure in a primary tooth is not recommended

A

True

35
Q

In a partial pulpotomy for carious and traumatic exposures, pulp tissue is removed up to __mm to reach healthy pulp tissue. In both cases ___ is recommended over calcium hydroxide.

A

3

MTA

36
Q

What is apexification (root end closure)?

A

Method of inducing root end closure of an incompletely formed non-vital permanent tooth by removing the coronal and nonvital radicular tissue just short of the roots end and placing a biocompatible agent such as calcium hydroxide in the canal space. Use MTA or absorbable collagen wound dressing, then use gutta percha to fill the remaining canal space. If too thin you can fill with MTA or composit resin.

Pedo 1 (14 decks)

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