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BDS2 Clinical Dental Science > Paediatric > Flashcards

Paediatric Flashcards

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1
Q

what is the pattern of eruption of primary dentition

A

generally lowers before uppers except upper later

a,b,d,c,e

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2
Q

when is primary dentition complete by

A

2.5 to 3 years

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3
Q

what are some differences between primary and permanent teeth

A

primary has more narrow roots which tend to flare out to make way for permanent
primary enamel and dentine is much thinner
pulp is much larger and more easily exposed in a restoration

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4
Q

what can be seen in first primary molars

A

large mesiobuccal tubercle

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5
Q

what is in a second upper primary molar

A

transverse ridge

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6
Q

what is in a second lower primary molar

A

3 cusps

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7
Q

how is space created for permanent dentition

A

anthroid space - infront of upper canine and behind lower canine
primary molars are much bigger than the permanent premolars to come - leeway space
also incisors are more tilted in permanent

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8
Q

what is the pattern of eruption in permanent teeth

A

first molar, central incisor, lateral incisor
then upper - first premolar, second premolar, canine, 2nd and 3rd molars
lower - canine, 1st and 2nd premolar, 2nd and 3rd molar

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9
Q

why is orthodontics not given until canine is through

A

canine pushes the incisors together

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10
Q

what is the ugly duckling phase

A

when the roots of incisors are displaced ditsally, creating a gap midline

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11
Q

what is the sequence of restorations in paeds

A

prevention, fissure sealant, preventative restoration, shallow restoration, restoration requiring LA, pulpotomy

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12
Q

what should be the depth of occlusal cavity

A

no deeper than 1.5mm, risk pulpal exposure

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13
Q

what are the indications to use a crown

A

no radiographic evidence of caries into pulp, enough sound tissue for a crown to bond to

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14
Q

what are the benefits of using a crown

A

lasts much longer, less likely to get secondary caries, doesnt require LA or tooth prep so child doesnt have to co-ordinate too much

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15
Q

what other restorative materials are available and how do they compare to one another

A

amalgam (but not now), composite, compomer, RMGI, GI
amalgam lasts longer than all
compomer lasts longer than composite and RMGI
RMGI is better than GI
composite is not ideal - requires good moisture control - rubberdam, need LA

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16
Q

what instruments are required for placement of stainless steel crown

A

fissure bur, crown climper pliers, GI cement

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17
Q

what factors influence caries management in children

A

compliance, extent of caries, OH, space maintainer

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18
Q

what are the indications and contraindications for a pulpotomy

A

indications - reversible pulpitis, good haemostasis, good co-operation, space maintainer, medical history prevents exraction, hypodontia
contraindications - poor co-operation, poor dental attendance, multiple grossly carious teeth,

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19
Q

what are some disadvantages of extraction of primary teeth

A

allows for drifting, especially permanent molar, traumatic, impeeded speech and masticatory

20
Q

what is used in pulpotomy for controlling bleeding, calming pulp and cement

A

ferric sulphate held on for 20 seconds to stop bleeding, the calcium hydroxide or zinc oxide eugenol, then GIC cement for crown

21
Q

what are the indications for a pulpectomy

A

irreversible pulpitis, cannot achieve haemostasis, periapical absess, pulp necrosis

22
Q

briefly describe steps in a pulpectomy

A

remove roof of pulp chamber, remove coronal pulp, try ferric sulphate to reduce bleeding, use filers to remove pulpal tissue, then rinse pulp chambers with chlorhexidine, fill with CaOH, and over coronal, can then place GI cement for crown

23
Q

why should the files be stopped 2mm from working length

A

to prevent damage to developing tooth, apices are open so can go through to permanent tooth

24
Q

what is the first thing that should be done when a tooth is fractured

A

prevent bacterial ingress as this causes pulpal death

25
Q

what treatments are available for a pulpal exposure due to fracture in a vital immature tooth

A

pulp cap - stop bleeding, CaOH, then restoration - small exposure
pulpotomy - some pulpal tissue removed, arrest haemorrage, CaOH, GIC lining, restoration - large exposure
allows for continued root formation

26
Q

what treatments are available for pulpal exposure of a non-vital immature tooth

A

pulpectomy - removal of necrotic tissue
barrier formation
apexification

27
Q

what is involved in barrier formation

A

MTA is placed at the ends of the root, to seal off the apex, this is a thick cement, wait for this to harden (24hours), then can pack against this for filling root canals

28
Q

what is involved in apexification

A

place CaOH in root canal to induce apical barrier formation, place it then go back 3 months later, remove and place more, do this 3 times - takes 9 months - then definitive restoration

29
Q

what are some disadvantages of apexification

A

every time you go back in, cause harm

CaOH in root canals may cause dentine to become brittle

30
Q

what can calcium hydroxide be used for

A

in a pulpotomy - inducing a calcific barrier between pulp and restoration. also alkaline so good antibacterial properties

31
Q

what treatment plans are available for pulp exposure in a mature tooth

A

pulp cap - small exposure less than 24 hours

pulpotomy or pulpectomy - convential RCT

32
Q

what is first aid for an avulsed tooth

A

dont handle the root, dont allow it to dry out, place in saliva or fresh milk, you can wash under cold water for 10 seconds if obvious debris, get it reimplanted quickly

33
Q

what kind of splint is used for an avulsed tooth

A

flexible - composite wire is best

34
Q

what is disctintive of molar incisive hypomineralisation

A

well demarcated - chalky white or yellow/brown stains, depending on how much enamel is effected. Don’t have to have all teeth effected, can have just one molar. Not symmetrical

35
Q

what is the difference between hypomineralisation and hypoplastic teeth

A

hypomineralisation - problem at mineralisation phase in development, secretory phase is fine. tooth forms but doesnt harden well
hypoplastic - secretory phase doesnt happen well, tooth doesnt form the right shape. but mineralises fine so is hardened

36
Q

what is the difference between true hypoplastic and acquired

A

true - erupts in the wrong shape. acquired - might be hypomineralised, as it is soft, then breaks off and wrong shape

37
Q

what are the 3 clinical periods of enquiry in children with MIH

A

prenatal, peri-natal, post-natal

38
Q

what questions can be asked at each stage of enquiry

A

prenatal - any problems in the last trimester of pregnancy, e.g. pre-eclampsia, or gestational diabetes
perinatal - was the birth particularly traumatic? did the baby spend any time in the special baby unit?
post-natal - did they have any infections? how long were they breast fed for?

39
Q

what are some likely causes of MIH

A

prolonged breast feeding, past 6 months and not on solid foods, deprivation

40
Q

what differences were found in MIH teeth compared to normal teeth

A

more neural activation, more vascular, more immune cells

41
Q

what are the clinical problems with MIH

A

loss of tooth tissue, more tooth wear, less caries resistant, increased sensitivity and poor appearance

42
Q

what is the problem with using composite in MIH

A

poor bonding to the tooth with reduced enamel mineral content

43
Q

how does the treatment change for patients depending on their age

A

young - dont want to bleach, more likely to just do composite coverage
teen - can do acid pumice microabrasion followed by bleaching
older - can do veneers

44
Q

what is considered in extraction of HFPM’s

A

severity of MIH, age, skeletal, future ortho needs

45
Q

what age would HFPM be extracted

A

depending on when bifurcation of 7’s is seen, means when 7 erupts, can drift mesially, prevent any gaps. must also take out upper 6’s or will over erupt

46
Q

why might upper 6s not be extracted at same time as lower 6s

A

if overcrowded, wait until the 7 comes in before extracting. creates the space required for orthodontics, without losing the 5 too

BDS2 Clinical Dental Science (6 decks)

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