Paediatric dentistry Flashcards
What is the hall technique
Biological caries control method
No removal of caries
Caries are sealed within the preformed metal crown
What are the most successful restorative material on primary molars
Preformed metal crown
What techniques are used to treat cervical anterior and inerproximal caries
Cervical Caries
-hand excavate caries or use a slow speed handpiece with a round bur
-wash & isolate (preferably with rubber dam)
-either glass ionomer cement covered with vaseline or compomer
Interproximal caries ( strip crowns)
-hand excavate or use a slow-speed round bur
-wash & isolate (preferably with rubber dam)
-place an acetate strip into interproximal area and restore with compomer / composite
What bur should be used to prep for a preformed metal crown on primary teeth
Tapered diamond separating bur
How is the tooth prepped for a metal crown
Break contact area producing a knife edge finish (remove marginal ridges)
Reduce occlusal surface by 1-2mm
Remove only periphery of buccal and lingual (basically just sharp edges)
What are common problems associated with crowns
Rocking
Canting - leaning
Loss of space
What causes rocking
When the cervical margin is more than 1mm beyond the maximum curvature it becomes difficult to contour the margins sufficiently to contact all areas so open margins result in an unstable crown
What causes canting
Uneven reduction of occlusal surface
resolved by rounding the occluso-buccal line angle
What are separaters for
Make space for the crown to be fitted interproximally
What is used to stick the crown to the tooth
GI / cement
What are the steps to placing the crown
Dry the crown.
Fill with glass ionomer luting cement, ensuring the crown is well filled and there are no air bubbles.
Dry tooth if possible.
Place crown over tooth and partially seat until crown engages with the contact points.
Remove the finger and encourage the child to bite into place.
Or fully seat the crown with firm finger pressure alone
Extruded cement will need to be removed from margins asap (taste can upset the child).
Ask the child to bite firmly on the crown for 2 – 3 minutes or hold the crown with firm finger pressure
prevents crowns from springing back a short way and sucking back the cement from the margins and potentially reducing effective seal.
What minor failures can occur with metal crowns
new/secondary caries
filling/crown worn, lost or requiring other intervention
restoration lost but tooth restorable
reversible pulpitis treated without requiring pulpotomy or extraction
What major failures happen with metal crowns
irreversible pulpitis
abscess requiring pulpotomy or extraction
interradicular radiolucency
filling lost and tooth unrestorable
What is used to maintain space for permanent teeth is primary are lost/extarcted prematurely
Band and loop spacer
Distal shoe retainer
