Paediatric session slides Flashcards
What should restorations be to the highest standard possible to maximise?
restorations should be to the highest standard possible to maximise the longevity of the restorations
What are operative differences between children and adults?
operative differences between children and adults:
- developmental maturity/behaviour
- constant change
- developing dentition
- operator access (smaller mouths)
- tooth size and shape
- preventive care
- choice of restoration
What questions should you ask when taking a pain history from a child?
taking a pain history from a child:
- where is the pain?
- what does the tooth feel like?
- how long has the tooth been painful?
- does anything make it better or worse?
- does it stop you sleeping?
- relieved by analgesics or antibiotics?
- spontaneous or precipitated?
Sequence of restoration:
>
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in upper arch first
sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in upper arch first
Sequence of restoration:
> prevention
>
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in the upper arch first
sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in the upper arch first
Sequence of restoration:
> prevention
> fissure sealants
>
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in the upper arch first
sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in the upper arch first
Sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
>
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in the upper arch first
sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in the upper arch first
Sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
>
> pulpotomies in the upper arch first
sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in the upper arch first
Sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
>
sequence of restoration:
> prevention
> fissure sealants
> preventive restorations
> simple fillings (eg. shallow cervical cavities)
> fillings requiring LA but not into pulp in co-operative children
> pulpotomies in the upper arch first
Would minimal cavities that require hand excavation or limited caries removal with a slow speed handpiece require LA?
no , minimal cavities that require hand excavation or limited caries removal with a slow speed handpiece may not require LA
What is the maximum dose of lignocaine in mg/kg?
the maximum dose of lignocaine is 4.4mg/kg
What is the maximum dose of prilocaine in mg/kg?
the maximum dose of prilocaine is 6mg/kg
With primary molar cavity design, what size should the occlusal portion be no greater than?
with primary molar cavity design, the occlusal portion should be no greater than 1.5mm
What should primary molar cavity design include?
primary molar cavity design should include all pits and fissures
What should be preserved in primary molar cavity design?
transverse ridges should be preserved in primary molar cavity design
What can be said about transverse ridges in primary molar cavity design?
in primary molar cavity design, transverse ridges should be preserved unless they are undermined by caries
When should transverse ridges not be preserved in primary molar design?
transverse ridges should not be preserved in primary molar design unless they are undermined by caries
How deep should an occlusal cavity on a primary molar be?
an occlusal cavity on a primary molar should be around 1.5mm deep
An occlusal cavity in a primary molar should be around 1.5mm deep - what is used to create this cavity?
an occlusal cavity in a primary molar should be around 1.5mm deep, use a high speed fissure or round bur to create this
For an interproximal cavity in primary molars, what width should the isthmus be relative to the width of the occlusal surface?
for an interproxima cavity in primary molars, the isthmus should be 1 / 2 to 1 / 3 of the width of the occlusal surface
For an interproximal cavity in primary molars, what does the axial wall follow?
for an interproximal cavity in primary molars, the axial wall follows the contour of the tooth
For an interproximal cavity in primary molars, what can be said about the line angles?
for an interproximal cavity in primary molars, the line angles are rounded
For an interproximal cavity in primary molars, what should be 1 / 2 to 1 / 3 of the width of the occlusal surface?
for an interproximal cavity in primary molars, the isthmus should be 1 / 2 to 1 / 3 of the width of the occlusal surface
In a box preparation in primary teeth, what does the axial wall follow?
in a box preparation in primary teeth, the axial wall follows the contour of the tooth
In a box preparation in primary teeth, what follows the contour of the tooth?
in a box preparation in primary teeth, the axial wall follows the contour of the tooth
In a box preparation in primary teeth, what can be said about line angles?
in a box preparation in primary teeth, there is rounded line angles
In a box preparation in primary teeth, is there an occlusal extension?
no , in a box preparation in primary teeth there is not occlusal extension
When a minimal box preparation is required, is dental dam used?
yes , for a minimal box preparation, ideally use dental dam
What is a matrix and wedge used to obtain?
a matrix and wedge is used to obtain good contact points
What can be used to obtain good contact points in interproximal box preparations?
in interproximal box preparations, a matrix and wedge can be used to obtain good contact points
What bur(s) should be used for an occlusal cavity preparation?
for an occlusal cavity preparation, a round bur should be used for the plunge cut or/then a fissure bur
What bur should be used for an interproximal cavity preparation?
a fissure bur should be used for an interproximal cavity preparation
What bur should be used for a minimal interproximal box preparation?
a fissure bur should be used for a minimal interproximal box preparation
What are examples of restorative materials used in paediatric dentistry?
restorative materials used in paediatric dentistry:
- fissure sealants
- temporary and intermediate dressings (eg. ZOE)
- glass ionomer
- resin modified glass ionomer
- compomer
- composite
- preformed metal crowns
- amalgam - although banned in under 15s from July 2018
What should you base the requirement of local anaesthetic on?
local anaesthetic use should be based on the:
- extent of caries
- longevity of the tooth
- co-operation of the child
What should the choice of restorative material be based on?
the choice of restorative material should be based on the:
- caries extent
- longevity of the tooth
- co-operation of the child
What has a greater success in interproximal cavities after 3 years - RMGIC or conventional GIC?
RMGIC has a greater success in interproximal cavities after 3 years than conventional GIC
What can be said about preformed metal crowns in terms of longevity?
preformed metal crowns have the greatest longevity when compared to other resotrative materials
What can be said about the failure rates of amalgam and compomer over a 3 year period?
amalgam and compomer have similar failure rates over a 3 year period
What lasts the shortest time out of amalgam, compomer and GIC?
amalgam and compomer both last longer than GIC, GIC lasts the shortest time
What is more successful - RMGIC or conventional GIC?
RMGIC is more successful than conventional GIC
What is the most successful restorative material in primary molars?
preformed metal crowns are the most successful restorative material in primary molars
Cervical caries:
- hand excavate caries or use a X speed handpiece with a round bur
- wash and isolate (preferably with rubber dam)
- either glass ionomer cement covered with Vaseline or compomer
X - slow
Cervical caries:
- hand excavated caries or use a slow speed handpiece with a X bur
- wash and isolate (preferably with rubber dam)
- either glass ionomer cement covered with Vaseline or compomer
X - round
Cervical caries:
- hand excavate caries or use a slow speed handpiece with a round bur
- wash and X (preferably using rubber dam)
- either glass ionomer cement covered with Vaseline or compomer
X - isolate
Cervical caries:
- hand excavated caries or use a slow speed handpiece with a round bur
- wash and isolate (preferably with rubber dam)
- either X covered with Vaseline or compomer
X - glass ionomer cement
Cervical caries:
- hand excavated caries or use a slow speed handpiece with a round bur
- wash and isolate (preferably with rubber dam)
- either glass ionomer cement covered with X or compomer
X - Vaseline
Cervical caries:
- hand excavated caries or use a slow speed handpiece with a round bur
- wash and isolate (preferably with rubber dam)
- either glass ionomer cement covered with Vaseline or X
X - compomer
Interproximal caries (strip crowns):
- hand excavate or use a X round bur
- wash and isolate (preferably with rubber dam)
- place an acetate strip into interproximal area and restore with compomer/composite
X - slow speed
Interproximal caries (strip crowns):
- hand excavate or use a slow speed X bur
- wash and isolate (preferably with rubber dam)
- place an acetate strip into interproximal area and restore with compomer/composite
X - round
Interproximal caries (strip crowns):
- hand excavate or use a slow speed round bur
- wash and isolate (preferably with rubber dam)
- place an X strip into interproximal area and restore with compomer/composite
X - acetate
Interproximal caries (strip crowns):
- hand excavate or use a slow speed round bur
- wash and isolate (preferably with rubber dam)
- place an acetate strip into X area and restore with compomer/composite
X - interproximal
Interproximal caries (strip crowns):
- hand excavate or use a slow speed round bur
- wash and isolate (preferably with rubber dam)
- place an acetate strip into interproximal area and restore with X /compomer
X - composite
What instruments are needed for placing a stainless steel crown?
instruments needed for placing a stainless steel crown:
> tapered diamond separating bur
> preformed metal crowns
> glass ionomer luting cement
> crown crimping pliers
> curved crown scissors
What different techniques can you use for crown selection?
crown selection techniques:
- measure mesio-distal width of crown or space with dividers
OR - trial and error after crown preparation
OR - impression and crown prep on model
In the crown preparation for stainless steel crowns, where do you start marginal ridge reduction from?
in the crown preparation for stainless steel crowns, start marginal ridge reduction from the occlusal portion of the marginal ridge
What bur should be used in the interproximal preparation for stainless steel crowns?
a tapered diamond separating bur should be used in the interproximal preparation for stainless steel crowns
When preparing for stainless steel crowns, the contact area should be broken and what finish should be created mesially and distally?
when preparing for stainless steel crowns, the contact area should be broken and a knife edge finish produced mesially and distally
Why should you ensure that there is a knife edge finish when preparing for stainless steel crowns?
you should ensure that there is a knife edge finish when preparing for stainless steel crowns as this will prevent the crown from seating
What type of finish in the preparation for stainless steel crowns will allow ledges to prevent the crown from seating?
a knife edge finish will allow ledges to prevent the stainless steel crown from seating
In the crown preparation for preformed metal crowns, what should the occlusal reduction be?
in the crown preparation for preformed metal crowns, the occlusal reduction should be 1-2mm
In the crown preparation for preformed metal crowns, the buccal and lingual is a X reduction only
X - peripheral
With buccal and lingual reduction in crown preparation for preformed metal crowns, you are basically removing any X angles produced during the occlusal and interproximal reductions
X - sharp
What do you contour the preformed metal crown margin with to ensure there is a tight cervical fit?
you contour the preformed metal crown margin with pliers to ensure there is a tight cervical fit
What on a preformed metal crown do you contour with pliers to ensure a tight cervical fit?
you contour the crown margin of a preformed metal crown with pliers to ensure a tight cervical fit
What do you contour the crown margin of a preformed metal crown with pliers to ensure?
you contour the crown margin of the performed metal crown with pliers to ensure a tight cervical fit
What should you contour the interproximal region of a preformed metal crown to establish?
you should contour the interproximal region of a preformed metal crown to establish contact area
What area of a preformed metal crown should you contour to establish contact area?
you should contour the interproximal region of a preformed metal crown to establish contact area
A preformed metal crown should have a “ X “ fit
X - snap
Should you establish a contact area with a preformed metal crown if there was not one already present?
no , you should not establish a contact area with a preformed metal crown if there was not one already present
What are common problems with stainless steel crowns?
common problems with stainless steel crowns:
> rocking
> canting
> loss of space
Rocking:
cervical margin > X mm beyond maximum curvature
↓
difficult to contour margins sufficiently to contact tooth throughout
↓
open margins and an unstable crown will result
↓
solution = adjust tooth preparation
↓
stable crown - 0.5mm beyond maximum curvature
X - 1
Rocking:
cervical margin >1mm beyond maximum X
↓
difficult to contour margins sufficiently to contact tooth throughout
↓
open margins and an unstable crown will result
↓
solution = adjust tooth preparation
↓
stable crown - 0.5mm beyond maximum curvature
X - curvature
Rocking:
cervical margin >1mm beyond maximum curvature
↓
difficult to X margins sufficiently to contact tooth throughout
↓
open margins and an unstable crown will result
↓
solution = adjust tooth preparation
↓
stable crown - 0.5mm beyond maximum curvature
X - contour
Rocking:
cervical margin >1mm beyond maximum curvature
↓
difficult to contour margins sufficiently to contact tooth throughout
↓
X margins and an unstable crown will result
↓
solution = adjust tooth preparation
↓
stable crown - 0.5mm beyond maximum curvature
X - open
Rocking:
cervical margin >1mm beyond maximum curvature
↓
difficult to contour margins sufficiently to contact tooth throughout
↓
open margins and an X crown will result
↓
solution = adjust tooth preparation
↓
stable crown - 0.5mm beyond maximum curvature
X - unstable
Rocking:
cervical margin >1mm beyond maximum curvature
↓
difficult to contour margins sufficiently to contact tooth throughout
↓
open margins and unstable crown will result
↓
solution = adjust X
↓
stable crown - 0.5mm beyond maximum curvature
X - tooth preparation
Rocking:
cervical margin >1mm beyond maximum curvature
↓
difficult to contour margins sufficiently to contact tooth throughout
↓
open margins and an unstable crown will result
↓
solution = adjust tooth preparation
↓
stable crown - X mm beyond maximum curvature
X - 5
What is the problem that causes canting to one side of a preformed metal crown?
an uneven reduction of occlusal surface can cause canting of a preformed metal crown to one side
What can an uneven reduction of occlusal surface cause in preformed metal crowns?
an uneven reduction of occlusal surface in preformed metal crowns can cause canting to one side
What is the solution when a preformed metal crown cants to one side?
when a preformed metal crown cants to one side, the solution is to round occluso-buccal line angles
When there is no loss of space, what is the ideal preparation shape for a preformed metal crown?
when there is no loss of space, a rectangular preparation is the ideal shape for a preformed metal crown
What can the retention of primary 5s be important to maintain?
the retention of primary 5s is important to maintain space
Generally, is LA or preparation for the Hall technique needed?
no , generally there is no need for LA or preparation for the Hall technique
In the Hall technique, what is it crucial to choose the correct size of?
in the Hall technique, it is crucial to choose the correct size of crown
What should be used in the Hall technique if contact points are a problem?
if contact points are a problem, separators should be used in the Hall technique
In the Hall technique, what should be used to cement?
in the Hall technique, glass ionomer should be used to cement
Ideally, in the Hall technique, the fit should be X or at least below the margins of any cavitation
X - subgingival
Ideally, in the Hall technique, the fit should be subgingival or at least below X of any cavitation
X - margins
Ideally, in the Hall technique, the fit should be subgingival or at least below margins of any X
X - cavitation
When using the Hall technique, should there be any clinical or radiographic signs of pulpal involvement?
no , when using the Hall technique, there should be no clinical or radiographic signs of pulpal involvement
With the Hall technique, what should the tooth have sufficient sound tooth tissue left to retain?
with the Hall technique, the tooth should have sufficient sound tooth tissue left to retain the crown
With separators, what should be threaded through them?
with separators, 2 lengths of dental floss should be threaded through the separator
What should separators be “flossed” through?
separators should be “flossed” through a contact point
How long after placed should you see a patient for removal of a separator (if it has not already fallen out)?
you should see a patient 3-5 days after placement of a separator for it to be removed (if it has not already fallen out)
What should a preformed metal crown be filled with?
a preformed metal crown should be filled with glass ionomer luting cement
A preformed metal crown should be filled with glass ionomer luting cement, ensuring the crown is well filled and there are no X present
X - air bubbles
Should the tooth be dry or wet when placing a preformed metal crown in the Hall technique (with glass ionomer luting cement)?
the tooth should be dry if possible when placing a preformed metal crown in the Hall technique (with glass ionomer luting cement)
In the Hall technique, the crown should be placed over the X of the tooth and partially seated until the crown engages with the contact points
X - crown
In the Hall technique, the crown should be placed over the tooth and X seated until the crown engages with the contact points
X - partially
With the Hall technique, what should encourage the child do to help the preformed metal crown go into place?
with the Hall technique, you should encourage the child to bite together to help the crown go into place
If the child does not want to bite to help the preformed metal crown go into place, how should you fully seat the crown?
if the child does not want to bite to help the preformed metal crown go into place, you should fully seat the crown with firm finger pressure alone
After a preformed metal crown is fully seated, what should you do with the extruded cement?
after a preformed metal crown is fully seated, extruded cement will need to be removed from the margins as soon as possible
After a preformed metal crown has been fully seated, what should you ask the child to do?
after the preformed metal crown has been fully seated, you should ask the child to bite firmly on the crown for 2-3 minutes
After the preformed metal crown has been fully seated, what should you do for the next 2-3 minutes if the child does not want to bite down on it?
after the preformed metal crown has been fully seated, you should hold the crown with firm finger pressure for 2-3 minutes
What does biting down or holding the preformed metal crown for 2-3 minutes after its placement prevent it from doing?
biting down or holding the preformed metal crown for 2-3 minutes after its placement prevents it from springing back a short way
What should you reassure the child and parent after a preformed metal crown is fitted?
after placement of a preformed metal crown, reassure the child and parent that:
- the crown is supposed to fit tightly and the gum will adjust
- child will get used to the feeling of the crown within 24 hours
- the occlusion tends to adjust to give even contacts bilaterally within a few weeks
What minor failures could come from the Hall technique?
minor failures of the Hall technique:
- new/secondary caries
- filling/crown worn, lost or requiring another intervention
- restoration lost but tooth restorable
- reversible pulpitis treated without requiring pulpotomy or extration
What are major failures that could come from the Hall technique?
major failures from the Hall technique:
- irreversible pulpitis
- abscess requiring pulpotomy or extraction
- interradicular radiolucency
- filling lost and tooth unrestorable
How are band and loop space maintainers kept in the mouth?
band and loop space maintainers are cemented
What are disadvantages of unplanned primary tooth extractions?
disadvantages of unplanned primary tooth extractions:
- loss of space causing increased risk of malocclusion
- decreased masticatory function
- impeded speech development
- psychological disturbance
- trauma from anaesthesia/surgery
What are indications for pulp treatment?
indications for pulp treatment:
- good co-operation
- medical history precludes extraction
- missing permanent successor
- over-riding necessity to preserve the tooth (eg. space maintainer)
- child under 9 years of age
Is a missing permanent successor an indication for pulp treatment?
yes , a missing permanent successor is an indication for pulp treatment
What are contra-indications for pulp treatment?
contra-indications for pulp treatment:
> poor co-operation
> poor dental attendance
> cardiac defect
> multiple grossly carious teeth
> advanced root resorption
> severe/recurrent pain or infection
Is poor dental attendance a contra-indication for pulp treatment?
yes , poor dental attendance is a contra-indication for pulp treatment
Is having a cardiac defect a contra-indication for pulp treatment?
yes , having a cardiac defect is a contra-indication for pulp treatment
Is having multiple grossly carious teeth an indication for pulp treatment?
no , having multiple grossly carious teeth is a contra-indication for pulp treatment
Is having severe/recurrent pain or infection an indication for pulp treatment?
no , having severe/recurrent pain or infection is a contra-indication for pulp treatment
What can be said about the success rate of pulp capping a vital tooth?
there is a poor success rate of pulp capping a vital tooth
What procedure is the carious or traumatic exposure of a bleeding pulp?
the carious or traumatic exposure of a bleeding pulp is a vital pulpotomy
In a vital pulpotomy, what pulp is preserved and the bleeding controlled?
in a vital pulpotomy, the radicular pulp is preserved and the bleeding controlled
Should local anaesthetic be used for a vital pulpotomy?
yes , always use local anaesthetic for a vital pulpotomy
Should rubber dam be used for a vital pulpotomy?
yes , rubber dam should be used for a vital pulpotomy
Prior to access for a vital pulpotomy, what should be removed?
prior to access for a vital pulpotomy, caries should be removed
In a vital pulpotomy, how much of the roof of the pulp chamber should be removed?
in a vital pulpotomy, remove the entire roof of the pulp chamber
Vital pulpotomy:
- remove roof of X
- remove coronal pulp with sterile excavator or slow running large round steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place zinc oxide/eugenol in the pulp chamber and restore using a preformed metal crown
X - pulp chamber
Vital pulpotomy:
- remove roof of pulp chamber
- remove X pulp with sterile excavator or slow running large round steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place zinc oxide/eugenol in the pulp chamber and restore using a preformed metal crown
X - coronal
Vital pulpotomy:
- remove roof of pulp chamber
- remove coronal pulp with X excavator or slow running large round steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place zinc oxide/eugenol in the pulp chamber and restore using a preformed metal crown
X - sterile
Vital pulpotomy:
- remove roof of pulp chamber
- remove coronal pulp with sterile excavator or slow running X round steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place zinc oxide/eugenol in the pulp chamber and restore using a preformed metal crown
X - large
Vital pulpotomy:
- remove roof of pulp chamber
- remove coronal pulp with sterile excavator or slow running large X steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place zinc oxide/eugenol in the pulp chamber and restore using a preformed metal crown
X - round
Vital pulpotomy:
- remove roof of pulp chamber
- remove coronal pulp with sterile excavator or slow running large round steel bur
- place a cotton X with ferric sulphate for 20 seconds
- place zinc oxide/eugenol in the pulp chamber and restore using a preformed metal crown
X - pledget
Vital pulpotomy:
- remove roof of the pulp chamber
- remove coronal pulp with sterile excavator or slow running large round steel bur
- place a cotton pledget with X for 20 seconds
- place zinc oxide/eugenol in the pulp chamber and restore using a preformed metal crown
X - ferric sulphate
Vital pulpotomy:
- remove the roof of the pulp chamber
- remove coronal pulp with sterile excavator or slow running large round steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place X /eugenol in the pulp chamber and restore using a preformed metal crown
X - zinc oxide
Vital pulpotomy:
- remove roof of pulp chamber
- remove coronal pulp with sterile excavator or slow running large round steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place zinc oxide/ X in the pulp chamber and restore using a preformed metal crown
X - eugenol
Vital pulpotomy:
- remove roof of pulp chamber
- remove coronal pulp with sterile excavator or slow running large round steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place zinc oxide/eugenol in the X and restore using a preformed metal crown
X - pulp chamber
Vital pulpotomy:
- remove roof of pulp chamber
- remove coronal pulp with sterile excavator or slow running large round steel bur
- place a cotton pledget with ferric sulphate for 20 seconds
- place zinc oxide/eugenol in the pulp chamber and restore using a X
X - preformed metal crown
In a vital pulpotomy, what should you remove the roof of the pulp chamber using?
in a vital pulpotomy, remove the roof of the pulp chamber using a sterile diamond fissure bur
In a vital pulpotomy, what do you gain access by removing?
in a vital pulpotomy, you gain access by caries removal
In a vital pulpotomy, what pulp do you remove?
in a vital pulpotomy, you remove coronal pulp
In a vital pulpotomy, what do you remove coronal pulp using?
in a vital pulpotomy, remove coronal pulp using a sterile excavator or a large round steel bur
In a vital pulpotomy, what should you control?
in a vital pulpotomy, you should have haemorrhage control
In a vital pulpotomy, what should you evaluate?
in a vital pulpotomy, you should evaluate pulp stumps
In a vital pulpotomy, what should be placed over root stumps for 20 seconds?
in a vital pulpotomy, you should place ferric sulphate over root stumps for 20 seconds
In a vital pulpotomy, what do you use as pulp stump evaluation?
in a vital pulpotomy, you use minimal oozing as a pulp stump evaluation
In a vital pulpotomy, what do you cover root stumps with?
in a vital pulpotomy, you cover root stumps with reinforced ZOE paste / CaOH / MTA
In a vital pulpotomy, what do you restore the tooth with?
in a vital pulpotomy, you restore the tooth with a preformed metal crown
If there is normal bleeding, what can be said about the inflammation of the pulp?
if there is normal bleeding, the pulp is uninflammed
What can be said about bleeding when the pulp is uninflammed?
when the pulp is uninflammed, bleeding is normal
When there is normal bleeding and the pulp is uninflammed, what can be said about the colour of the blood?
when there si normal bleeding and the pulp is uninflammed, the blood is a bright red colour
What can be said about haemostasis when the pulp is uninflammed and bleeding is normal?
when the pulp is uninflammed and bleeding is normal there is good haemostasis
What can be said about inflammation of the pulp when there is abnormal bleeding?
when there is abnormal bleeding there is inflammation of the pulp
When the pulp is inflammed, what can be said about bleeding?
when the pulp is inflammed, there is abnormal bleeding
What can be said about the colour of the blood if there is abnormal bleeding and an inflammed pulp?
if the pulp is inflammed and bleeding is abnormal the blood will be a deep crimson colour
If there is abnormal bleeding and an inflammed pulp there will be X bleeding after pressure
X - continued
When is a pulpectomy performed?
a pulpectomy is performed when:
- non-vital or hyperaemic pulp
- irreversible pulpitis
What pulp treatment is performed for a non-vital pulp?
a pulpectomy is performed for a non-vital pulp
What pulp treatment is performed for a hyperaemic pulp?
a pulpectomy is performed for a hyperaemic pulp
What pulp treatment is performed for irreversible pulpitis?
a pulpectomy is performed for irreversible pulpitis
What is signs of a non-vital primary molar?
signs of a non-vital primary molar:
- hyperaemic pulp - bleeding
- pulp necrosis and furcation involvement
What are symptoms of a non-vital primary molar?
symptoms of a non-vital primary molar:
> irreversible pulpitis
> periapical periodontitis
> chronic sinus
What does a severe infection with facial swelling result in?
a severe infection with facial swelling results in extraction
What is the aim of a primary molar pulpectomy?
the aim of a primary molar pulpectomy is to prevent / control infection by extirpation of radicular pulp followed by cleaning and obturation of canals
What is prevention/control of infection by extirpation of radicular pulp followed by cleaning and obturation of canals the aim of?
prevention/control of infection by extirpation of radicular pulp followed by cleaning and obturation of canals is the aim of primary molar pulpectomy
What is the estimated working length for a primary molar pulpectomy assessed on?
the estimated working length for a primary molar pulpectomy is assessed on the pre-op radiograph
What is the radiograph taken prior to a primary molar pulpectomy used to assess?
the radiograph taken prior to a primary molar pulpectomy is used to assess the estimated working length
Pulpectomy:
- X /hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with CaOH and iodoform paste (alternatively a very thin mix of ZOE)
- seal with thick mix of ZOE/GI and restore with a preformed metal crown
X - non-vital
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the X
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from the canals 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with CaOH and iodoform paste (Vitapex) (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - pulp chamber
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the X of the pulp chamber
- use files to remove the pulpal tissue from canals to 2mm short of the estimated working length
- irrigate the chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - contents
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use X to remove pulpal tissue from the canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - files
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove X from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - pulpal tissue
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to X short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate the canals with Vitapex which is a CaOH and iodoform paste (alternatively a very thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - 2mm
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the X
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - estimated working length
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove the pulpal tissue from the canals to 2mm short of the estimated working length
- X with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - irrigate
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the estimated working length
- irrigate with X and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a very thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - chlorhexidine
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and X with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - dry
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with X
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - paper points
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate the X with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - canals
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate the canals with Vitapex which is a X and iodoform paste (alternatively a thin mix of ZOE)
- seal with thick mix of ZOE/GI and restore with a preformed metal crown
X - CaOH
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissues from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and X paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - iodoform
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissus from the canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a X mix of ZOE)
- seal with a thick mix of ZOE/GI and restore with a preformed metal crown
X - thin
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of X )
- seal with a thick mix of ZOE/GI ans restore with a preformed metal crown
X - ZOE
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with X mix of ZOE/GI and restore with a preformed metal crown
X - thick
Pulpectomy:
- non-vital/hyperaemic pulp
- open roof of pulp chamber
- remove contents of pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with thick mix of X /GI and restore with a preformed metal crown
X - ZOE
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissues from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with a thick mix of ZOE/ X and restore with a preformed metal crown
X - glass ionomer
Pulpectomy:
- non-vital/hyperaemic pulp
- open the roof of the pulp chamber
- remove the contents of the pulp chamber
- use files to remove pulpal tissue from canals to 2mm short of the estimated working length
- irrigate with chlorhexidine and dry with paper points
- obturate canals with Vitapex which is a CaOH and iodoform paste (alternatively a thin mix of ZOE)
- seal with thick mix of ZOE/GI and restore with X
X - preformed metal crown
What are potential complications with pulpectomies?
potential complications with pulpectomies:
> early resorption leading to early exfoliation
> over-preparation
What can indicate clinical failure of a pulpotomy or pulpectomy?
clinical failure of pulpotomy or pulpectomy:
- pathological mobility
- fistula/chronic sinus
- pain
What, radiographically, can indicate failure of a pulpotomy or pulpectomy?
radiographic failure of a pulpotomy or pulpectomy:
- increased radiolucency
- external/internal resorption
- furcation bone loss
An X in radiolucency can be a sign of failure of a pulpotomy or pulpectomy
X - increase
How frequent is the clinical review of a pulpotomy or pulpectomy?
the clinical review of a pulpotomy or pulpectomy is every 6 months
How frequent is the radiographic review of a pulpotomy or a pulpectomy?
a pulpotomy or pulpectomy is radiographically reviewed 12-18 monthly
What does E# indicate?
E# indicates an enamel fracture
How is an incisor with an enamel fracture managed?
incisor enamel fracture:
- selective grinding
- acid etched tip (AET)
What does ED# indicate?
ED# indicates an enamel and dentine fracture
How do you manage an incisor with an enamel and dentine fracture?
management of an incisor with an enamel and dentine fracture:
- acid etched tip (AET)
- reattach crown fragment
What does EDP# indicate?
EDP# indicates a fracture causing pulpal exposure
How is a fractured incisor causing a pulpal exposure managed?
a fractured incisor causing a pulpal exposure is managed:
- pulp capping
- pulpotomy - partial/total
- pulpectomy
With crown fractures, after taking a history and examination what should you cover over?
with crown fractures, after taking a history and examination you should cover over the exposed dentine
With crown fractures, you should take a history and examination and then cover over exposed dentine using what as a “bandage”?
with crown fractures, you should take a history and then cover over exposed dentine with compomer or composite as a “bandage”
With pulpal exposure, what does the survival of the pulp depend on?
with pulpal exposure, the survival of the pulp depends on:
- associated periodontal ligament injury
- extent of the exposed dentine
- age of the patient (open vs closed apex)
With pulpal exposure fractures, what can be said about the prognosis when it is not a luxation (displacement) injury?
with pulpal exposure fractures, when there is no luxation (displacement) injury then the prognosis is better
What does bacterial ingress in pulpal exposure fractures cause?
bacterial ingress in pulpal exposure fractures causes pulp death
When there is a vital open apex tooth with an exposed pulp, what kind of exposures should you use a pulp cap for?
when there is a vital open apex tooth with an exposed pulp, you should use a pulp cap for small exposures
When there is a vital immature (open apex) tooth with a pulp exposure fracture, you should use a pulp cap on small exposures when they are less than X old
X - 24 hours
When there is a vital immature (open apex) tooth with a pulp exposure fracture, what should you apply direct to the exposure site when doing a pulp cap?
when there is a vital immature (open apex) tooth with a pulp exposure fracture, you should apply Ca(OH) 2 direct to the exposure site when doing a pulp cap
When there is a vital immature (open apex) tooth with a pulp exposed fracture, what type of exposures should a pulpotomy be used for?
when there is a vital immature (open apex) tooth with a pulp exposed fracture, a pulpotomy should be used for larger exposures
What does a pulpotomy maintain of the remaining (non-infected) pulp?
a pulpotomy maintains the vitality of the remaining (non-infected) pulp
What does a pulpotomy maintain the vitality of?
a pulpotomy maintains the vitality of the remaining (non-infected) pulp
What can be said about root formation with pulpotomies in vital immature (open apex) teeth with exposed pulp factures?
in vital immature (open apex) teeth with pulp exposed fractures, pulpotomies allow root formation to continue
When direct pulp capping, what do you arrest with pressure with moistened cotton wool?
when direct pulp capping, you arrest haemorrhage with pressure with moistened cotton wool
When direct pulp capping, what do you arrest haemorrhage with?
when direct pulp capping, you arrest haemorrhage with pressure via moistened cotton wool
When direct pulp capping, what is placed directly over the exposure site?
when direct pulp capping, Ca(OH) 2 is placed directly over the exposure site
When direct pulp capping, where is Ca(OH) 2 placed?
when direct pulp capping, Ca(OH) 2 is placed directly over the exposure site
In a pulpotomy, what is the pulp dressed with?
in a pulpotomy, the pulp is dressed with Ca(OH) 2
In a non-vital immature (open apex) tooth, what does a pulpectomy remove?
in a non-vital immature (open apex) tooth, a pulpectomy removes all necrotic pulp
In a non-vital immature (open apex) tooth, X is used to provide apical barrier against which to condense root canal filling (gutta persha)
X - mineral trioxide aggregate
In a non-vital immature (open apex) tooth, mineral trioxide aggregate is used to provide an X barrier against which to condense root canal filling (gutta persha)
X - apical
In non-vital immature (open apex) teeth, mineral trioxide aggregate is used to provide an apical barrier against which to condense X (gutta persha)
X - root canal filling
In apexification of non-vital immature (open apex) teeth, what is placed in root canals to induce an apical barrier?
in apexification of non-vital immature (open apex) teeth, calcium hydroxide is placed in root canals to induce apical barrier
In apexification of non-vital immature (open apex) teeth, what is calcium hydroxide placed in root canals to induce?
in apexification of non-vital immature (open apex) teeth, calcium hydroxide is placed in root canals to induce apical barrier
What are some concerns that the long term use of CaOH inside root canals reduces in dentine?
there are some concerns that the long term use of CaOH inside root canals reduces the mineral content of dentine
There are some concerns that the long term use of CaOH inside root canals reduces the mineral content of dentine, making a tooth more likely to what?
there are some concerns that the long term use of CaOH inside root canals reduces the mineral content of dentine, making a tooth more susceptible to root fracture
With apical barrier formation using MTA, what depth of MTA should be placed at the apical end of the root?
with apical barrier formation using MTA, 5mm of MTA should be placed at the apical end of the root
With apical barrier formation using MTA, what is the placement of MTA carried out using?
with apical barreir formation using MTA, placement of MTA is carried out using obtura probes
When there is a mature (closed apex) tooth with a pulp exposed fracture, what exposed would a pulp cap be used on?
when there is a mature (closed apex) tooth with a pulp exposed fracture, a pulp cap would be used in small exposures
When there is a mature (closed apex) tooth with a pulp exposed fracture, what should be used on small exposures that are less than 24 hours old?
when there is a mature (closed apex) tooth with a pulp exposed fracture, a pulp cap should be used on small exposures that are less than 24 hours old
When there is a mature (closed apex) tooth with a pulp exposed fracture, what should be done for teeth with large exposures that are over 24 hours old with necrotic pulp?
when there is a mature (closed apex) tooth with a pulp exposed fracture, a pulpotomy or pulpectomy should be done for teeth with large exposures that are over 24 hours old with necrotic pulp
What is calcium hydroxide used to induce a calcific barrier following?
calcium hydroxide is used to induce a calcific barrier following pulpotomy procedures
What type of barrier is calcium hydroxide used to induce following pulpotomy procedures?
calcium hydroxide is used to induce a calcific barrier following pulpotomy procedures
What is calcium hydroxide useful for decreasing in non-vital mature permanent teeth?
calcium hydroxide is useful for decreasing microbial load in non-vital mature permanent teeth
What does calcium hydroxide do to root dentine?
calcium hydroxide makes root dentine brittle
What should you store an avulsed tooth in?
you should store an avulsed tooth in fresh cold milk or saliva
What should you not allow an avulsed tooth to do?
you should not allow an avulsed tooth to dry out
If there is obvious debris on a tooth, how should you wash it?
if there is obvious debris on a tooth, wash it for 10 seconds under cold water while holding the crown
What should you not handle in an avulsed tooth?
with an avulsed tooth you should not handle the root
How should you re-implant an avulsed tooth?
you should re-implant an avulsed tooth quickly
What should be placed fro 2 weeks with a re-implanted avulsed tooth?
a flexible splint should be placed with a re-implanted avulsed tooth for 2 weeks
How long should a flexible splint be placed for with an re-implanted avulsed tooth?
a flexible splint should be placed for 2 weeks with a re-implanted avulsed tooth
With an avulsed tooth, what should be started in 2 weeks unless the open apex is replanted within 30-45 minutes?
with an avulsed tooth, root canal treatment should be started in 2 weeks unless the open apex is replanted within 30-45 minutes
What should flexible 2 week splints be provided for?
flexible 2 weeks splints should be provided fro avulsions
How long should flexible splints be provided for with avulsions?
with avulsions, flexible splints should be provided for 2 weeks
What should flexible 4 week splints be provided for?
flexible 4 week splits should be provided for luxations or apical and middle 3rd root fractures
How long should flexible splints be provided for luxations?
flexible splints should be provided for luxations for 4 weeks
What should rigid splints be provided for 4 weeks fo?
rigid splints should be provided for 4 weeks for dento-alveolar fractures
How long should rigid splints be provided for dento-alveolar fractures?
rigid 4 week splints should be provided for dento-alveolar fractures
What are better for splints - composite or acrylic wires?
composite wires are better than acrylic wires for splints
When is an acrylic URA type splint useful?
an acrylic URA type splint is useful when there are few abutment teeth
What splints are useful when there are few abutment teeth?
acrylic URA type splints are useful when there are few abutment teeth
Orthodontic brackets and wires can be used as splints, however they must be X or else the teeth will be moved
X - passive
What happens to teeth in orthodontic brackets if the wire is active?
with orthodontic brackets, if the wire is active then the teeth will be moved
Creating splints:
- cut and bend X mm stainless steel wire
- apply composite resin to traumatised tooth and those adjacent
- sink the contoured, passive wire into the composite
- shape and cure composite
- smooth rough composite and wire ends
X - 0.6
Creating splints:
- cut and bend 0.6mm stainless steel wire
- apply X to traumatised tooth and those adjacent
- sink the contoured, passive wire into the composite
- shape and cure composite
- smooth rough composite and wire ends
X - composite resin
Creating splints:
- cut and bend 0.6mm stainless steel wire
- apply composite resin to traumatised tooth and those adjacent
- sink the contoured, X wire into the composite
- shape and cure composite
- smooth rough composite and wire ends
X - passive
Creating splints:
- cut and bend 0.6mm stainless steel wire
- apply composite resin to traumatised tooth and those adjacent
- sink the contoured, passive wire into the composite
- shape and cure the composite
- X rough composite and wire ends
X - smooth
What is a fissure sealant?
a fissure sealant is a protective plastic coating used to seal fissures and pits to prevent food and bacteria getting caught in them and causing decay
What is the name given to the protective plastic coating used to seal fissures and pits to prevent food and bacteria getting caught in them and causing decay?
fissure sealants are protective plastic coatings that are used to seal fissures and prevent food and bacteria getting caught in them and causing decay
What is less protected by fluoride - fissures, smooth surfaces or interproximal surfaces?
fissures are less protected than smooth surfaces or interproximal caries from fluoride
Is it possible to clean the base of fissures with a toothbrush?
no , it is not possible to clean the base of fissures with a toothbrush
What material is mostly used for fissure sealants?
it is mostly bis-GMA that is used for fissure sealants
What is occasionally used for fissure sealants?
[not bis-GMA]
glass ionomer is occasionally used for fissure sealants
What children are indications for fissure sealant placement?
indications for fissure sealant placement:
- children deemed to be high risk for caries
- medically compromised children
- children with learning difficulties
- children with physical and mental disabilities
If a child is a low caries risk, do they need to have their first permanent teeth routinely sealed?
no , if a child is low caries risk they do not need to have their first permanent teeth routinely sealed - rather these fissures should be closely monitored
What teeth and surfaces do fissure sealants have the greatest benefit?
fissure sealants have the greatest benefit on the occlusal surfaces of permanent molar teeth
What pits of upper incisors should be fissure sealed?
the cingulum pits of upper incisors should be fissure sealed
What pits of lower molars should be fissure sealed?
the buccal pits of lower molars should be fissure sealed
What pits of upper molars should be fissure sealed?
the palatal pits of upper molars should be fissure sealed
What should be done with a child that has caries in one permanent first molar?
if a child has caries in one permanent first molar, they should have the other 3 fissure sealed immediately
What does occlusal caries in first permanent molars indicate for the second permanent molars?
occlusal caries in the first permanent molars indicates that the second permanent molars must be sealed on eruption
What dental dam placement should be used for fissure sealing?
when fissure sealing, use a single tooth dental dam
What should be used to etch the enamel surface for fissure sealant placement?
35% ortho-phosphoric acid should be used to etch the enamel surface for fissure sealant placement
If etch touches the soft tissues, why should you rinse this?
if etch touches the soft tissues, you should rinse this as it could cause a burn
What appearance should the etched surface have when dry?
when dry, the etched surface should have a chalky-white/frosty appearance
Any etched enamel not eventually covered with fissure sealant will take how long to remineralise?
any etched enamel not eventually covered with fissure sealant will remineralise within 24 hours
What can you use to add resin to the depths of the dry fissure pattern when fissure sealing?
when fissure sealing, add the resin to the depths of the dry fissure pattern using a brush , micro-brush or small excavator
What must you ensure the fissure sealant material is in the base of?
you must ensure that the fissure sealant material is in the base of the fissure
What will overfilling when fissure sealing lead to in terms of long term retention?
overfilling when fissure sealing will lead to a decrease in long term retention
What should you do to check that a fissure sealant is firmly adhered?
to check that a fissure sealant is firmly adhered, use a sharp probe and try and dislodge
What should you do if there are air-blows present in a fissure sealant?
if there are air-blows present in a fissure sealant, remove this part of the sealant and redo
What should you do if some of the fissure sealant material has flowed interproximally?
if some fissure sealant material has flowed interproximally, remove this with a sharp probe and dental floss
How often should you clinically review fissure sealants?
you should clinically review fissure sealants every 4-6 months
What are indications for glass ionomer fissure sealants?
indications for glass ionomer fissure sealants:
> where good moisture control cannot be achieved
- high risk children with partially erupted molars
- special needs children
- poorly co-operating children
> where there is a high degree of sensitivity due to developmental or hereditary enamel defects - drying the tooth would be extremely painful in these cases
What should you use to smooth GI fissure sealant into fissures?
you should use your finger or thumb to smooth GI fissure sealant into fissures
Why should you keep your finger over a GI fissure sealant or place petroleum jelly until it is set?
keep your finger over GI fissure sealant or place petroleum jelly to decrease moisture contamination until it is set
What is a fissure that is discoloured, brown or black known as?
a fissure that is discoloured, brown or black is known as a stained fissure
What can be used in the diagnosis of stained fissures?
diagnosis of stained fissures:
> visual (dry tooth)
> probe/explorer
> bitewing radiograph
> electronic
> fibre optic transillumination
> CO 2 laser
> air abrasion
When is there greater accuracy in the diagnosis of a stained fissure?
there is greater diagnosis of a stained fissure when 2 or 3 methods are used together
If an investigation reveals that caries does not enter the dentine, should you provide a fissure sealant?
yes , if an investigation reveals that caries does not enter the dentine, provide a fissure sealant and monitor
What is a preventive resin restoration (PRR) or a sealant restoration (SR)?
a preventive resin restoration (PRR) or a sealant restoration (SR) is when a defect is filled with a small amount of composite then sealed over the top with a fissure sealant
What is it known as when a defect is filled with a small amount of composite then sealed over the top with a fissure sealant?
when a defect is filled with a small amount of composite then sealed over the top with a fissure sealant this is known as a preventive resin restoration (PRR) or a sealant restoration (SR)
What should be maximised in the management of virgin caries in first primary molars?
prevention should be maximised in the management of virgin caries in first primary molars
What teeth should be prioritised in any mixed dentition treatment plan?
always prioritise the first permanent molars in any mixed dentition treatment plan
Caries most commonly affects the pits and fissures of first permanent molars but where else may it develop?
caries most commonly affects the pits and fissures of first permanent molars but may also develop proximally below the contact point
When caries in first permanent molars is extensive what should you always consider?
when caries in first permanent molars is extensive you should always consider the long term prognosis
In what cases may bulk fill composite be useful?
bulk fill composite may be useful when the child cannot sit for the length of time necessary for completion of a quality composite restoration under rubber dam
Under what age can you not use amalgam in children?
you cannot use amalgam in children under 15 year sold
When carrying out extractions of the first permanent molars, when would the optimal occlusal result be obtained?
when carrying out extractions of the first permanent molars, the optimal occlusal result will be obtained when:
- bifurcation of the lower 7 is seen to be forming on a panoramic radiograph (typically around 8.5-10 years)
- 5s and 8s are all present and in a good position on the panoramic radiograph
- mild buccal segment crowding
- class I incisor relationship
In some situations, what can extraction of first permanent molars of poor prognosis at the correct time allow?
in some situations, extraction of the first permanent molars of poor prognosis at the correct time can allow the development of a caries-free dentition in the adolescent , without spacing
