Paeds 1 - Restorative Flashcards

1
Q

5 reasons to restore the deciduous dentition?

A
maintain form
maintain space
avoid GA
avoid sepsis/infection - damage to perm
acclimatisation
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2
Q

why do deciduous roots splay?

A

to make room for the tooth germ

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3
Q

if a deciduous tooth is prematurely extracted, how can this affect the eruption of the permanent tooth?

A

eruption of the perm tooth is stimulated by root resorption - this is absent if tooth is extracted - perm tooth may come in palatally/lingually

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4
Q

what can infection at the root of a deciduous tooth cause in the permanent successor?

A

opaque/brown staining

misshapen

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5
Q

what is Turners tooth?

A

permanent incisor is misshapen bc infection in deciduous tooth

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6
Q

why does caries happen faster in deciduous teeth?

A
larger pulp to crown ratio
thinner enamel
pulp horns nearer surface
more aprismatic enamel
contact points are flatter and wider
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7
Q

why is it harder to spot a WSL in primary tooth?>

A

demineralisation process is faster - often carious before noticed

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8
Q

where are the root canals on a LOWER deciduous molar?

A

MesioBuccal
MesioLingual
Distal

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9
Q

where are the root canals on an UPPER deciduous molar?

A

MesioBuccal
MesioLingual
Palatal

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10
Q

if creating an isthmus on a deciduous tooth ensure it is what size?

A

less than a 1/3 of width of buccal/lingual and palatal cusps = weakened structure if not

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11
Q

what is the preferred treatment of a deciduous Class II cavity?

A

Halls crown

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12
Q

why does occlusal caries suggest a higher decay risk in a primary tooth?

A

fissures in primary dentition are wider and flatter

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13
Q

what aspect of tooth morphology allows a halls crown to stay in place?

A

cervical constriction

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14
Q

what situations could a halls crown be used?

A

Large class II
badly broken down tooth
following a pulpotomy
hard tissue anomaly - amelogenesis imperfecta

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15
Q

what are the symptoms of reversible pulpitis?

A

pain on sweet/hot/cold
mainly when eating
pain stops when stimuli removed
short duration

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16
Q

what would you see with reversible pulpitis on exam?

on a radiograph?

A
  • early carious lesion

- caries into dentine

17
Q

what are the symptoms of irriversible pulpitis?

A
constant pain
awake at night
relieved by analgesics
increased temp
lymphadenopathy
18
Q

what would you see with irriversible pulpitis on exam?

on a radiograph?

A

extensive marginal ridge destruction, sinus, swelling

caries close to pulp

19
Q

treatment option for reversible?

irriversibly?

A

restoration

XLA/RCT

20
Q

if under 7 years and doing an IDB use what kind of needle?

A

short needle

21
Q

per kg/weight how much lidocaine with epinephrine can be given to a child?

A

1/10th of a cartridge per kg

22
Q

per kg/weight how much prilocaine with felypressin can be given to a child?

A

1/11th of a cartridge per kg

23
Q

what is the rule of 10?

A

childs age plus number of tooth

10 = IDB

24
Q

why restore deciduous dentition?

A
restore form
restore aesthetics
restore function 
maintain space
acclimatisation
avoiding sepsis and infection to perm successors
avoid extraction
25
Q

what are the stages of deciduous tx planning?

A
relief of pain
prevention at home
professional prevention 
- stabilisation of caries
- restorations
- pulp therapy
- extractions
- behaviour management
- reinforce prevention
26
Q

if a child presents with toothache check for what?

A
abscesses
caries
trauma
toothwear
infection
soft tissue lesions
exfolliatoin/eruption
27
Q

what to consider when trying to decide whether to restore or extract?

A

depends on type of pulpitis
likelihood pulpotomy will work
quality and quantity of tooth tissue left
prev extractions/edentulous spaces

28
Q

what is temporisation?

A

placement of temporary dressing as effective pain relief until restoration can be completed, extracted or arranged to be under observation

29
Q

what properties should the material used to temporise a tooth?

A

not be detrimental to pulp
good seal
doesnt conflict with final restoration material

30
Q

what is stabilisation?

A

managing the child continual poor OH with active high amounts of caries needs thought and should be stabilised first before definitive restorations

31
Q

how is stabilisation done?

A

remove caries from the margin
dress
buys time for cooperation to improve, tx of other restorable teeth

32
Q

what are the advantages of stabilisation?

A

prevents lesion progression
arrests caries
prevent sensitivity in teeth

33
Q

how does thinner enamel contribute to planning cavity prep?

A

caries penetration distance is more rapid-less distance
cracking/fractures are more common
small burs used
pulp horns near surface

34
Q

how does the cervical bulge affect cavity prep?

A

floor of box tends to be too deep

re establishes floor by moving axial wall towarcs pulp = exposure risk

35
Q

how does the narrow occlusal table affect the cavity prep?

A

cusp weakened by over extension of cavity prep in a bucco lingual direction

36
Q

how do the broad contact areas located gingivally affect cavity prep?

A

difficulty in clearing buccal and lingual walls of box to clear contact

37
Q

why do the large pulp horns situated below the cusps affect cavity prep?

A

isthmus must be narrow to avoid pulp exposure

reduce failure of material by deepening pulpoaxial line to increase material bulk