Paeds 1 - Restorative

Question 1

5 reasons to restore the deciduous dentition?

Answer 1

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

Question 2

why do deciduous roots splay?

Answer 2

to make room for the tooth germ

Question 3

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

Answer 3

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

Question 4

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

Answer 4

opaque/brown staining

misshapen

Question 5

what is Turners tooth?

Answer 5

permanent incisor is misshapen bc infection in deciduous tooth

Question 6

why does caries happen faster in deciduous teeth?

Answer 6

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

Question 7

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

Answer 7

demineralisation process is faster - often carious before noticed

Question 8

where are the root canals on a LOWER deciduous molar?

Answer 8

MesioBuccal
MesioLingual
Distal

Question 9

where are the root canals on an UPPER deciduous molar?

Answer 9

MesioBuccal
MesioLingual
Palatal

Question 10

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

Answer 10

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

Question 11

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

Answer 11

Halls crown

Question 12

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

Answer 12

fissures in primary dentition are wider and flatter

Question 13

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

Answer 13

cervical constriction

Question 14

what situations could a halls crown be used?

Answer 14

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

Question 15

what are the symptoms of reversible pulpitis?

Answer 15

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

Question 16

what would you see with reversible pulpitis on exam?

on a radiograph?

Answer 16

• early carious lesion

- caries into dentine

Question 17

what are the symptoms of irriversible pulpitis?

Answer 17

constant pain
awake at night
relieved by analgesics
increased temp
lymphadenopathy

Question 18

what would you see with irriversible pulpitis on exam?

on a radiograph?

Answer 18

extensive marginal ridge destruction, sinus, swelling

caries close to pulp

Question 19

treatment option for reversible?

irriversibly?

Answer 19

restoration

XLA/RCT

Question 20

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

Answer 20

short needle

Question 21

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

Answer 21

1/10th of a cartridge per kg

Question 22

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

Answer 22

1/11th of a cartridge per kg

Question 23

what is the rule of 10?

Answer 23

childs age plus number of tooth

10 = IDB

Question 24

why restore deciduous dentition?

Answer 24

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

Question 25

what are the stages of deciduous tx planning?

Answer 25

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

Question 26

if a child presents with toothache check for what?

Answer 26

abscesses
caries
trauma
toothwear
infection
soft tissue lesions
exfolliatoin/eruption

Question 27

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

Answer 27

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

Question 28

what is temporisation?

Answer 28

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

Question 29

what properties should the material used to temporise a tooth?

Answer 29

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

Question 30

what is stabilisation?

Answer 30

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

Question 31

how is stabilisation done?

Answer 31

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

Question 32

what are the advantages of stabilisation?

Answer 32

prevents lesion progression
arrests caries
prevent sensitivity in teeth

Question 33

how does thinner enamel contribute to planning cavity prep?

Answer 33

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

Question 34

how does the cervical bulge affect cavity prep?

Answer 34

floor of box tends to be too deep

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

Question 35

how does the narrow occlusal table affect the cavity prep?

Answer 35

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

Question 36

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

Answer 36

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

Question 37

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

Answer 37

isthmus must be narrow to avoid pulp exposure

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