Paeds Flashcards
How many different sizes are there per tooth?
6 sizes
When would you use preformed crowns?
When large or multi-surface carious teeth are involved
pulp treated teeth
Trauma
Enamel and dentine defects - imperfecta
Abutment for crown-loop space maintainer
Infraoccluded teeth to maintain mesial/distal space (vertical space)
When would you not use preformed crowns?
unrestorable tooth
failed pulp therapy
teeth that are soon to exfoliate
When would you be cautious about placing preformed crowns?
severe wear/ severe space loss
pre-cooperative
poor motivation
Multiple grossly carious teeth
When should you use preformed crowns in permanent teeth?
Hypomineralised molars Amelogenesis imperfecta temporary restoration severe erosion Dentinogenesis imperfecta
What are the advantages of preformed metal crowns?
Straightforward technique
quick and cheap
evidence of excellent longevity, low failure rates, compares well with other materials
failure can be easily corrected
What are the disadvantages of preformed metal crowns?
Poor aesthetics
may impede eruption of adjacent teeth if too big
may cause gingival inflammation if cement not removed completely
theoretical nickel allergy risk
What should you tell the patient/parent about the PMC
They stay on until the tooth falls out
They need to be brushed just like normal teeth
The glue tastes a bit like lemons/salt and vinegar crisps
They feel a bit funny to bite on to start with
How would you protect the child’s airways when using a PMC?
Gauze with adhesive handle
What is the technique to placing a PMC?
- topical/LA
- remove caries
- pulpotomy/pulpectomy if needed
- prepare tooth (occlusal reduction first, then meisial and distal reduction)5. Select crown
- Adapt crown or modify prep
- cementation
What do you cement the PMC with?
Glass ionomer (Aquacem) - creamier consistency
How would you adapt the crown to deal with problems?
- poorly adapted crown - crimp it
- space loss - modify shape and use crown from opposite side and arch
- gingival blanching - will resolve
- occlusal discrepancies - will resolve
What is the Hall technique?
- No tooth prep
- no local
- no try-in
- not for extensively carious teeth
- caries not removed but sealed into tooth to isolate it
How is the hall technique carried out?
If necessary place separators 1 week before
Topical (optional)
Choose crown
Airway protection
Try crown to contact point only
Fill crown with GIC
Push down as far as possible
Allow child to bite on band seater/cotton wool roll
Remove excess cement with wet gauze
Get child to bite together
Remove further cement with gauze, excavator or probe
Knotted floss between contact points (practice biting down with the child first)
What is the difference between the Hall technique and the conventional method of placing PMC?
No occlusal reduction - but anterior open bite will resolve itself in the next few weeks
No removal of caries
usually no local either
What is object permanence?
Understanding objects continue to exist when they cannot be seen
Why is child development relevant for dentists? 203
Predict what a child is experiencing in the dental surgery
Interpret what children are thinking, feeling and how they are behaving
Dental professionals to support young patients
What can an infant at 6 months do physically, emotionally and socially, sensory and cognitively? 203
Physical Sit without support Reach and grab a toy Put objects in their mouths Feeds themselves with fingers
Emotional and social
Distressed when their mother leaves
Increasing wariness to strangers
Sensory
Turn towards noise
Visually very alert – follow activities
Cognitive
Understand meaning of words such as ‘bye-bye’
Start to understand objects
