Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NBDE II Board Busters > Pediatric Dentistry > Flashcards

Pediatric Dentistry Flashcards

1
Q

max. conc. of nitrous should not exceed

flow rate is

A

50%

6 L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

earliest symptom of conscious sedation is

A

light headedness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

drug used for pediatric sedation by acting on CNS to induce sleep is

A

CHLORAL HYDRATE

-kids enter period of excitement and irritability before becoming sedated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

short acting barbiturates include

A

secobarbital (seconal)
pentobarbital (nembutal)

sedatives by oral admin. but aren’t as good, non-analgesic, can cause hyper-excitability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

standard prophylaxis for kids is

A

amox

50 mg/kg 1 hr before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pulpectomy (RCT) is indicated when

A
  • periapical pathology

- canals filled with ZOE paste (min. tissue rxn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

pulpotomy

A

preserves radicular VITAL pulp when the entire coronal pulp is amputated; allows resorption and exfoliation of the primary tooth, but preserves its role as a natural space maintainer
-coronal pulp shows evidence of inflammation and degen. change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2 pulpotomy techniques

A
  1. Calcium hydroxide - tx PERMANENT teeth when there is a pathologic change in pulp at carious exposure site; indicated for peranent teeth with immature root development and healthy pulp tissue in canals
  2. Formocresol - tx PRIMARY teeth with carious exposure, success depends on VITAL root tip. Formecrosl causes surface fixation of pulp tissue and odontoblast degeneration.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

indications and contraindications for Formecresol pulpotomy

A

indications - tooth sensitive to sweets, pulp exp during caries excavation, xray shows deep caries to pulp

contra - internal resorption on xray, tooth painful with swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

direct pulp capping is used on

A

PERMANENT teeth (not primary cause of CaOH’s alkaline pH), tooth is ASYMPTOMATIC, there’s a small exposure

with mild irritation, resolves itself
with severe irritation, internal resorption can occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

contraindications of a direct pulp cap on primary teeth

A

spontaneous pain
large exposure
excessive bleeding
xray evidence of internal resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

indirect pulp capping goals

A

preserve pulp vitality, prevent exposure, save tooth structure, arrest caries, promote reparative dentin formation

indications - permanent teeth with rampant caries, large caries close to pulp

contraindications - don’t use when spontaneous pain, furcation involvement, pulpal involvement, don’t do in KIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

adolescents with rampant caries may need caries control before final restoration to arrest lesions. this involves __

A

removing gross caries, placing CaOH and an interim restoration like IRM (reinforced ZOE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ER tx of fractures of permanent teeth with immature apices

A

Class I - smooth edges, restore
Class II - CaOH to exposed dentin and restore
Class III - CaOH, place temp, if exposure is big then perform CaOH pulpotomy -> pulpectomy eventually
Class IV - CaOH pulpotomy -> pulpectomy eventually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

in a kid with a fully formed apex, if there is a pinpoint exposure and it has been a while (day) since it happened, what is tx?

what if it happened right away?

A

1 day - conventional RCT

imm - direct pulp cap with CaOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MOST COMMON craniofacial malformations (50% of all defects)

A

cleft palate and cleft lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cleft lip

A

during 5th-6th week of embryonic life, from failure of maxillary and frontonasal processes to merge

  • more common in males
  • more common on left side

Class I - unilateral notch of vermillion NOT into lip
Class II - unilateral notch of vermillion extending into lip but not nasal floor
Class III - unilateral notch of vermillion but into lip and floor of nose
Class IV - bilateral clefting

-occurs during 4-6 wks of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cleft palate

A

opening in roof of mouth where 2 sides of palate did not unite, occurs in 6th-8th week of embryonic life

  • fissure in midline
  • isolated clefts more common in females
  • impaired speech and swallowing

Class I - only soft palate
Class II - both palates but not alveolar process
Class III - both palates and alveolar process on one side of premaxilla
Class IV - soft palate and continues thru alveolus on both sides of premaxilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Acute Necrotizing Ulcerative Gingivitis (ANUG, Vincent’s Angina, Trench Mouth)

clinical manifestations

tx

A

painful hyperemic gingiva, punched out papilla, covered by GRAY pseudomembrane with foul odor

  • fusopirochetal infxn caused by FUSIFORM/FUSIBACTERIUM, SPIROCHETES, P. INTERMEDIA
  • assoc. with poor OH, common in conditions with crowding and malnutrition, stress and smoking risk factors too
  • YOUNG ADULTS 15-35 yrs.

clinical manifestations - inflamed, painful, bleeding gingiva, poor appetite, fever, malaise, odor

tx - debridement, H2O2, abx therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Primary (Acute) Herpetic Gingivostomatitis

A

viral infection

  • characterized by: inflamed gingiva, sore throat, fever, malaise, lymphadenopathy, small fluid filled vesicles on mucosa of the lips/tongue/gingiva
  • round ulcers with RED AREOLAE on CHEEKS
  • self limiting, lasts 7-10 days
  • tx: oral fluids
  • common in PRESCHOOL kids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Atrophic Gingivitis

A

gingival recession without bone loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acute Lymphocytic/Lymphoblastic Leukemia (ALL)

A

most common pediatric cancer, form of acute leukemia most responsive to therapy

signs - fatigue, pallor, weight loss, easy bruising -> fever, hemorrhages, weak, bone/joint pain, repeated infxns

oral features - gingival oozing, petechiae, hematoma, ecchymosis, oral ulceration, pharyngitis, gingival infxn unresponse to therapy, submandibular lymphadenopathy

-susceptible to candida infxns (Nystatin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

most common type of leukemia in kids is

A

lymphoblastic leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Apert Syndrome

A

cranial-limb anomaly

  • malformations of skull, midface, hands, feet (NOT blindness)
  • assoc. with supernumerary teeth, crowding, Class III

major features - prematurely fused cranial sutures, retruded midface, fused fingers and toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Autism

A

appears in first 3 yrs, 4x more common in boys

  • difficult to tx autistic pt cause of impaired communication
  • can use sedatives and reduce loud sonds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Attention Deficit Disorder (ADD)

what tx?

A

short attention span, hyperactivity, impulsive behavior

  • cause unknown
  • 10x more common in males

Methylphenidate (ritalin) - mild CNS stimulant
Amphetamines (dextroamphetamine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Achondroplasia

A

short-limb dwarfism
-most kids die before 1

clinical features - disproportionate short stature, prominent forehead, depressed bridge of nose, small maxilla causing overcrowding of teeth, Class III malocclusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Gigantism oral features

A
  • enlarged tongue
  • teeth tipped buccal or lingual
  • mand prognathism
  • long roots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pituitary dwarfism oral features

A
  • delayed eruption and exfoliation
  • short clinical crowns, smaller roots
  • smaller dental arch -> malocclusion
  • mandible underdeveloped
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Cellulitis

A

acute spreading infxn of dermis and subcutaneous tissues, causing pain, erythema, edema, warmth

caused by - Group A streptococci & Staph Aureus

-harder to tx in kid cause dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Ludwig’s Angina

A

cellulitis that affects submandibular, sublingual, submental spaces

  • causes elevation of tongue and mouth -> obstruction of airway
  • hospital immediately
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Cretinism (child hypothyroidism) is a

A

deficiency caused by congenital absence of THYROXINE

  • severe HYPOthyroidism in a kid characterized by defective mental and physical development
  • dwarfed body with curved spine and pendulous abdomen
  • distorted limbs
  • severe mental retardation

dental findings - underdeveloped mandible, overdeveloped maxilla, enlarged tongue causing malocclusion, delayed tooth eruption, longer retention of deciduous teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Cystic Fibrosis

A

INHERITED disease of exocrine glands

  • sticky mucus from faulty transport of Na+ and Cl in cells lining organs
  • glands most affected are in pancreas, respiratory system, sweat glands
  • inherit defective copy of CF gene
  • dx tool is sweat test (elevated Na and Cl)
  • dark teeth

combo of steatorrhea, chronic resp. infxn, functional disturbances in secretory mechanisms of various glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Cleidocranial Dysplasia (dDysostosis)

A

INHERITED disorder of bony development

  • absent or incompletely formed clavicles
  • characteristic facial appearance, dental abnormalities
  • supernumerary teeth, delayed eruption, peg-shaped teeth, missing teeth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Ectodermal Dysplasia

A

HEREDITARY condition caused by abnormal development of skin, hair, nails, teeth, sweat glands

  • different types but X-linked anhidrotic is most common
  • anodontia or oligodontia, conical shaped anteriors
  • atrophic skin, defective hair, hypoplastic sweat glands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Anhidrotic ectodermal dysplasia

A

most common, only affects males, characterized by lack of perspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

retained primary teeth are an oral manifestation of what 2 conditions

A

Ectodermal and

Cleidocranial Dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Diabetes

what is the triad?

oral complications?

A

body can’t properly use and store glucose

triad - polydipsia (thirst), polyphagia (hunger), polyuria (freq. urination)

Type I Diabetes (insulin dependent, juvenile-onset) - body stops making insulin, prone to ketoacidosis, blindness may develop

oral complications - xerostomia, infection, poor healing, perio disease, burning mouth syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Diphtheria

A

acute, contagious disease caused by bacterium CORYNEBACTERIUM DIPHTHERIA
-production of a systemic toxin damaging to heart and CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Down Syndrome (Trisomy 21)

A

CONGENITAL, chromosomal abnormality

low caries rate
high prevalence perio disease
delayed eruption
malocclusion
enamel dysplasia
delayed mental and physical development
short, stocky build, broad, flat face, slanty eyes
prominent, thick tongue
**heart defects common, SBE prophylaxis is required for dental tx**
reduced resistance to infxn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Gingivostomatitis

A

sores on mouth and gingiva caused by HERPES (HSV-1), characterized by inflammation of gingiva and mucosa, common esp. in kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Acute (Primary) Herpetic Gingivostomatitis

A

kids <3 (1-5 yrs) with prodromal symptoms (fever, malaise, irritability, headache, dysphagia, vomiting, lymphadenopathy)

  • tx by mild topical (ex. Dyclone) for pain
  • virus that causes this is closely related to herpes that causes chickenpox (varicella zoster)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

common sequelae of Acute Herpetic Gingivostomatitis

A
  • recurrent herpes labialis (cold sores)
  • spherical vesicles
  • kid will have circulating anti-herpes antibodies (HSV-1 antibodies)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Herpangina

A

viral infection (strain of coxsackie A)

  • young kid
  • oral ulcers (white to whitish gray base and red border on roof of mouth and throat)
  • fever, sore throat, headache
  • goes away in a week, tx is palliative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Hemangioma

A

most COMMON BENIGN TUMOR of INFANTS

  • vascular birthmarks, biologically active
  • 5x more common in girls
  • common on lips, tongue, buccal mucosa, flat or raised, deep red or blushish
  • removed surgically

ex. asymptomatic blue lesion on tongue, minimal increase in size 5 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Lymphangioma

A

well circumscribed nodule or mass of lymphatic vessels, often in neck and axilla
-compressible and spongy red to blue translucent lesions

tx by excisional biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Neurofibroma

A

firm, encapsulated tumor by proliferation of SCHWANN CELLS

  • on tongue, buccal mucosa, vestibule, palate
  • can become malignant (5-15%)

MULT. LESIONS are assoc. with NEUROFIBROMATOSIS (Von Recklinghausen’s Disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Nursing Bottle Caries (Baby Bottle Tooth Decay/Bottle Mouth Syndrome)

A

widespread caries, most commonly affecting MAXILLARY INCISORS
-in combo with Strep mutans

max incisors > max and mand 1st molars > mand. canines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Pierre Robin Syndrome

A

HEREDITARY disorder

-presents micrognathia, glossoptois (down displacement/retraction of tongue), high arch or cleft palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Porphyria

3 major findings?

dx?

A

INHERITED disorders, abnormalities in production of heme pigments, myoglobin, ctyochromas
-can cause discoloration of teeth

3 major findings

  1. Photodermatitis (light sensitivity causing rash)
  2. Neuropsychiatric complaints
  3. Visceral complains (ab pain, cramping)

Dx - red urine, purple brown teeth, sensitive to sunlight, gets blisters and swelling on face/hands in sunlight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Causes of tooth discolration (4 conditions)

A
  1. Porphyria
  2. Cystic Fibrosis - dark
  3. Erythroblastosis Fetalis - destruction of erythrocytes, blue-green
  4. Tetracycline therapy - yellow to brown, gray to black
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Rieger’s Syndrome

A

delayed sexual development, hypothyroidism, dental features like hypodontia, underdeveloped premaxilla, cleft palate, protruding lower lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Recurrent Aphthous Ulcers (Canker sores)

A

unknown cause, triggered by stress, dietary deficiencies (iron, folic acid, vit B12), periods, hormonal changes, etc.

  • painful white or yellow ulcers with red halo on NON-KERATINIZED oral mucosa
  • RAS and intra-oral herps are distinguished on location
  • more in women
54
Q

RAS occur on __ whereas intra-oral herpes occur on __

A

RAS - mobile mucosa

intra-oral herps - tissue bound to periosteum

55
Q

3 classes of Recurrent Aphthous Ulcers

A
  1. Recurrent minor < 1 cm
  2. Recurrent major > 1 cm, lasts > 2 wks, scars
  3. Recurrent herpetiform - clusters and ulcers
56
Q

pts with __ ulcers should be screened for diabetes mellitus or Behcet’s syndrome

A

Recurrent herpetiform

57
Q

Grand Mal Epilepsy (Tonic Clonic)

A

most common seizure disorder (90% of epileptics)

  • tonic-clonic, 2-5 min.
  • tx: pt in supine position, prevent injury, basic life support (head tilt), oxygen if cyanosis
58
Q

Petit Mal Epilepsy (Absence)

A
  • in childhood under 16 yrs., 5-10 sec.

- mgmgt is protective, little or no danger

59
Q

Measles (Rubeola)

A

from PARAMYXOVIRUS

  • fever, cough, rash
  • KOPLIK’S SPOTS 1-2 mm yellow white oral lesions, looks like necrotic ulcers with bright red margin
60
Q

German Measles (Rubella)

A

benign viral disease

  • red, bumpy rash, swollen lymph nodes, mild fever
  • PETECHIAE spots on soft palate
  • hypoplastic primary incisors from maternal rubella
61
Q

Mumps

A

uni or bilateral swelling of salivary glands, usually PAROTID (parotitis)
-papilla on opening of parotid duct on buccal mucosa is puffy and red

62
Q

Smallpox (Variola)

A

viral disease, high fever, nausea, vomiting, chills, headache

oral manifestations - ulceration of mucosa and pharynx, sometimes swollen tongue

63
Q

Scarlet Fever

A

exotoxin mediated, from group A beta hemolytic strep infxn

symptoms - strep throat, fever, sore throat, headache, STRAWBERRY TONGUE

-enlargement of FUNGIFORM PAPILLAE above level of white desquamating filiform papilla -> looks like strawberry

tx by penicillin

64
Q

Amelogenesis Imperfecta

A

INHERITED, dominant trait

-thin, soft enamel

65
Q

Dentinogenesis Imperfecta

A

INHERITED, dominant

  • undermineralized dentin
  • bulbous crowns with short roots, opalescent dentin obliterates pulp cavity
  • teeth wear rapidly

Type I: assoc. with OSTEOGENESIS IMPERFECTA, kids have blue schlera, fragile bones, hearing loss
Type II: most common
Type III: Brandywine, multiple pulpal exposures

66
Q

Dens-in-Dente (Dens Invaginatus)

A

tooth within tooth from invagination of all enamel organ layers into DENTAL PAPILLA

  • most involves MAX LATERAL incisor
  • pulp usually exposed, so should be RCT
67
Q

Enamel hypocalcification

A

HEREDITARY

  • enamel is soft and undercalcified, but normal in quantity
  • defective maturation of ameloblasts
68
Q

Enamel hypoplasia

A

DEVELOPMENTAL

  • enamel is hard, but thin and deficient cause of defective enamel matrix formation with deficiency in cementing substance
  • common sequelae in kid with hx of generalized growth failure in first 6 mo. of life
  • manifestation of HYPOPARATHYROIDISM (prevent with Vit D)
69
Q

Concrescence

Gemination

Fusion

A

C - joined by cementum, after roots complete

G - single tooth germ splits to form 2 separate crowns

F - 2 tooth buds joined and appear as a large crown

Fusion or gemination occurs during INITIATION and PROLIFERATION stages

70
Q

Anodontia

  1. Complete True
  2. Partial
A
  1. Complete true - usually assoc. with hereditary ectodermal dysplasia
  2. Partial - common and affects max 3rds, max laterals, mand 2nd PMs`
71
Q

Conditions that cause DELAYED EXFOLIATION and DELAYED ERUPTION

A

Systemic
-Cleidocranial dysostosis, Down’s, Ectodermal dysplasia, Gardner’s, Osteogenesis imperfecta, Rickets, Severe congenital heart disease, MR

Localized - abscess, ankylosis

Hypothyroidism, Hypopituitarism, Hypoparathyroidism

72
Q

Child vs. Adult Periodontium

A
  • Child periodontium has greater blood and lymph supply
  • alveolar crest is flatter and bone is thinner
  • gingival pockets are larger, attached gingiva is narrower
  • tissues are redder
  • lack of stippling
  • round and rolled gingival margins
  • cementum is thinner
  • PDL fibers run parallel to tooth
73
Q

primary teeth begin to form at __ weeks in utero and calcify at __ months in utero

A

6 wks

4 months

74
Q

Stages in tooth development (life cycle)

A
  1. Initiation (Bud) - formation of dental lamina [fusion, gemination]
  2. Proliferation (Cap) - enamel organ formed [fusion, gemination]
  3. Differentiation (Bell, Histodifferentiation) - final shaping of tooth, cells become tissue forming cells in enamel organ [dentinogenesis and amelogenesis imperfecta]
  4. Apposition - deposit dental tissues, most cells of pulp are fibroplasts
  5. Calcification (Mineralization) - primary teeth calcify in 2nd trimester of pregnancy (14 wks/4 mo. in utero)
    - at birth, 20 deciduous and 4 1st molars calcified
    - in a 2 yr. old 40 teeth have calcified
    - cariostatic effect of fluoride
    - tetracycline stain incorporated
    - roots done by 3-4 yrs.
  6. Eruption - through gingiva
  7. Attrition - loss of tooth structure
75
Q

enamel is derived from what germ layer

A

ECTODERM - determine crown root and shape

All other tooth structures come from mesenchyme (MESODERM)

76
Q

Stages of Tooth Histogenesis (5)

A
  1. Elongation of inner enamel epithelial cells of enamel organ
  2. Differentiation of odontoblasts
  3. Deposit of 1st layer of DENTIN
  4. Deposit of 1st layer of ENAMEL
  5. Deposit of root dentin and CEMENTUM
77
Q

Korff’s fibers

A

rope-like fibers in pulp periphery, help form dentin matrix

78
Q

Hertwig’s Epithelial Root Sheath (HERS)

A

from joining of inner and outer enamel epithelium of enamel organ
-uniform growth causes single rooted tooth, medial outgrowths cause multi-rooted teeth

79
Q

when a tooth erupts, how much of the root has formed?

in primary teeth, root is formed in __ months

in permanent, it takes __ yrs

A

2/3

18 months

3 yrs

80
Q

Lobes

A

primary centers of ossification, separated by developmental grooves

min # of lobes from which a tooth develops is 4

anteriors = 4 (3 labial, 1 lingual)
premolars = 4 (3 buccal, 1 lingual) cept md 2nd (3 buccal, 2 lingual)
1st molars = 5
2nd molars = 4
3rd molars = 4
81
Q

Primary Tooth Eruption

Rule of Four

A

7 mo. - 4 teeth erupted - 4 mand centrals
11 mo. - 8 teeth erupted - 4 max laterals
15 mo. - 12 teeth erupted - 4 1st molars
19 mo. - 16 teeth erupted - 4 canines
23 mo. - 20 teeth erupted - 4 second molars

82
Q

Periods of dentition

A
  1. Primary 6 mo. - 6 yr.
  2. Mixed 6-12 yr.
  3. Permanent 12+
83
Q

Primary vs. Permanent Teeth

A
  • primary are lighter in color
  • primary pulps are bigger
  • primary crowns are bulbous, constricted
  • primary crowns smoother
  • primary anteriors roots taper more
  • enamel ends abruptly at cervical line instead of getting thinner
84
Q

Primary vs. Permanent Molars

A
  • crowns shorter with pronounced B & L cervical ridges, constricted cervical area
  • occlusal table is narrow F-L
  • anatom is shallower
  • prominent mesial cervical ridge
  • longer roots, more slender, divergent, less curved

sum of M-D widths of primary molars in a quadrant is 2-5 mm > permanent teeth that follow them (premolars)

-enamel on occlusal is 1 mm thick (perm = 2.5 mm)

85
Q

permanent tooth most likely malposed in cases of mand arch space discrepancy

A

permanent mand 2nd premolar

86
Q

primary tooth most likely to be crowded out of the arch

A

primary maxillary canine

87
Q

primary tooth that does not look like any other primary or permanent tooth

A

primary mandibular 1st molar

  • oval occlusal surface, wider M-D > B-L
  • occlusal table rhomboid shape
  • transverse ridge btw MB and ML
  • MB cusp largest and longest
88
Q

primary mandibular 2nd molar looks like

A

permanent mandibular 1st molar

-this primary tooth has the greatest F-L diameter of all primary teeth

89
Q

most atypical tooth of all the molars (primary and perm)

A

primary maxillary 1st molar

  • smallest molar in all dimensions except labiolingual
  • bicuspid
  • H shaped occlusal pit-groove pattern
  • has THREE ROOTS
90
Q

primary tooth that looks like permanent max 1st molar

A

primary max 2nd molar

  • can have 5th cusp of carabelli
  • prominent MB cervical and oblique ridge
91
Q

when do permanent 1st molars calcify

A

at birth

92
Q

at 6, a child’s head is __ % of adult size

A

90%

-brain and cranial base are fully developed

93
Q

human development facts at birth

A
  • jaw large enough to accomodate all primary teeth
  • width of face reached its adult size
  • palate is flat
94
Q

from ages __ to __ body’s lymph tissue is 200% of normal adult

A

6-12

95
Q

fissure sealants succeed by

A

altering host susceptibility

96
Q

caries activity is directly proportional to

A

consistency, frequency, oral retention of fermentable carbs

97
Q

to prevent caries, CDC recommends __ ppm of fluoride in drinking water, and the max is __

A

0.7 ppm

max = 1.2

98
Q

optimal conc. of fluoride for water depends on

A

air temp

99
Q

fluorides often added to water are (3)

A

sodium fluoride
sodium silicofluoride
hydrofluosilic acid

deposits of fluoride happens on SMOOTH SURFACES

100
Q

professional applied topical fluorides (3)

A
  1. Sodium Fluoride (NaF) - basic, good taste, no effect on materials
  2. Stannous Fluoride (SnF2) - does not etch porcelain, tastes bad, ACIDIC, STAINS demin enamel and porcelain, not used in US, advantage is single tx can be given
  3. Acidulated Phosphate Fluoride - tastes better, but can damage prcelain, ACIDIC, contraindicated on porcelain and composite, can corrode surface of titanium implants
101
Q

most stable reaction product of a topical app of F- is

A

fluoroapatite

102
Q

beneficial effects of fluoride

A
  1. interferes with plaque (plaque sticks to teeth cause DEXTRANS are insoluble and sticky)
  2. antibacterial
  3. enhances enamel remin
  4. decreases enamel solubility
  5. inhibits glycolysis
103
Q

mechanisms of fluoride to inhibit caries

A
  1. topical effect - enamel remin
  2. F- converts hydroxyapatite by substituting OH for F- (F- is smaller and has greater affinity for HA)
  3. F- inhibits glycolysis (inhibits production of glucosyltransferase)
104
Q

F- mouth rinses have greatest effect on

A

newly erupted teeth

105
Q

greatest conc. of F- exist on

A

outermost layer of enamel (so be careful in prophy)

106
Q

the toothpaste/dentrifice component most likely to inactive F- is

A

dicalcium phosphate

107
Q

ER tx for kid who ate a lot of F- is

acute F- toxicity symptoms may appear within __ min and persist up to __ hrs

A

induce vomiting, have them drink a lot of milk or something with calcium to decrease acidity and form complexes with fluoride

DON’T have them drink sodium bicarb or do ammonia under nose

Acute F- toxicity appears in 30 min, lasts up to 24 hrs

108
Q

F- is mainly eliminated from body via

most F- absorption happens where?

A

kidneys
(but fluoride in body mostly in skeletal tissue)

absorption in stomach

109
Q

acute fluoride poisoning

A

-causes of death are cardiac failure and respiratory paralysis

15 mg/kg for kid can be lethal
4-5 g for adult is lethal

range of lethal dose is 20- 50 mg/kg

110
Q

dental fluorosis

A

irreversible diffuse symmetric hypomineralization disorder of ameloblasts

  • only when exposure when enamel is developing
  • from chronic (low dose long term) intake, NOT topical
111
Q

pit and fissure sealants are best retained on what teeth?

which teeth benefit the most?

A

retained on max and mand. premolars

max and mand 1st molars benefit the most

112
Q

principal feature of a sealant req for success is

A

adequate retention

caries protection is 100% in pits and fissures that remain sealed

113
Q

components of pit and fissure sealants

A
  1. bis-GMA - monomer
  2. initiator - benzoyl peroxide
  3. accelerator - amine is self cured
  4. opaque filler - titanium oxide added to make it look diff than occlual enamel
114
Q

H&N cancer pts can benefit by using what 2 kinds of fluoride at home?

A

NaF

Stannous F-

115
Q

daily use of F- gels at home is indicated in

A
  • rampant enamel or root caries
  • xerostomia
  • H&N radiation therapy
  • use on abutment teeth under overdenture
  • hypersensitive roots
116
Q

components of NaF paste used to treat root sensitivity

A

sodium fluoride
kaolin
glycerin

117
Q

__ ppm is optimum F- conc. in drinking water

A

1.0 ppm

US public health sets optimum at 0.7-1.2

118
Q

How much F- is in a 8.2 oz tube of toothpaste? mg? ppm?

A

232 mg
1100 ppm

NaF or sodium monofluorophosphate contain 1.0 mg/g toothpaste

119
Q

F- conc. increases or decreases in external layer of enamel through life

A

increases

120
Q

Ellis Crown Fracture Classification

A

Class I - simple, involves little or no dentin -> enameloplasty

Class II - involves considerable dentin, no pulp -> CaOH or GI

Class III - with pulpal exposure -> pulp therapy and restore, then RCT with ZOE

Class IV - entire crown lost -> pulpectomy and SSC

121
Q

Root fractures in primary teeth

A

uncommon cause pliable bone lets the teeth fall out

  • in apical third usually heals itself
  • use heavy wires to stabilize (splinting NOT recommended in kids teeth)
122
Q

most reliable vitality test

A

thermal esp. in incisors (if it doesnt respond -> necrosis)

EPT not reliable

shine light to see pulpal hyperemia

123
Q

why don’t you need gingival bevel in Class II for primary teeth

A

enamel rods in gingival third extend occlusally from DEJ

124
Q

indications for SSCs

A

extensive caries, hypocalcified teeth, teeth with dentinogenesis or amelogenesis imperfecta, after pulpal tx, abutment for a space maintainer, or fractured tooth

125
Q

SSC Tooth Prep

A

cusps reduced 1.0 - 1.5 mm

break contact

126
Q

where is mandibular foramen in relation to occlusal plane compared to adults

A

it’s LOWER

127
Q

girls reach puberty __ yrs earlier than boys

A

2 yrs

128
Q

contraindications to rubber dam

A

if they have fixed ortho, congested nose, recently erupted tooth that won’t hold clamp

129
Q

most common premed prior to general anesthesia for kids is

A

VERSED

premed with barbiturate can cause paradoxical excitement

130
Q

how to manage angry child

A

separate parent, with permission use HOME technique, display authority

131
Q

how to manage fearful child

A

parent stand behind chair, allow child to express fear, change focus, use sedaiton

132
Q

how to manage mentally retarded child

A

short appts, morning, give tour, only 1 instruction at a time, reward

NBDE II Board Busters (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions