Pediatricos Flashcards
increase in skill and complexity of function:
Level of organization and Qualitative content:
Development
Maturity
Distal ends radius and ulna - carpals - metacarpals - phalanges
Skeletal Age
*assess 8 carpals in order of appearance from capitate to pisiform
3 Factors to determine Dental Age:
Teeth erupted
Primary Root Resorption
Permanent Root Development
Avg birth weight:
5 months:
1 year:
2 years:
7,5 lbs
double birth weight
triple birth weight
quadrupled birth weight
Scammon’s Curve, top to bottom:
Lymphoid
Neural
Mx
Mn
General
Genital
On Scammon’s Curve, Lymphoid reaches 200% at what age?
10 years
so kiddos have big tonsils
*smaller @ 2 and 12, obviously
Pre-natal Developmental Milestones: 3 - 6 weeks:
6th week:
7th - 8th week:
14th week:
14 - 32nd week:
Birth:
face
deciduous tooth buds
palate fuses
deciduous calcification
revlexes
Permanent teeth begin calcification
Mx is part of the Head/Brain/Cranium and grows in what direction?
This displaces:
Up and Back
Down/Forward
Scammon’s, the majority of neurologic growth happens when?
First 2 yrs of life
Neural growth is 95% of adult size when?
7-8 y/o
Cranial vault growth has soft _______
This allows passage through the birth canal, expansion through ______ growth across them
Fontanelles
Appositional
When do Fontanelles close?
2+ years
Premature fusion of fontanelles:
Cranial Synostosis
*assymmetry
Cranial Base grows by _____
Endochondral Ossification
Mn growth is ______
Displaces (translates)
Up/Back
Down/Forward
Mn Growth is _______ on the posterior ______
Minimally where?
appositional, Ramus
chin
What area of the Cranium remains active up until childhood?
Spheno-Occipital Base
3 Kinds of Inclusion Cysts:
Epstein’s Pearls
Bohn’s Nodules
Dental lamina Cyst
Remnants of epithelial tissue trapped along midpalatal raphe
Epstein’s Pearls
Buccal/Lingual aspects of dental ridges/Junction hard/soft palate
*they are remnants of mucous gland tissue
Bohn’s nodule
Crest of alveolar ridge
*remnants of Dental lamina
Dental-Lamina Cyst
(epstein) Pearls are found on the ______
Bohn’s are found _______
Dental lamina cyst ______
palate
junction
alveolar crest
Epstein peal is remnants of what?
Bohn’s nodule, remnants of…
dental lamina
epithelial tissue
mucous gland tissue
dental lamina
6 wks in Utero:
14-19 wks in Utero:
1st year of life:
2nd year of life:
3rd yr of life:
primary teeth begin to form
calcification begins
enamel of all primary teeth complete
all primary teeth erupted
roots of primary teeth complete
_____ teeth are present at birth
_____ teeth erupt within 30 days of birth
Natal
Neonatal
Eruption Pattern, Primary teeth:
Timescale:
CI, LI, 1M, C, 2M (A, B, D, C, E)
6m, 9m, 11-18m, 16-20m, 20-30m
*for incisors, Mn slightly ahead of Mx
Eruption pattern, Permanent Mx:
CI 7-8 LI 8-9 C 11-12 1P 10-11 2P 10-12 1M 5.5-7 2M 12-14 3M 17-30
Eruption pattern, Permanent Mn:
CI 6-7 LI 7-8 C 9-11 1P 10-12 2P 11-13 1M 5.5-7 2M 12-13 3M 17-30
Primary to Permanent teeth: Girls before boys:
Eruption follows exfoliation by ____
Enamel of permanent tooth complete _______ yrs prior to eruption
Root formation complete ______ after eruption (permanent)
Eruptive force fo 1st permanent Molar closes what spaces?
True
6 months
3 years
3 years
remaining primary molars
Mx Eruption Sequence: (Palmer)In
Mn:
6-1-2-4-5-3-7-8
6-1-2-3-4-5-7-8
Leeway space Mx:
Mn
- 5mm/quadrant
- 5mm/quadrant
* remember, primary dentition larger than permanent
Initiation/Calcification of Primary Teeth:
#’s are IN UTERO in WEEKS
CI 6 14 LI 6 16 C 7 17 1M 6 15 2M 8 19
The only permanent tooth that displays calcification at birth?
1st Molars
9 months, what teeth?
12 months?
18 months?
24 months?
A, B
A, B, D
A, B, C, D
A, B, C, D, E
Eruption sequence (primary/Palmer)
Calcification sequence (primary/Palmer)
A, B, D, C, E
A, D, B, C, E
With the exception of the 3rd Molar, all permanent teeth have hard tissue formation by 3 y/o
True
Distal occlusion that will result in Class I occlusion:
Flush or Mesial Step
*Mesial Step is Ideal
Distal occlusion will result in Class III occlusion:
Result in Class II occlusion:
Exaggerated Mesial Step
Distal Step
*distal step manDIble = class II
Class I Canine:
Class II Canine
Class III
Mn C between Mx LI/C
…distal to LI/C midline
mesial to LI/C midline
Primary molar occlusion described as…
Primary Canines described as…
steps
class I, etc
If the Canine is lost, sometimes will remove the contralateral to maintain symmetry
True
4 Basic Fixed appliances:
Band/Crown and Loop
Distal Shoe
Transpalatal (Nance)
Lower Lingual Holding Arch (LLHA)
Band/Crown and Loop used in what situation?
example?
single tooth loss
1st primary Molar loss, before eruption of first permanent Molar
Distal Shoe is used in what situation?
example?
Single tooth loss
2nd primary Molar loss, before eruption 1st permanent Molar
2 options for single teeth:
2 options for multiple teeth/bilateral loss:
Band/Crown and Loop, Distal Shoe
Nance (Transpalatal), LLHA
Nance is used where?
LLHA?
Mx
Mn
When do you NOT use Nance/LLHA and Do Nothing?
If permanent dentition is in occlusion
AND a mesial proximal contact
*basically, only if Primary 1M missing
Moyers Analysis uses what level of Probability?
*Mn incisors estimating size of rest of dentition w/ 95% accuracy
75%
4 y/o w/ Hx Leukemia, wants distal shoe:
negative
*Med situation contraindicates distal shoe
Tanaka-Johnson, add 2 Mn incisors and add ______ for each quadrant in the Mx (this estimates Palmer 3,4,5)
add 2 Mn incisors and add ______ for each quadrant in the Mn (estimates Palmer 3,4,5)
11 mm
10.5 mm
Tanaka-Johnson, what incisors are predictive?
Mn
Mn incisors/2 + 11 =
Mn incisors/2 + 10.5 =
Mx quadrant 3,4,5
Mn quadrant 3,4,5
2 strategies to interact w/ kiddos:
Tell Show Do
Ask Tell Ask
Voice control, positive reinforcement, memory reconstruction
General behavior concepts
Simple Protective Stabilization
Active immobilization:
hands over pts hands/arms
holding hands, legs, shoulders, knee to kne
*think - seat belts
Protective Sabilization Papoose Board: safe ____ limited, non-punish
pre-________, disables or Emergency
Rist of injury to ___, staff, dentist, parent
Needs…
Limited…
time
cooperative
pt
Specific Consent
Care
Never use Protective Stabilization w/ cooperative, med contraindications, psych/physical contraindiction, Hx psychological trauma due to immobilization, non-emergent Tx, practitioner’s conveniece
True
92% mothers believe should’ve been present
90% understood restraints keep child from harm
True
Mouth props are Protective Stabilization
False
*used w/ all procedures
Caries is multifactorial
True
ECC is _____ or younger, 1 or more decayed/missing/filled
Severe ECC is any smooth surface lesion younger than _____
3-5, one or more caivitated, missing, filled score of greater than 4 at age 3, 5 at age 4, 6 at age 5
71 months
3
True
Pattern to Severe ECC (list 6 in descending order)
Mx Incisors
Mx 1M
Mn 1M
Mx C/2M
Mn C/2M
Mn incisors seldom
Strep Mutans primary source transmission
Maternal (24-100%)
Dental Home established no later than ____
12 months
Goal of Fluoride toxicity is to minimize absorption with what?
Calcium products
*remember, 1 tube might kill 60 pounder
The 6’s (four of them): No Fluoride Supplement if:
Less than 6 months
more than 0.6 ppm
more than 16 years
Dosage changes at 6 mo’s / half of 6years (3) / 6 years
Cause of Methemoglobinemia:
Benzocaine
CAR
PRR
Conservative Adhesive Restoration
Preventive Resin Restoration
CAR type 1
type 2
type 3
enamel (sealant)
dentin (flowable)
dentin (packable/sealant)
CAR only need what?
Pits and grooves
What restoration is seldom used in children?
Why?
Do what instead?
Class IV
limited strength, encroaches on pulp
SCC
Indications for SCC: (composite/strip crown)
Decay, IP lesions, pulp therapy, fracture, incisal edge involvement
Strip crowns are exclusively for what?
Incisors/Canines
SCC (comp crowns) vs. Class II Amalgams: SCC for children less than…
SCC ___x successful as Amalgams
4
2x
Rule of 4 SSC:
IP Caries or Posterior Lesion, Less than 4 y/o
Any Child more than 4 IP posterior lesions
ITR =
Interim Therapeutic Restoration
When circumstances do not permit traditional cavity prep and/or placement traditional restorations OR when caries control necessary prior to placement of definitive restorations
ITR
3 indications for ITR
minimal lesions
young children
caries control
4 indications Anterior SSC
inadequate tooth structure
occlusal probs
Primary canines/occlusion
esthetics vs durability
Class II
Proximals
*no marginal ridge break through
T/F
No MOD on Primary molars
True
*not enough structure
Class III incisal edges involved
False
Never use Class IV restorations, instead Crown
True
