Pedo Flashcards
Initiation seen in ______weeks inutero
bell stage- apposition________weeks
cap stage- enamel organ ______weeks inutero
6 wweks
14 weeks
9 weeks
Apposition and maturation defects
apposition:Defects= enamel hypoplasia, enamel pearls, concrescence
masturation: Defects= enamel hypomineralization, fluorosis, tetracycline staining
- Enamel organ
– Ameloblasts- - Dental papilla
– Odontoblasts-
– Central cells - - Dental follicle
– Cementoblasts -
– Osteoblasts -
– Fibroblasts -
- Enamel organ
– Ameloblasts à enamel - Dental papilla
– Odontoblasts à dentin
– Central cells à pulp - Dental follicle
– Cementoblasts à cementum
– Osteoblasts à alveolar bone
– Fibroblasts à PDL
Congenitally Missing Teeth:
3rd molars>man.2nd pm>max.lat>max.2nd pm
primary max. lat most commonly congenitally missing
- Enamel organ
- Dental papilla
- Dental follicle
forms in _____stage and ____ weeks inutero
and defects
cap stage and 9 weeks in utero
Defects= cyst, odontoma, gemination, fusion, dens in dente
Dens Invaginatus most common in
permanent maxillary lateral
Vertically elongated pulp chamber and short
roots
Taurodontism
Blue sclera
Dentinogenesis Imperfecta
Dentin Dysplasia
* Type I-
Type II-
- Type I- “chevron-shaped” pulps.
Type II-“thistle tube-shaped” pulps.
Enamel Pearl
* Chunk of enamel blocking attachment of
__________ fibers
Enamel Pearl
* Chunk of enamel blocking attachment of
Sharpey’s fibers
Only primary tooth with cusp of Carabelli, oblique ridge, and DL groove
Primary Maxillary 2nd Molar
ML “ice cream cone” cusp is highest and sharpest
Primary Mandibular 1st Molar
- MB cusp is largest
Primary Mandibular 1st Molar
CEJ dips more on mesial half, resulting in S-shaped cervical ridge
Primary Mandibular 1st Molar
Amalgam for Primary Tooth
* ______mm deep
Amalgam for Primary Tooth
* 1.5mm deep
Stainless Steel Crown
* For teeth affected by extensive caries especially past the ________angles
* _________mm occlusal reduction
- For teeth affected by extensive caries especially past the axial line angles
- 1mm occlusal reduction
Strip Crown
indication:
For primary incisors with proximal caries that approximates or involves incisal edge
- Furcation radiolucency is a sign of _________ for a primary pulp
- Furcation radiolucency is a sign of necrosis for a primary pulp
Indirect Pulp Cap cements
Calcium hydroxide or RMGI
Calcium hydroxide May cause _____________ root resorption in primary teeth
internal root resorption
Pulpectomy Usually contraindicated in __________ because they usually have lots of accessory canals
primary first molars
Extraction Only exception may be
for a _________ primary
molar
Only exception may be
for a second primary
molar
- Space management=
- Space maintenance=
- Space regaining=
- Space management= proactive
- Space maintenance= reactive
- Space regaining= retroactive
Primary Canine Loss (Cs) appliance
Lower lingual holding arch or
Nance holding arch from
permanent first molars
Primary First Molar Loss (Ds) appliance
- Band and loop
- LLHA or Nance
Primary Second Molar Loss (Es) appliance
- Distal shoe from primary first molar to unerupted permanent first molar
- LLHA or Nance if permanent first molar is already erupted
- Average tooth pierces bone with ______ root formation
- Average tooth pierces gingiva with ______root formation
- Average tooth pierces bone with two-thirds
root formation - Average tooth pierces gingiva with threefourths root formation
- Primary molar lost before age 7 - eruption of
premolar - Primary molar lost after age 7 - eruption of
premolar
- Primary molar lost before age 7 - eruption of
premolar is delayed - Primary molar lost after age 7 - eruption of
premolar is accelerated
Space Closure
* Most occurs within the first ______ months after
tooth loss
Space Closure
* Most occurs within the first 6 months after
tooth loss
Ankylosed Primary Molars more common in
Ds than in Es (updated)
graft
– Free gingival graft -
– Connective tissue graft-
graft
– Free gingival graft -widen band of keratinized tissue
– Connective tissue graft -root coverage
Eruption Cyst
* Most common around _______ and _______ teeth
Eruption Cyst
* Most common in children* Most common around
incisors and mandibular first molars
High Frenum Tx:
Tx: close space first, then
frenectomy
- Localized aggressive
periodontitis
– Involves ______ and ________ teeth
– Tx: - Generalized aggressive
periodontitis
– Tx: - Prepubertal periodontitis
– Involves ______ teeth
– Tx:
Localized aggressive
periodontitis
– Involves first permanent
molars and permanent
incisors
– Tx: surgical intervention and
antibiotics
* Generalized aggressive
periodontitis
– Tx: surgical intervention and
antibiotics
* Prepubertal periodontitis
– Involves primary molars
– Tx: debridement and
antibiotics
Dental trauma
* Increased overjet ______mm more often
- Increased overjet (>6mm) more often
- Tetanus coverage
– Active immunization is three ______, _______-, and
________ vaccines during first year, booster at
_____, _________, and ______ years and then every ________years after
- Tetanus coverage
– Active immunization is three tetanus, diphtheria, and
pertussis (Tdap) vaccines during first year, booster at
1.5, 3, and 6 years and then every 4 to 5 years after
- Radiographs at incident and follow-ups at ___, _________, and ______ months after
- Radiographs at incident and follow-ups at 1, 2,
and 6 months after
Extrusion less than 3mm
Tx:
when a primary tooth is extruded less than 3 mm, no treatment is needed and the recommended plan is to follow-up and monitor for spontaneous repositioning.
- If extruded more than 3mm -
- If patient is seen before formation of periapical blood
clot -
- If extruded more than 3mm - extract
- If patient is seen before formation of periapical blood
clot - reposition carefully, flexible splint for 1-2 weeks, endo treatment
Avulsed primary teeth
Tx:
avulsed primary teeth are typically not replanted because it can render them susceptible to trauma again or can cause damage to the permanent successor.
- Internal (IRR)= _______ layer in pulp is damaged
- External (ERR)= __________ layer in PDL is damaged
– Surface=
– Replacement=
– Inflammatory=
– Cervical (CRR)=
– Apical (ARR)=
- Internal (IRR)= odontoblastic layer in pulp is damaged
- External (ERR)= cementoblastic layer in PDL is damaged
– Surface= normal PDL, small areas
– Replacement= ankylosis, risk increases with long-term splinting
– Inflammatory= granulation tissue, radiolucency
– Cervical (CRR)= biologic width area, pink spot
– Apical (ARR)= orthodontic forces
- Ages ________ are most commonly abused or
neglected
- Ages 0 to 3 are most commonly abused or
neglected
Potentially Cooperative
* Defiant=
* Uncontrolled= _______-years old,
* Timid= ________ years old,
* Tense-cooperative= _____- years or older
* Whining=
Potentially Cooperative
* Capable of appropriate behavior, but are disruptive in dental setting
* Defiant= any age, spoiled and stubborn, do not like to be advised by adults
* Uncontrolled= 3-6 years old, tantrum
* Timid= 3-6 years old, may hide behind parents (shielding), may deteriorate into uncontrolled
* Tense-cooperative= 7 years or older, white knuckler, want to behave but very nervous
* Whining= continuous, usually no tears
Frankl Rating Scale
* 1=
* 2=
* 3=
* 4=
Frankl Rating Scale
* 1= definitely negative
* 2= negative resistance
* 3= positive acceptance
* 4= definitely positive
- First dental visit should be by ______ year old
- First dental visit should be by 1 year old
Knee-to-Knee Exam
* For infants (________years old)
Knee-to-Knee Exam
* For infants (<2 years old)
Aversive Conditioning not for _______ children
- Not for timid and tense-cooperative
ADHD
* More common in girls/boys
* Most commonly first appears age _____
* Three most common psychostimulant
medications:
ADHD
* Inattentive (AD) and hyperactive (HD)
* More common in boys
* Most commonly first appears age 3 to 6
* Three most common psychostimulant
medications:
– Methylphenidate (Ritalin)
– Atomoxetine (Strattera)
– Amphetamine (Adderall)
Autism
Condition related to:
symptoms:
Autism
* Condition related to brain development that impacts how a person perceives and socializes with others
* Spectrum refers to wide range of symptoms
– Repetitive behavior
– Heightened sense of light and sound
Local Anesthesia in Children
* ________ is maximum recommended dose of
anesthetic
Local Anesthesia in Children
* 4.4mg/kg is maximum recommended dose of
anesthetic
– Fill bag with oxygen and place hood on patient’s nose with flow rate of __________ L/min
* Contraindications
– __________ is most common complication
– Fill bag with oxygen and place hood on patient’s nose with flow rate of 4-6 L/min
– Nausea is most common complication
* Contraindications
– <2 years old
– Uncooperative
– Wheezing episode (mild to moderate asthma is okay)
Four Plateaus of Stage I Anesthesia
Four Plateaus of Stage I Anesthesia
* Paresthesia= tingling
* Vasomotor= warm
* Drift= floating, target analgesia for nitrous
sedation
* Dream= eyes closed, jaw sag
fluoride for Children
* <3 years old -
* >3 years old-
* >6 years old -
– ____% NaF solution weekly
– _____% NaF solution daily
luoride for Children
* ≤3 years old à fluoride drops, because children
this young have difficulty chewing and swallowing
tablets
* >3 years old à fluoride tablets and lozenges
* >6 years old à fluoride mouth rinse
– 0.2% NaF solution weekly
– 0.05% NaF solution daily
Thumbsucking
* Very common up to age ____
* Depends on time per day, duration, and intensity
* Effects are
* Intervention with appliance therapy recommended by age _________
appliances:
Thumbsucking
* Very common up to age 3
* Effects are increased overjet, anterior open bite, maxillary
constriction, and posterior crossbite
* Intervention with appliance therapy recommended by age 5 or 6
* Crib= stainless steel fixed reminder appliance in anterior palate
region
* Bluegrass= fixed reminder appliance with roller in anterior palate
region
- Natal teeth=
- Neonatal teeth=
associated with _________- disease
- Natal teeth= present at birth
- Neonatal teeth= erupt within first 30 days
Associated with * Riga-Fede Disease
ECC
* Any dmft on patient younger than age ______
– Infants should drink from a cup as they approach
age _______-
– First dental visit by age ________
children under the age of _______ use an amount of toothpaste the size of a smear of a grain of rice
and a pea-size amount for those ______.
- Any dmft on patient younger than age 6
– Infants should drink from a cup as they approach age 1
– First dental visit by age 1
children under the age of 3 use an amount of toothpaste the size of a smear of a grain of rice and a pea-size amount for those 3 to 6. (updated)
all primary teeth should exfoliate by the age of ______
12
_________is used when there isunilateralloss of aprimary first molar.
Aband and loop
The tooth most likely to erupt after the permanent mandibular second premolar is the permanent __________.
maxillary canine
The first permanent tooth to erupt is the ___________.
mandibular first molar around 6 years of age.
_________ is not acceptable obturation material for primary teeth.
Gutta percha
The most common age range for dental trauma is _______ years old.
8-12
The most common cause of pulp calcification in primary teeth is __________.
trauma
