Peds Final Flashcards
What is the primary objective of pulp therapy in primary dentition? There are 8 ways that it does this, what are they?
- Prevent or eradicate infection and to maintain the integrity and health of the teeth and their supporting tissues.
- Prevent space loss and malocclusion, Aid in mastication, Preserve primary teeth in case of hypodontia, Prevent possible speech problems, Maintain esthetics, Prevent tongue habits, Prevent psychosocial effects, Maintain normal eruption patterns and timing.
Anatomical differences of pulps between primary and secondary teeth? *(pulp size, mesial pulp horns, pulp horns, mand. vs max., accessory canals, roots, canals, anterior teeth, cervical region of molars)
- In relation to crown, pulps of primary are larger.
- Mesial pulp horns are closer to the outer surface.
- Pulp horns are longer.
- The mandibular molar chambers are larger than the maxillary molar chambers.
- Accessory canals allow for pulp chamber infections to lead into the intra-radicular furcation.
- Roots are longer and more slender.
- Canals are more tortuous/ribbon like.
- Anteriors are narrower mesiodistally.
- Cervical region roots of molars diverge greatly.
To identify/diagnose a tooth you need the Diagnostic Criteria. What is involved in obtaining the Diagnostic Criteria? Before preceding what most be obtained and then documented in the chart?
- History, Symptoms, Radiographs and Clinical Evaluation.
- Informed Consent
When should you use a Protective Liner? How is it done? What 5 materials are used?
- Tooth with normal pulp, all caries removed.
- Liner placed in deep areas of a preparation to minimize injury, promote tissue healing, promote tertiary dentin formation, minimize micro-leakage and minimize sensitivity.
- GLUMA, Calcium Hydroxide, Bonding Agents, Glass Ionomers and RMGI
When should you use an Indirect Pulp Cap? How is it done? What 5 materials are used?
- Tooth with no pulpitis OR that has reversible pulpitis. Deepest carious dentin is not removed to avoid pulp exposure. Pulp is still vital and able to heal from insult.
- Radiopaque base placed over existing caries (leave some caries) and may be covered by a stainless steel crown.
- Calcium Hydroxide, Zinc Oxide/Eugenol, Resin Glass Ionomer, Mineral Trioxide Aggregate and Glass Ionomer Cement.
When should you use an Direct Pulp Cap? How is it done? What 5 materials are used?
- Tooth with normal pulp following a small mechanical/traumatic exposure (pulp exposure), when conditions are optimal - if carious this is not recommended in primary teeth.
- Radiopaque base placed over pulp.
- Calcium Hyroxide, Mineral Trioxide Aggregate, Glass Ionomer, RMGI and reinforced ZOE.
When should you use a Pulpotomy? How is it done? What materials?
- When caries removal results in pulp exposure in a primary tooth with a normal/reversible pulpitis/traumatic pulp exposure.
- Prepare tooth for full coverage, do not perforate pulpal floor, just remove CORONAL pulp (4,6, spoon), apply medicaments.
- Doesn’t matter what material you use as long as your procedures are good. *(ZOE-IRM is the gold standard)
When should you use a Pulpectomy? How is it done? What 4 materials?
- Primary tooth with irreversible pulpitis/necrosis or when a pulpotomy fails.
- Prepare for full coverage crown, do not perforate pulpal floor, remove pulp (4,6, spoon, broach) and file until point of resistance/just short of radiographic apex (<35), obturate (ZOE/Iodoform).
- ZOE, Calcium Hydroxide, MTA, Iodoform Paste.
What are the 4 keys to success in these pulp therapies?
- Diagnosis, Isolation, Technique and Seal
What are contraindications for pulp therapies in primary teeth (5)?
- Close to exfoliation
- Periapical abscess formation with swelling and drainage.
- Cellulits
- Unrestorable Tooth
- Medically Complex (Transplants, cancer, immunosuppression)
What are the crown options for primary teeth (3)?
- Stainless Steel Crown
- Veneered Stainless Steel Crown
- Zirconium Crown
With pulpal therapies, what are differences in the procedures between primary and permanent teeth?
- Protective Liner, Indirect Pulp Cap and Direct Pulp Cap are the same.
- Pulpotomy: In maturing permanent teeth it is more conservative with pulpal access, want to promote tooth maturation and apexogenisis.
- Pulpectomy: In maturing permanent teeth it is more conservative with pulpal access, want to promote tooth maturation and apexogenisis. May want to endodontically refer.
Dental caries are ___ more times common than asthma and ___ more common than hay fever. ____ million school hours per year are lost. Caries prevalence of children under 4 in us ___-___%
- 5, 7
- 51 million
- 38-49%
What is the most common chronic childhood disease, most common reason for a child to miss school and is largely untreated in children under age 3?
- Dental Caries
What is caused by gastric acid and acid regurgitations usually due to acid reflux, anorexia or bulimia?
- Intrinsic Erosion
What is caused by dietary acids (sugar, sugar drinks) and contribute to an acidic state of the mouth? At what pH level does tooth enamel begin to demineralize?
- Extrinsic Erosion
- Below 5.5 (soda averages at 2.5)
What causes tooth discoloration, transparency of the edges of the tooth, tooth sensitivity and chips/falling out of restorations?
- Enamel Erosion
What is loss of root structure due to living body cells attacking part of the tooth, and can be caused by trauma, tooth eruption, chronic inflammation, but MOST commonly Orthodontics? When it is caused specifically by tooth eruption, what is it called?
- External Root Resorption
- Ectopic Root Resorption
What is a condition where the dentin and pulpal walls begin to resorb centrally within the root canal and can be caused by trauma, or a reaction of materials/methods used in pulpotomies?
- Internal Root Resorption
What makes trauma different between primary and permanent teeth? What is Concussion, Intrusion, Extrusion, Subluxation, Lateral Luxation, and Avulsion?
- Primary: Teeth tend to move within softer bone and have less fractures.
- Permanent: Teeth tend to fracture and not move within denser bone.
- Concussion: Trauma that causes sensitivity but no damage.
- Intrusion: Tooth up into bone.
- Extrusion: Tooth away from bone.
- Subluxation: Increased mobility but no damage.
- Lateral Luxation: Sideways
- Avulsion: Tooth falls out of socket due to trauma.
What is a chemical, bacterial, and mechanical irritation, but is usually due to bacterial invasion from death of pulp tissue? What does this look and feel like?
- Acute Alveolar Abscess
- Tenderness of the tooth. Patient has throbbing severe pain with swelling of the overlying soft tissue. When swelling become extensive, it result into cellulits and the patients facial appearance changes.
What is a diffuse infection of the soft tissues, occurs more frequently in younger children, caused by primary or permanent pulpal necrosis, is characterized by considerable swelling of face or neck due to collateral edema and a spreading fascial infection acutely ill, patient may have high fever with malaise and lethargy, is very painful and have a hard time sleeping and eating?
- Cellulitis
What is due to long standing, low grade infection of the periradicular bone, a chronic alveolar abscess develops?
- Chronic Alveolar Abscess
What is caused by bacteria in plaque building up, gums become inflamed and bleed during tooth bushing, the teeth are still firmly planted in their sockets and no irreversible bone or other tissue damage has occurred?
- Gingivitis
What is a chronic inflammatory disease that destroys bone and gingival tissues that support the teeth and it is the major cause of adult tooth loss? ___% of Americans are affected by this.
- Periodontal Disease
- 75%
What are Firm, non-tender, fixed to the surface, rough or cauliflower surface, pale, usually well-circumscribed, asymptomatic, slowly growing? What are examples of this?
- Benign Epithelial Tumors
- Papilloma, Verruca vulgaris, Fibroma, irritation fibroma, epulis fissuratum.
