PEDs OSCE Flashcards
What occurs when space is lost in dentition that should be present?
Greater chance of decay
Ectopic Eruption
Abnormal Eruption Patterns
Malocclusion
What complications occur with early loss of primary teeth?
Supraeruption
Mesial/Distal drift
Change in arch dimensions (length & circumference)
Ectopic or blocked eruption of permanent teeth
Increased chance of ortho in future
Prior to placing space maintainers, what should you consider?
Motivation & Dental Hx
Space Available
Occlusion or malocclusion
Development stage
Don’t Place if:
* Bad Hygiene
* Permanent teeth should erupt w/in 1 year
* High caries risk
When shouldn’t we use space maintainers?
Cosmetic issue not clinical issue
Lose 1st primary molars too early
Early: Band & Loop
Late: Lower Lingual Holding Arch
Band & Loop fabrication process
- Fit band, crown, modified crown
- Scan or impress
- Remove band and seat or send t lab
- Solder .036 wire to band
- Cement
Should be wide enough for tooth to erupt through
Loss of 2nd Primary Molars before 1st perm molars erupt
Distal shoe from primary 1st molar
Once 1st perm molars erupt, switch to:
* reverse Band & Loop
* Lingual arch
* Transpalatal arch
* Nance appliance
Lose 2nd primary molars after 1st perm molars erupted
LLHA-Mandible if incisors have erupted
TPA or Nance-Maxilla, incisors dont have to be present
* must be passive, hygienic, not impinge soft tissue
When should we use lower lingual holding arches?
after incisors have erupted
hold leeway space, “e” space
Hold multiple spaces unilaterally or bilaterally
What is a transpalatal (TPA) and Nance Appliance?
Upper Arch
can use before eruption of incisors
What can occur with loss of canines?
Midline Shift
Increase OJ & OB
Loss of arch dimensions (Length & Circumference)
After placing an oral appliance, what is required?
Check for:
* tooth movement, not passive
* Loose or broken appliance
* Decay
* gingival issues
* Dental development
What can you do if patient looses 6 year molars early?
3rd molar transplantation
Need:
* socket for transplanted tooth
* immature 3rd molar
* Cooperation
* good Hygiene
* Healthy Patient
Eruption Sequence
What space is normal in pediatric dentition?
Primate spaces
Leeway spaces
Primate Spaces
Mesial to upper canines
Distal to lower canines
Lose at 6 y.o.
When is the ugly duckling stage?
age 7-11
Leeway Space
MD width of primary molars + canine is wider than…
MD width of permanent canine + premolars
Mandible: 1.7-2.5 mm per side
Maxilla: 0.9-1.5 mm per side
Lose at 11-12 y.o.
What are alternatives to space maintenance?
regaining space maxes at 3 mm
Space management=Proactive
Space maintenace-reactive
Space regaining-retroactive
When is space maintenance unnecessary after primary teeth are lost?
No bone present b/w primary and perm tooth
avg tooth erupts with 2/3 root formation
If a primary molar is lost after age 7, what happens to the eruption of the perm premolar?
Accelerated eruption of premolar
* No space maintainer if 1st perm molars have stable occlusion
If a primary molar is lost before age 7, what happens to the eruption of the perm premolar?
Delayed premolar eruption
Maintain
When does space close after primary tooth loss?
1st 6 months
most is due to tipping
What can increase space loss w/primary tooth loss?
active eruption of adjacent perm teeth
What is the significance of ectopic erupting incisors?
What is the significance of ectopic erupting premolars?
Distal Eruption:
* Mandibular 2nd premolar-Most common
* resorbs distal root of primary 2nd molar
B or L Eruption:
* Very common
* Ext Primary Molar if not ready to exfoliate in a few weeks
What is the significance of ectopic erupting molars?
Mesial Eruption
* Impacted under Distal of primary 2nd molar
* Spacer
* Halterman Apppliance
Maxilla-most common
