PP BDS4 Flashcards
Why might a first molar be impacted?
Angle of path of eruption
Small maxilla
Morphology of surrounding teeth
Ectopic crypt
What are the deleterious effects of impacted teeth?
Root resorption
Bone loss
Tooth loss
Ectopic teeth
Tilting and tipping of teeth
What features of the permanent dentition allow for replacement of primary teeth without crowding?
Slightly proclined permanent teeth
Natural space between the primary teeth allows for relief of crowding in permanent dentition
Leeway space (extra mesial- buccal - distal space occupied by primary molars)
- 5mm per side on upper
- 5mm per side on lower
What is an extrusion injury?
Partial displacement of the tooth out its alveolar socket characterised by partial or total separation of the PDL resulting in loosening of the tooth within its socket
What thickness of stainless steel wire would you use for a flexible splint?
0.6 mm
How long would you splint an extrusion injury for?
Flexible splint for 2 weeks
What are the different types of dentinogenesis imperfecta?
Type 1 = associated with osteogenesis imperfecta
Type 2 = not associated with osteogenesis imperfecta
Type 3 = brandywine isolate (rare condition)
What are the clinical signs of Dentinogenesis Imperfecta?
Loss of enamel
Discolouration
Both primary and permanent teeth affected
What are the radiographic signs of Dentinogenesis Imperfecta?
Bulbous crowns with apparent cervical constriction
Periapical radiolucency without any apparent pathology
Obliterated (missing) pulp chamber and canals due to deposition of dentine
Reduced root length with rounded apices
What are the risks of orthodontic treatment?
Root resorption Relapse Decalcification Gingival recession Trauma Loss of vitality
5 year old brought to clinic, she is pyrexic, in pain and has a swollen left side of face associated with gross caries in all primary molar teeth - you provisionally diagnose an acute periapical abcess
What should you establish prior to the examination of her?
What would be your short term management of this case?
Thorough history;
Pain history
Medical history
Dental history
Determine if airway is compromised;
If patient is unable to swallow or they are unable to push their tongue forward in the mouth, send to emergency services
Pain relief - ibuprofen Abscess drainage Antibiotics due to systemic involvement Amoxicillin capsules 250mg or oral suspension 125mg/5ml 500mg x 3 daily for 5 days Review patient in 5 days time
Advise that if pain or swelling gets worse, to go to A&E
What are the general indications for a pulpotomy?
Good child co-operation Medical history precludes extraction Missing permanent successor Overriding necessity to preserve the tooth e.g. space maintainer Child is under 9
What are the clinical indications for a pulpotomy?
Pulp minimally inflamed/reversible pulpitis
Marginal ridge destroyed
Caries extending >2/3rds into dentine
What are the clinical indications for a pulpectomy?
Exposure of hyperaemic pulp
Irreversible pulpitis
Acute abscesses
What are the advantages of non-vital bleaching?
Simple procedure
Tooth conserving
Original tooth morphology remains
What are the disadvantages of non-vital bleaching?
Risk of spillage of bleaching agent
May fail to bleach teeth effectively
Can over bleach the teeth
Can cause brittleness of tooth
Describe the bleaching inside-out technique
Open up access cavity of tooth
Ensure root filling is removed to below gingival level
Provide custom made mouthguard with windows cut out of the guard for the teeth that aren’t being bleached
Patient applies bleaching agent (10% Carbamide Peroxide) to back of tooth and tray
Patient keeps access cavity clean, replacing gel and removing debris every 2 hours except during the night
Tray should be worn at all times except when eating and cleaning
When does primary tooth eruption begin and end?
Begins at 6 months and ends around 2.5/3 years of age
What are the eruption dates for the permanent dentition?
6 yrs = 6s and lower 1s 7 yrs = upper 1s and lower 2s 8 yrs = upper 2s 9 yrs = lower 3s 10yrs = 4s and 5s 11 yrs = upper 3s 12 yrs = 7s
How long does it take for a permanent tooth root to complete apexogenesis?
3 years
Name 4 types of Amelogenesis Imperfecta
Type 1 = Hypoplastic
Type 2 = Hypo-maturational
Type 3 = Hypo-calcified
Type 4 = Mixed with taurodontism
What are the causes of Amelogenesis Imperfecta?
Caused by inherited gene mutations which are responsible for making proteins needed for normal formation of enamel
What orofacial injuries are suspicious of child abuse?
Bruising of face Bruising of ears Burns Lacerations Bites Neck marks Fractures
You wish to refer a child who you suspect may be victim to child abuse. Who do you refer to and how do you do it?
Observe the child - assess, take a history and examination
Record everything in notes
Communicate with patient and parents regarding concerns
Communicate with senior colleague or dental protection for advice
Refer to social services for suspicions of abuse, neglect or if child is at risk (confirm in writing)
Inform other relevant professionals e.g. GP, schoolteacher
Contact police if you feel the child is in immediate danger
Follow up within 48 hrs