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Pedodontics > Pulp Therapy in the Primary Dentition - Reinemer > Flashcards

Pulp Therapy in the Primary Dentition - Reinemer Flashcards

1
Q

upper molars drift distally. T/F

upper molars also rotate T/F

A

False - mesially

True

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2
Q

lower molars tip mesially T/F

A

True

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3
Q

T/F a tongue thrust pattern can be developed if teeth are missing

A

true

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4
Q

What are the reasons we want to do pulp therapy instead of extraction?

A

prevent space loss and malocclusion
aid in mastication
preserve the primary tooth in the case of hypodontia
prevent possible speech problems
maintain esthetics
prevent aberrant tongue habits
prevent potentially damaging psychosocial effects
maintain normal eruption patterns and timing

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5
Q

Should you do a mesial prep on a 1st molar? Why or why not?

A

no because the pulp horn is too big

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6
Q

Where is the first sign of pulpal infection in a primary tooth?

A

the furcation of the tooth because there are accessory canals located there.

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7
Q

which molar chambers are bigger, mandibular or maxillary?

A

mandibular

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8
Q

you should always compare the mobility of one tooth to what?

A

the contralateral matching tooth

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9
Q

which is better for isolation, isolite or rubber dam?

A

dam

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10
Q

when should you place a protective liner at the bottom of a restoration?

A

if the tooth has been sensitive beforehand or if the caries are deep

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11
Q

what are the objectives of a protective liner?

A

minimize injury to pulp

promote pulp tissue healing

minimize post op sensitivity

preserve tooth vitality

promote tertiary dentin formation

minimize bacterial microleakage

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12
Q

What is the difference between tertiary and secondary dentin formation?

A

tertiary is secondary to trauma

secondary is any dentin deposited after eruption of a tooth not due to chemical or physical trauma

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13
Q

What is the composition of gluma and what does it do?

A

it is 5% glutaraldehyde and 35% HEMA (hydroxyethyl methacrylate)

it is useful as a desensitizer, cavity disinfectant, and rewetting agent and promotes adhesion

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14
Q

T/F glass ionomers can be placed in the deep areas of restorations to eliminate post-op sensitivity

A

True

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15
Q

what is the HALL technique?

A

place a glass ionomer cement over a carious lesion and crown the tooth to eliminate the bacteria’s food source

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16
Q

what is the modified hall?

A

the modified hall is to scoop out all infected dentin but not affected dentin, stick glass ionomer cement in and crown the tooth

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17
Q

if you do an indirect pulp cap and the patient still has sensitivity, pain, or swelling, it will go away. T/F

A

no, you probably should have done pulpotomy

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18
Q

if you use calcium hydroxide or MTA as an indirect pulp cap, what should be placed over it to prevent the calcium hydroxide from dissolving due to saliva?

A

glass ionomer or reinforced ZOE

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19
Q

indirect pulp caps are successful about _____% of the time

A

85-90%

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20
Q

what are 5 indirect pulp cap materials?

A 
Calcium Hydroxide
ZOE
MTA
Resin Modified glass Ionomer (RMGI)
Glass Ionomer cement
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21
Q

You should never do a direct pulp cap on what kind of pulp?

A

a pulp that has had carious exposure. You only do it on teeth with mechanical exposure

22
Q

the pulpotomy procedure is indicated when caries removal results in pulp exposure in a primary tooth with pulp in what condition?

A

normal pulp or reversible pulpitis

or a traumatic pulp exposure

23
Q

what instrument and/or what bur do we use to remove the pulp chamber in a pulpotomy?

A

use a spoon excavator or a slow speed round bur

24
Q

If after a pulpotomy procedure is done, a follow-up radiograph shows internal resorption, what should be done?

external resorption?

A

the internal resorption should be watched because it is usually self limiting. Extract the tooth if perforation causes loss of supportive bone and/or clinical signs of infection and inflammation.

external resorption should not occur after pulpotomy so the tooth would need to be extracted likely

25
Q

What is formocresol used for?

A

to devitalize/fix tissues like the pulp

26
Q

if you want to preserve the pulp you should use what?

but what is the problem with that solution?

A

ferric sulfate and chlorhexidine

it may mask pulpal symptoms

27
Q

if you want to try to regenerate some of the pulp what material should you use on the pulp?

A

MTA

28
Q

What is the gold standard for sealing and filling the coronal pulp chamber?

A

ZOE

29
Q

If you open up a tooth to perform a pulpotomy and you can’t get the bleeding to stop when you take out the pulp in the chamber or it doesn’t bleed at all then what does that mean?

A

it means there is irreversible pulpitis or necrosis and you need to due a pulpectomy

30
Q

if there was root pathology and a pulpectomy was performed, how long after should there be good bone deposition in the previously radiolucent areas?

A

6 months

31
Q

a pulpectomy treatment should permit resorption of the primary tooth root and filling material to permit normal eruption of the succedaneous tooth. T/F

A

True

32
Q

What materials are placed in a tooth that has had a pulpectomy performed?

A

ZOE
or
Iodoform paste (bactericidal, resorbable)

33
Q

what are the 4 keys to success when it comes to pulp therapy?

A

Diagnosis
Isolation
Technique
Seal

34
Q

T/F pathologic internal resorption or external root resorption can be treated successfully via pulp therapy

A

False - they are both contraindications for pulp therapy in primary teeth

35
Q

T/F if a tooth is close to exfoliation a pulp therapy treatment is a good idea to ensure the infection does not damage the permanent tooth underneath

A

False - just extract the tooth if it is close to exfoliation

36
Q

which tooth helps guide the first permanent molar into place?

A

the second primary molar

37
Q

having a periapical abscess formation with swelling and drainage is a contraindication for pulp therapy unless what?

A

the tooth is deemed important, like primary 2nd molar before the 1st molar has erupted

38
Q

if a patient has cellulitis, you need to do pulp therapy in order to help resolve the infection. T/F

A

False - extract the tooth

39
Q

Tansplant patients, cancer patients, and immunosuppressed patients should have teeth extracted instead of pulp therapy. T/F

A

True

40
Q

if a patient has a traumatic and small pulp exposure what treatment should be done?

what if the patient doesn’t come in for about two days after the trauma, now what is the treatment?

A

direct pulp cap

treatment is now a pulpotomy because bacteria have found their way to the pulp

41
Q

pulpectomies really should be limited to which teeth?

A

second primary molars

42
Q

small swelling around tooth S (1st primary molar) limited to the buccal vestibule. Patient is 5. What is the treatment?

A

extraction

43
Q

if you open up the pulp of a primary molar and it will not stop bleeding what are some possible causes?

A

pathology and inflammation in the roots

bleeding disorder

perforation of the furcation

tissue tags on the canals (you should check this one first always)

44
Q

What kind of margin should not be done for a stainless steel crown?

A

chamfer

45
Q

should you prep the tooth for the crown first or do the pulpotomy first? and why?

A

you should prep for the crown first because if you do it after you have placed the restorative material in the pulp chamber then you may displace that restorative material with air/water as you are prepping the tooth for a crown. that will introduce bacteria and cause problems

46
Q

Reinemer says he wants us to focus on the indications and contraindications for each of the various pulp therapies for the exam. T/F

A

True

So the remaining flashcards will be indications. I realize there will be repeats

47
Q

what is the indication for a protective liner?

A

normal pulp with deep caries

48
Q

What is the indication for an indirect pulp cap?

A

no pulpitis or reversible pulpitis when the deepest carious dentin is not removed to avoid a pulp exposure.

49
Q

What is the indication for a direct pulp cap?

What is the contraindicaiton?

A

normal pulp following a small mechanical or traumatic exposure

do not direct pulp cap a carious exposure.

50
Q

What are the indications for a pulpotomy?

A

caries removal results in pulp exposure in a primary tooth with normal pulp or reversible pulpitis

or after a traumatic pulp exposure that happened days ago.

51
Q

What are the indications for a pulpectomy?

A

indicated in a primary tooth with irreversible pulpitis or necrosis or a tooth treatment planned for pulpotomy in which the radicular pulp exhibits clinical sings of irreversible pulpitis or pulp necrosis

52
Q

What are the contraindications to pulp therapy?

A

pathologic internal or external root resorption

close to exfoliation

pariapical abscess formation with swelling and drainage unless tooth is deemed important

cellulitis

unrestorable tooth

medically complex patients (transplant, cancer, immunosuppresion)

Pedodontics (9 decks)

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