Restoration In Primary Dentition

Question 1

Anatomic differences in primary teeth

Answer 1

Thinner enamel and dentin

Larger pulp chambers

Pulp horns closer to surface of tooth

Broader flatter proximal contacts

Greater cervical constriction

More prominent cervical contour

Question 2

Class I indications

Answer 2

Caries confided to occlusal surface
No pulp involvement
No cusp involvement
No marginal ridge involvement
Ability to maintain conserverative preparation

Question 3

Class I outline form

Answer 3

Conservative preparation
Remove caries
No extension for prevention
Do not cross oblique ridge unless undermined by caries
Seal unprepared grooves

Question 4

Class I depth

Answer 4

Remove cares

No extension or prevention

Pulp floor into dentin

No liners/bases

Question 5

Not into dentin consider using

Answer 5

Flowable or sealant

Question 6

Advanatage of composites and compomers

Answer 6

More esthetic

May be less prone to failure

Question 7

Advantage of amalgam

Answer 7

Less sensitive to moisture contamination

Slightly quicker

Likely less prone to failure

Question 8

Advantages of GI

Answer 8

Less sensitive to moisture

No etch/bond

Some fluoride release

Question 9

Class II indications

Answer 9

Small proximal lesions

Inner enamel to outer dentin

Ability to maintain ideal preparation

No more than 2-3 years of service needed

Consider deferring

Question 10

Class II contraindications

Answer 10

Larger than ideal class II use SSC

> 2-3 years of service remaining SSC may be a better option

Pulpotomy

Question 11

Proximal box

Answer 11

Broader at cervical than occlusal

Gingival contact broken

Buccal/Lingual contacts need not be broken

Axial wall .5 mm into dentin

Question 12

Class II amalgams failures

Answer 12

Isthmus fracture

Question 13

Class II composites failure

Answer 13

Recurrent decay at gingival margin

Question 14

SSC indications

Answer 14

Large various lesions

Pulpotomy/pulpectomy
Cusp/marginal ridge involvement
MOD
Single surface proximal 
Developmental defects

Question 15

SSC occlusal reduction

Answer 15

1-1.15
Maintain cusps inclines
Depth cuts helpful
Bur
169
Football diamond
High speed 8

Question 16

SSC proximal reduction

Answer 16

Break bucco-lingual and gingival contact

Prep extends subgingival

Gingiva will bleed

Explorer should pass through entire contact

Feather edge marking with no ledge or chamfer

Bur
169
Thin

Question 17

SSC buccal lingual reduction

Answer 17

Minimal
Round line angles
Round occlusal
Do not remove cervical bulge completely

Question 18

Contouring

Answer 18

Bend gingival 1/3 of SSC with 114 or 137 plier to restore anatomic shape and reduce marginal circumference of SSC

Question 19

Crimping

Answer 19

Tuck cervical margin under to ensure tight adaptation with 137 or crimping plier

Question 20

Flattening

Answer 20

Use Howe pliers to flatten interproximal walls and deform crown if needed

Question 21

Seat SSC

Answer 21

Lingual to Buccal and snap over Buccal bulge

Question 22

Problems with seating SSCs

Answer 22

Proximal contacts not broken
Gingival Ledge
Inadequate occlusal reduction SSC too long

Question 23

Primary pulps

Answer 23

More slender and longer roots

Thinner enamel

Thinner dentin

Larger chamber

Higher pulp horns especially in mesial

Question 24

Pulp testing

Answer 24

Not reliable in primary dentition

Question 25

Reversible pulpitis

Answer 25

Capable of healing Vital pulp therapy

Question 26

Irreversible pulpitis

Answer 26

Incapable of healing Non vital pulp therapy

Question 27

Necrotic pulp

Answer 27

Incapable of healing Non vital pulp therapy

Question 28

Vital pulp therapy

Answer 28

Indirect pulp treatment Direct pulp cap Pulpotomy

Question 29

Non-vital pulp therapy

Answer 29

Pulpectomy Alternative = Extraction

Question 30

Indication for vital pulp therapy

Answer 30

Intermittent short duration Thermal or chemical stimulation

Question 31

Indication for non vital pulp therapy

Answer 31

Spontaneous pain Nocturnal pain Prolonged pain Soft tissues signs Pathological mobility Furcation/apical radiolucency Radiographic evidence of internal/external resorption

Question 32

Indirect Pulp Treatment

Answer 32

``` Restorable tooth Near pulp exposure Vital Pulp: No spontaneous pain No clinical signs No radiographic signs ```

Question 33

IPT procedure

Answer 33

Excavate but leave the deepest caries behind to avoid a pulp exposure Place protective liner such as RMGI Restore: The Seal is the deal

Question 34

Direct Pulp cap selection criteria

Answer 34

Restorable tooth Pulp is exposed during various dentin removal Pulp exposure is 1 mm of less Low success

Question 35

DPC procedure

Answer 35

Caries removal leads to pulp expsoure Apply medicaments Place protective liner such as RMGI

Question 36

Pulpotomy selection criteria

Answer 36

Restoable tooth with various pulp exposure

Question 37

Pulpotomy procedure

Answer 37

Occlusal reduction Access and completely de roof pulp chamber Removal all coronal pulp tissue and remaining caries Irrigate pulp chamber with water and dry with cotton pellets Apply medicaments Seal chamber with IRM Break contacts with 169 SSC

Question 38

Pulpotomy medicaments

Answer 38

Formocresol Ferric sulfate Mineral trioxide aggregate Sodium hypochlorite

Question 39

Formocresol

Answer 39

Long history of clinical success Contains formaldehyde so creates a zone of fixation at the surface of the radicular pulp

Question 40

Ferric sulfate

Answer 40

Ferric ions interact with blood proteins leading to agglutination -forms plug

Question 41

MTA

Answer 41

High alkalinity is antibacterial High biocompatibility Excellent seal Promotes hard tissue formation Expensive

Question 42

Pulpectomy selection criteria

Answer 42

``` Restorable tooth Irreversible pulpitis or necrotic pulp Spontaneous pain Clincal sighs Radiographic signs ```

Question 43

Pulpectomy Procedure

Answer 43

Debridement and shape root canals with files Irrigate canals with chlorhexidine and dry with paper points Fill with resorbable material ZOE Under fill> over fill