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Pedo/Ortho > Restorative Dentistry and Pulp Therapy > Flashcards

Restorative Dentistry and Pulp Therapy Flashcards

1
Q

What ate the 2 primary objectives in pulp therapy for baby teeth?

A

1- eradicate infection

2-maintain the integrity and heath of the teeth and supporting tissures

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2
Q

8 reasons why we don’t just pull baby teeth

A

1- prevent space loss and malocclusion
2- aid in mastication
3- preserve the primary tooth in case of hypodontia
4 - Prevent possible speech problems
5- Maintain esthetics
6- Prevent aberrant tongue habits
7- Prevent potentially damaging psychosocial effects
8-Maintain normal eruption patterns and timing

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3
Q

If a primary tooth is removed, and space is not maintained, what can happen with the premolars?

A

1st premolar can come in ectopically and resorb roots of 2nd premolar

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4
Q

what are the 5 pulpal therapies offered in pediatric dentistry?

A 
1- protective liner
2- indirect pulp cap
3- direct pulp cap
4- pulpotomy
5- pulpectmy
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5
Q

T/F In relation to crowns, the pulp in primary teeth are smaller than in the permanent dentition

A

False

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6
Q

Which pulp horn is closest to the outer surface of the tooth?

A

Mesial pulp horns

**makes it more readily exposed to caries or trauma

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7
Q

T/F Pulp horns under each cusp are longer than suggested by external anatomy?

A

true

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8
Q

Which arch has molars with bigger pulp chambers?

A

Mandibular

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9
Q

where do accessory canals in primary teeth lead?

A

directly to the intra radicular furcation

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10
Q

Describe how roots compare to crown size in primary teeth

A

Longer and more slender than permanent teeth

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11
Q

Describe primary tooth canals

A

long, ribbon like, tortuous

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12
Q

T/F primary teeth are wider mesiodistally

A

False- they are narrower

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13
Q

proper identification and diagnosis requires what 4 things?

A

1-History
2-symptoms
3- radiographic eval
4- clinical eval

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14
Q

Do you need consent from parents?

A

yes. Duh.

  • *or Legal guardian
  • *Get documentation of concent
  • *answer all questions
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15
Q

What pulpal therapy is indicated if you have normal pulp, all caries are removed for a restoration?

A

Protective Liner

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16
Q

what are the 3 purposes of a protective liner?

A

1- minimize injury to pulp
2- promote pulp tissue healing
3- minimize post-op sensitivity

  • *Place in deep spots
    • a good seal is more important than the actual material type that is placed
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17
Q

What are the 4 objectives for a protective liner?

A

1- preserve tooth vitality
2- promote pulp tissue healing
3- promote tertiary dentin formation
4- minimize bacteria microleakage

**Should prevent post-op sensitivity, pain, swelling

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18
Q

5 protective liner materials

A 
1- GLUMA
2- calcium hydroxide
3- bonding agents
4- glass ionomers
5- RMGI
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19
Q

What makes up gluma ?

A

5% glutaraldehyde

35% HEMA (hydroxyethyl methacrylate in water)

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20
Q

What 4 things does GLUMA do?

A

1- Desensitizer
2- cavity disinfectant
3- rewetting agent
4- adhesion promoter

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21
Q

what are 2 indications to use an indirect pulp cap?

A

1- no pulpitis or irriversible pulpitis

2- deepest caries are NOT removed to avoid pulp exposure

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22
Q

The pulp is judged by what 2 things to determine if tooth is vital and able to heal from the carious insult?

A

1- radiograph

2- clinical criteria

23
Q

7 Steps to indirect pulp cap

A 
1- prep tooth for restoration
2-caries free margins
3- remove gross caries and infected dentin
4- don't hit the pulp
5- leave affected dentin
6- place radiopaque base
7- restore
24
Q

5 objectives of indirect pulp cap

A 
1-seal involved dentin
2- preserve tooth vitality
3- no post-op symptoms
4- no evidence of root resportpion or path. changes 
5- no harm to perm. tooth
25
Q

5 indirect pulp cap materials

A 
1- Calcium hydroxide
2- ZOE
3- resin modified glass ionomer
4- mineral trioxide aggregate (MTA)
5- glass ionomer cement
26
Q

what should be placed over CaOH?

A

glass ionomer or ZOE to provide seal

27
Q

CaOH has high or low solubility?

A

high

28
Q

CaOH has good or poor seal?

A

poor

**one of the reasons it needs to be reinforced

29
Q

CaOH has high or low compressive strength

A

low

30
Q

2- indication for direct pulp cap

A

1- normal pulp following small exposure

2-favorable conditions to heal

31
Q

T/F direct pulp cap of carious pulp exposure is recommended

A

false

32
Q

3 basic steps of direct pulp exposure

A

1-mechanical or traumatic pulp exposure
2- place radiopaque base
3- restore and seal

33
Q

2 main objectives if direct pulp cap

A

1-mainain tooth vitality

2- no post-op symptoms

34
Q

what should result from direct pulp cap?

A

pulp healing and reparative dentin formation

35
Q

2 materials for direct pulp cap

A

1- CaOH

2- MTA

36
Q

what should be placed as a seal in direct pulp cap to prevent microleakage?

A

Glass ionomer, RMGI or reinforced ZOE

**CaOH have high solubility, poor seal, low compressive stregnth

37
Q

2 indication for pulpotomy

A

1- pulp exposure from caries removal with normal pulp

2- reversible pulpitis from traumatic pulp exposre

38
Q

9 pulpotomy basic steps

A 
1- prep tooth for full coverage
2- remove caires
3- unroof pulp chamber
4- remove coronal pulp (#4, 6, spoon)
5- stop bleeding with pressure
6- apply medicaments
7- dry with cotton pellets
8- seal
9- place crown
39
Q

3 objectives of pulpotomy

A

1- radicular pulp should remain asymptomatic
2- no post op root resorption
3- internal resorption should be stable and self limiting
**might need to remove tooth in perf. causes loss of supportive bone

40
Q

5 pulpotmy materials

*material (purpose)

A

1- Formocresol - 1:5 dilution, bactericidal, 65-95% success
*(devitalization/fixation)
2- Ferric sulfate- mask pulp signs (preservation)
3- Chlorhexidine (preservation)
4-MTA (regeneration)
5- ZOE (IRM) is the gold stanard for sealing and filling coronal pulp chamber

41
Q

In class hint regarding pulpotmy materials

A

***it doesn’t really matter what product you use as long as you SEAL THE TOOTH

42
Q

3- pulpectomy indications

A

1- irreversible pulpitis or necrosis
2- planned for pulpotomy but you see radicular pulp is bad
3- roots have minimal or no resorptions

**you’ll know you need to go to pulpetomy if there is excessive bleeding

43
Q

11 basic steps for pulpectomy

**steps 5-9 are different from pulpotomy

A

1- prep tooth
2- remove caries
3- unroof pulp chamber
4- remove coronal pulp
5- extiprate radicular pulp with broaches
6- short fine for radiographic apex (<35)
7- instrument only to point of resistance
8-dry with paper points
9-obturate with ZOE or iodoform past
10- seal
11- place crown

44
Q

3 pulpectomy objectives

A

1- radiographic infection should resolve
2- clinical signs should resolve
3- tx will allow for primary tooth resorption and allow perm. tooth to erupt

45
Q

how long after pulpectomy will radiographic evidence go away?

A

6 month

46
Q

how long after pulpectomy will clinical pre-tx go away?

A

few weeks

47
Q

4 pulpectomy materials

A

1- ZOE
2-CaOH
3-MTA
4- Iodoform paste (bactericidal, resorbable)

48
Q

4 keys to success of any pulp therapy?

A

1- diagnose
2- isolate
3- technique
4- seal

49
Q

4- Contraindications to pulp therapy in primary teeth

A 
1-close to exfoliation
2-PA abscess with swelling and 
drainage
3- unrestorable 
4- medically complex
50
Q

Crown options for primary teeth

A

1- stainless steel crown
2- veneered stainless steal crowns
3- zirconium crowns

51
Q

what three pulp therapies are the same for primary and perm. teeth?

A

1- protective liner
2- indirect pulp cap
3- direct pulp cap

52
Q

How does a pulpotomy in a primary tooth differ in a permanent tooth?

A

more conservative pulp access. uses reparative materials like CaOH and MTA

53
Q

How does a pulpectomy in a primary tooth differ in a permanent tooth?

A

endo referal

same as pulupotomy: more conservative pulp access. uses reparative materials like CaOH and MTA

Pedo/Ortho (5 decks)

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