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Pediatric Dentistry > Restorative Dentistry in Children > Flashcards

Restorative Dentistry in Children Flashcards

1
Q

basis for treatment plan consideration

A
  1. dental status of the patient
  2. caries risk assessment based upon the caries history of the patient
  3. patient’s oral hygiene
  4. anticipated parental compliance and likelihood of timely recall
  5. px’s ability to cooperate for treatment
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2
Q

why we need to restore primary dentition

A
  1. restore damage caused by dental caries
  2. protect and preserve remaining pulp and tooth structure
  3. retain adequate function
  4. restore esthetics
  5. facilitate early maintenance of good oral hygiene
  6. maintain arch length and space
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3
Q

types of restorations

A
  • conventional restoration
  • full coverage restoration
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4
Q

types of conventional restorations

A
  • amalgam
  • composite
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5
Q

types of full coverage restorations

A
  • stainless steel crown (SSC)
  • strip off crown (SOC)
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6
Q

inclination of enamel rods of primary molars

A

occlusally

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7
Q

inclination of enamel rods of permanent molars

A

apically

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8
Q

thicker enamel and dentin: primary or permanent

A

primary

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9
Q

primary molars resemble permanent teeth except

A

primary mandibular first molar

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10
Q

why primary mandibular first molar differs from its permanent counterpart

A

mesial pulp horn is higher than distal pulp horn

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11
Q

principles of cavity preparation

A
  • outline form: dovetailed
  • transverse ridge: not included unless undermined
  • wall coverage: slightly with the greatest width of pulpal floor
  • CSM: sharp
  • angle of walls and floors: slightly rounded
  • APL angle: rounded
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12
Q

principles of cavity preparation: outline form

A

dovetailed

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13
Q

principles of cavity preparation: transverse ridge

A

not included unless undermined

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14
Q

principles of cavity preparation: wall coverage

A

slightly with the greatest width of pulpal floor

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15
Q

principles of cavity preparation: CSM

A

sharp

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16
Q

principles of cavity preparation: angle of walls and floors

A

slightly rounded

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17
Q

principles of cavity preparation: APL angle

A

rounded

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18
Q

class I cavity prep: internal outline form

A
  • 1.5mm cavity depth
  • rounded line angles
  • rounded pulpal floor
  • sharp cavosurface margins on lateral walls
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19
Q

class I cavity prep: isthmus width

A

1/3 of occlusal table

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20
Q

class II cavity prep: proximal box

A
  • buccal and lingual walls: extend into self-cleansing areas
  • cavosurface angle: sharp 90° angle (butt-joint)
  • B and L walls: converge occlusally
  • internal line angles: rounded
  • B and L retentive grooves: contraindicated
  • gingival floor: beneath contact point
  • no bevel
  • axial wall: follows contour of tooth
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21
Q

why marginal failure increases

A

when excess tooth structure is removed

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22
Q

% of multi-surface amalgam restorations needing replacement

A

70%

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23
Q

common errors in class II AM restorations

A
  • occlusal outline: extended into all susceptible pits and fissures
  • outline: follows cusps
  • isthmus: too wide
  • proximal walls: flare too great
  • axial, buccal, lingual wall: too great
  • gingival contact with adjacent tooth: not broken
  • axial wall: does not conform with proximal contour; M-D width of gingival floor greater than 1mm
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24
Q

matrix bands and retainers: uses

A
  • restore normal contact areas of primary teeth
  • prevent extension of access of restorative materials beyond the band into gingival tissue
  • convenient and easy to use for Am condensation and carving
  • easily removed
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25
Q

matrix bands and retainers: indications

A

class II cavity prep

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26
Q

matrix bands and retainers: difficulties

A
  • deep cervical constriction
  • broad contacts
  • prominent bulge
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27
Q

matrix band commonly used in pediatric dentistry

A

t-band

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28
Q

occurs when t-band is cut too long

A

can cut px’s cheek

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29
Q

occurs when t-band is cut too short

A

t-band cannot be adjusted anymore

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30
Q

occurs when their is faulty wooden wedge placement

A
  • overextension of restorative material (overhang)
  • open contact due to inadequate wedge pressure
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31
Q

solution for overhang

A

make sure band is tight and wedge is parallel

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32
Q

the use of a metal instrument to smooth and shape the surface of a newly inserted Am restoration

A

burnishing

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33
Q

when Am polishing is done

A

24-48 hours after restoration

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34
Q

objectives of polishing

A
  • resist corrosion and tarnish
  • reduction in recurrent caries and marginal failure
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35
Q

qualities of well-polished amalgam

A
  • no flash; no submarginal area
  • clearly defined grooves
  • anatomy and contour resemble corresponding tooth on opposite side
  • marginal ridge height equal to adjacent tooth
    – surface free of scratches
  • shiny surface finish
  • interproximal contact should be undisturbed
36
Q

composite restorations: advantages

A
  • elimination of mercury in dental environment
  • improved appearance and esthetics
  • reduced thermal stimulation too pulp
  • color matching potential
  • bonding with cavity walls
  • longevity
37
Q

composite restorations: disadvantages

A
  • increased tendency for abrasion
  • possible interproximal contacts
  • appearance of microscopic voids; can cause recurrent caries
  • lack of composite resin that is truly radiopaque
  • pulpal protection with liner is necessary
  • shrinkage during polymerization
38
Q

pulpal protection for class B depth

A

calcium hydroxide/dycal

39
Q

full coverage restorations: advantages

A
  • restore esthetics
  • prevent psychological trauma
  • restore function (speech and mastication)
  • maintain occlusion
  • prevent fracture
40
Q

full coverage restorations: indications

A
  • primary anterior teeth with extensive or multiple surface caries
  • malformed teeth with congenital anomalies
  • fractured teeth
  • final restoration after pulp therapy
  • disclosed anterior teeth
41
Q

examples of congenital anomalies that indicate full coverage restorations

A
  • peg laterals
  • microdontia/macrodontia
  • Hutchinson’s incisors (congenital syphilis)
42
Q

examples of conditions that cause tooth discoloration

A
  • fluorosis
  • tetracycline stains
43
Q

how to measure M-D width of SOCs

A
  • use a caliper
  • incisor-incisor measurement
  • take an impression and make a cast before indirectly measuring
  • trial and error
44
Q

advantage of taking an impression to measure M-D width of SOC

A

hygiene

45
Q

SOC: reduction for incisal edge

A

1-1.5mm; fine needle-like taper bur

46
Q

SOC: reduction for interproximal surface

A

0.5-1mm; tapering diamond bur

47
Q

SOC: margin

A

knife edge margin

48
Q

SOC: purpose for placing small undercut on facial surface with inverted cone

A

mechanical lock

49
Q

SOC: fit of a properly trimmed crown

A

fit 1mm below gingival crest

50
Q

SOC: purpose for punching hole in lingual surface of celluloid crown with explorer

A

serve as vent for the escape of trapped air as crown is placed

51
Q

SOC: surfaces to be polished

A

all surfaces except labial

52
Q

SSC: indications

A
  • multi-surface caries for primary molars
  • children with rampant caries
  • teeth with hereditary anomalies
  • fractured teeth
  • restoration for pulpotomized or pulpectomized tooth
  • primary teeth for abutments for space maintainers
  • protection of molars with bruxism
  • hypomineralized young permanent molar
53
Q

SSC: components

A
  • chromium: 17-20%
  • nickel: 8-12%
  • carbon: 0.15%
  • iron: 0.08-0.12%
54
Q

SSC: chromium %

A

17-20%

55
Q

SSC: nickel %

A

8-12%

56
Q

SSC: carbon %

A

0.15%

57
Q

SSC: iron %

A

0.08-0.12%

58
Q

SSC: advantages:

A
  • easy to place
  • durable
  • wear resistance
  • attached firmly to tooth until exfoliation
59
Q

SSC: armamentarium

A
  • No. 110 Howe Pliers
  • No. 417 Crimping Pliers
  • No. 114 Johnson Pliers
  • No. 112 Ball and Socket
60
Q

SSC armamentarium: flatting interproximal contour of crown

A

No. 110 Howe pliers

61
Q

SSC armamentarium: marked gingival crimping

A

No. 417 Crimping pliers

62
Q

SSC: use of No. 417 Crimping pliers

A

used to have snug fit on gingival 3rd

63
Q

SSC armamentarium: contouring occlusal and middle 3rd of crown

A

No. 114 Johnson pliers

64
Q

SSC armamentarium: most commonly used

A

No. 114 Johnson pliers

65
Q

SSC armamentarium: exaggerating interproximal contour in open contacts

A

No. 112 Ball and Socket

66
Q

No. 112 Ball and Socket

A
  • exaggerating interproximal contour in open contacts
  • not commonly used
67
Q

No. 114 Johnson Pliers

A
  • contouring occlusal and middle 3rd of crown
  • most commonly used
68
Q

No. 417 Crimping Pliers

A
  • marked gingival crimping
  • used to have snug fit on gingival 3rd
69
Q

No. 110 Howe Pliers

A

flattening interproximal contour of crown

70
Q

SSC armamentarium: not commonly used

A

No. 112 Ball and Socket

71
Q

SSC: reason for using knife-like edge gingival margin

A

to be able to insert SSC easily while fitting

72
Q

SSC: how to check the prep

A

pass through all surfaces around the area using explorer

73
Q

SSC: occlusal surface reduction

A

1-1.5mm

74
Q

SSC: common tooth prep errors

A
  • presence of ledge
  • too tapered
75
Q

SSC: main considerations for crown selection

A
  1. adequate M-D diameter
  2. proper occlusal height
  3. light resistance to seating
76
Q

SSC: size for primary 2nd molar

A

E2

77
Q

SSC: size for primary 1st molar

A

D4

78
Q

SSC: points to be considered once SSC is seated

A
  • no blanching of gingival tissue must occur
  • adjacent proximal contact must be maintained
  • occlusal relationship must be re-established
  • crown normally extends 1mm into sulcus
79
Q

SSC: used for cutting SSC

A

crown scissors and green stone bur

80
Q

SSC: cement of choice for non-vital tooth

A

polycarboxylate

81
Q

SSC: cement of choice for vital tooth

A

GIC

82
Q

SSC: liquid-powder ratio for GIC as cement

A

2:4

83
Q

SSC: why gauze is always put near the airway

A

to prevent aspiration

84
Q

SSC: clinical modifications for adjacent SSC

A
  • posterior most prep first
  • crown adjusted over and fitted into occlusion
  • crown reduction of adjacent crown alone
  • for broad contact: use no. 110 Howe plier
85
Q

SSC: failures

A
  • inadequate tooth reduction
  • inadequate crown contouring and crimping
  • innappropriately established occlusion
  • improper cementation methods with lost crowns/open margin
  • failure of pulp treatment
  • induced ectopic eruption of permanent 1st molar
  • recurrent caries
  • crown abrasions
86
Q

SSC: common errors

A
  • underreduced preparations
  • all around prep
  • overreduced SSC
  • no crimping; open margin
  • not fitted subgingivally
  • wrong sizing of SSC

Pediatric Dentistry (10 decks)

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