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Yr 3 Primary Care - Child dental health > Restorative management of caries in the primary dentition > Flashcards

Restorative management of caries in the primary dentition Flashcards

1
Q

Why bother restoring caries?

A

Maintain function, eliminate disease, restore health, prevent pain, avoid infection, preserve space, growth and development & have a positive attitude to oral health

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2
Q

Why is it important to restore health?

A

52 million school hrs/year are missed due to toothache

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3
Q

What % of 5 y/o are in pain?

A

12%

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4
Q

What is the purpose of preserving space?

A

Resorption of primary tooth sets place for permanent tooth to move into (without this may get delayed eruption etc)

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5
Q

Why is important to maintain a positive attitude to oral health?

A

To protect permanent teeth in the future

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6
Q

What % of 5y/o are caries free?

A

70%

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7
Q

What % of 5y/o have caries with an average dmft of 1.1?

A

30%

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8
Q

Why is so much untreated?

A

General problems: Co-operation, understanding, concentration, motivation, fear, parent
Oral problems: access, moisture control, dental anatomy, transient dentition, keeping mouth open

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9
Q

What are the different issues with crown morphology of primary teeth and their clinical significance?

A
  • narrow occlusal table = B-L width of cavity needs to be reduced
  • broad, flat, interproximal contact areas = problems with diagnosing caries
  • thinner enamel and dentine layers = caries progresses more quickly to the pulp
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10
Q

What % of all caries by the age of 10 in the primary dentition are interproximal?

A

60%

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11
Q

What is made especially difficult by children’s difficulty in keeping their mouth open?

A

toleration of bitewings is poor = lateral obliques and DPTs used instead = are not so good
- for early diagnosis bitewings are essential (18-71% detected clinically, 40-470% detected radiographically

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12
Q

What order do we do treatment planning in?

A
  1. following a full history and examination
  2. operative management based various factors
  3. choice of restorative material
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13
Q

What is the purpose of doing a full history and exam?

A

So we can deal with pain, plan prevention and manage caries

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14
Q

What is operative management based on?

A

Childs ability to cope, no. and size of lesions, time until exfoliation, presence of infection, family support for prevention

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15
Q

What is the preferred treatment if a tooth is not near to exfoliation?

A

pulp treatment and restore tooth with preformed metal crown

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16
Q

What different factors play a role in choice of restorative material?

A

Patient factos, Tooth factors and operator factors

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17
Q

What are the different options for restorative material?

A

Composite, amalgam, compomer, stainless steel crown, temporise (GIC)

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18
Q

What are the different patient factors?

A

caries status, general health, parafunction (grinding/occlusion), age, diet and co-operation

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19
Q

What are the different operator factors?

A

Material properties, quality of finished, moisture control, expertise and anaesthesia

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20
Q

Which materials are best for temporary restorations?

A

Conventional GIC (triage = fugi VII)

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21
Q

Which materials are best for permanent restorations?

A

If can rubber dam = composites, if not RMGIC (Fugi II) or compomer

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22
Q

What are the different tooth factors?

A

Tooth location (accessibility and aesthetics), cavity design, pulp involvement (metal crown = no root fill), dentition, occlusal load and tooth quality

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23
Q

What are the different stages of cavity prep?

A
  1. Gain access
  2. Remove caries
  3. Look, think and design (based on extent of caries, material)
    BE CONSERVATIVE
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24
Q

How do we manage interproximal caries that are confined to enamel?

A

Encourage to arrest = monitor, preventative advice, topical fluoride, avoid using bur

25
Q

Why do we avoid using a bur if possible?

A

Lifetime of fillings with cavity size increasing each time you replace

26
Q

How do we manage interproximal caries that are inter dentine?

A

Intracoronal restorations or extracoronal restorations

27
Q

What are the differences in anatomy for primary teeth?

A
  • smaller size of occlusal lock
  • omit dovetail
  • rounded line angles
  • minimal extension for prevention
  • mechanical retention = small grooves inside EDJ
28
Q

What are the benefits of amalgam?

A

cheap, easy to use, relatively technique tolerant, familiarity

29
Q

What are the disadvantages of amalgam?

A

not adhesive, not aesthetic, mechanical retention required (more tooth removal), no fluoride and amalgam toxicity

30
Q

What are the benefits of composite?

A

adhesive (micro mechanical), aesthetic, conservative, durable, setting under control (light)

31
Q

What are the disadvantages of composite?

A

technique sensitive, need for isolation (moisture control keep mouth ope, tongue move all over), no fluoride

32
Q

Tell me more about composites?

A

not widely used in primary teeth, needs etching, bonding then laying in increments
-Study = fillings remaining at 2 yrs 12-17%. and 62% at 6 yrs

33
Q

What are the benefits of anterior strip crowns?

A

They are the most aesthetic restoration for decayed primary incisors

34
Q

What are the disadvantages of anterior strip crowns?

A

They are very technique sensitive (if not incremental = susceptible to fractures and if too big size chosen = excess material around the gingivae)

35
Q

What is a RMGIC a combination of?

A

GIC and resin

36
Q

How does a RMGIC’s viscosity and strength compare to a compomer?

A

Lower viscosity and similar strength

37
Q

How do we place a RMGIC?

A

Condition, place and cure

38
Q

What are the benefits of a RMGIC?

A

Adhesive, aesthetic, leach F?, light cured, radiopaque, wear resistant

39
Q

What are the disadvantages of a RMGIC?

A

Limited data, leach F?, needs good moisture control

40
Q

When do we place RMGIC?

A

When pt doesn’t want a stainless steel crown

41
Q

What is a compomer?

A

A polyacid modified resin (dyract and compoglass)

42
Q

What are the benefits of a compomer?

A

Adhesive, aesthetic, leach F?, light cured and radio-opaque

43
Q

What are the disadvantages of a compomer?

A

Multistage techniques, leach F?, needs good moisture control

44
Q

How do we place a compomer?

A

Etch?, condition, place and cure

45
Q

How long do GIC’s usually last?

A
46
Q

What are the benefits of a GIC?

A

Adhesive, aesthetic, F leeching, good temp material = useful for

47
Q

What are the disadvantages of a GIC?

A

long set time, brittle, radio-lucent, poor resistance to wear and erosion, moisture damage

48
Q

If higher caries what should you also consider with GIC?

A

Sealant (“finger press” to fill fissures if unco-operative)
n.b. difficult if poor moisture control or partially erupted teeth

49
Q

What are the indications for a stainless steel preformed crown?

A

most interproximal cavities, 2 + carious surfaces, all pulpally involved primary molars and young children

50
Q

What do we stick a stainless steel crown down with?

A

GIC cement

51
Q

What are the contraindications for a stainless steel preformed crown?

A

non-vital tooth (needs xla), small occlusal cavities, tooth soon to exfoliate and parental preference (aesthetics)

52
Q

What is interproximal discing?

A

= smooth area inter proximally to make self cleansing area without a restoration

53
Q

When is interproximal discing used?

A

If minimal caries between two centrals

54
Q

What are the trade names for composites?

A

Spectrum (anterior) and herculite (posteriors)

55
Q

What are the trade names for GIC?

A

Chemfil

56
Q

What are the trade names for a self cure RMGIC?

A

Fuji IX

57
Q

What are the trade names for a light cure RMGIC?

A

Fuji II LC, Triage/Fuji VII

58
Q

What are the trade names for a compomer?

A

Dyract

Yr 3 Primary Care - Child dental health (11 decks)

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