Restorative Mangement Flashcards
Why restore primary teeth?
- Dental health is intertwined with general health
- Dental infections have detrimental effect on general health
- Children with caries don’t thrive
- Restore form
- Restore aesthetics
- Restore function
- Maintain space
- Acclimatisation
- Avoid infection
- Avoid extraction
Characteristics of primary teeth?
- Smaller
- Thin enamel
- Pulp is RELATIVELY larger
- Pulp horn nearer surface
- Contact points wider and flatter
What is important about the anatomy and morphology of primary teeth in relation to caries?
Leads to faster progression of caries and makes identification of demineralisation more difficult
How many canals in upper and lower molars?
3
Where do canals sit in lower molars?
Mesial Buccal
Mesial Lingual
Distal
Where do canals sit upper molars?
Mesial Buccal
Distal Buccal
Palatal
Where do pulp horns sit within tooth?
High into crown mesially
What should be considered when treatment planning in children?
- Only work if achievable
- Correct diagnosis is fundamental
- Compliance and support
Stages of treatment plan?
- Relief of pain
- Prevention at home
- Professional prevention
Hierarchy of treatment?
- Start with simple pleasant procedures
- Reinforce prevention
- Positive reinforcement
Common causes of pain in children?
- Abscess
- Caries (sometimes)
- Trauma
- Tooth wear
- Soft tissue lesions
- Exfoliation
Reversible pulpits signs and symptoms?
- Pain stops when stimulus is removed
- Short duration of pain
- Occurs when eating
- Early caries lesion
- Caries into dentine (radiographs)
Irreversible pulpits signs and symptoms?
- Constant pain
- Relieved with painkiller
- Keeps patient awake at night
- Lymphadenopathy
- Raised temperature
- Marginal ridge destruction
- Intra oral swelling
- Caries close to pulp (radiograph)
Restore or extract?
- Depends on type of pulpits
- Quality over quantity of tooth
- Previous extractions and edentulous spaces
Restore when?
- Compliance
- Space maintenance
- Painless
Extract when?
- Non compliance
- No support
- Not regular attenders
- Balancing extractions
What is the use of temporary filling?
- Effective in pain relief
- Effective until restoration or extraction
- Should have a good seal and not be detrimental to the pulp
What should be done before restoring a tooth in a child?
Stabilisation
What is stabilisation?
- Remove caries
- Dress cavity
- Buys time for improvement and cooperation
Value of stabilisation?
- Prevents lesion progression
- If multiple lesions - arresting caries
- Prevents sensitivity in teeth close to tooth that needs restored
When removing varies from primary teeth what is important?
Keeping cavity as minimal as possible
How do you chose material for restoration?
- Those relating to the tooth
- Factors relating to the patient
Example of tooth factors that would decide what material to chose for restoration?
- Extent of lesion
- Cavity shape after caries removal
Examples of patient factors that decide what material to use when restoring tooth?
- Moisture control
- Caries rate
- Aesthetic appearance
What is considered the definitive restoration for molar teeth in children?
Stainless steel crown
How is a stainless steel crown held in place?
Cervical constriction and morphology of tooth
How to select stainless steel crown?
- Marked with size and position
- Measure mesiodistal width of crown in the mouth
How to place crown?
- Prep tooth
- Check size (do not seat fully)
- Cement crown
- Remove excess cement
- Check occlusion
