Stephens Columns Flashcards
1
Q
5 Advantages of Rubber Dam (dr berry)
A
improved management Improved working conditions Aseptic field for pulp treatment Protect patient Increased efficiency
2
Q
5 advantages of rubber Dam (chat 18)
A
saves time Aids management Controls saliva Provides protection Helps dentist educate parents
3
Q
When is a slit dam indicated (Ch 18)
A
primary dentition quadrant restoration and no pulp therapy indicated
4
Q
If only one tooth requires work, is a slit dam indicated( Ch 18)
A
No, just isolate that tooth
5
Q
What should be done to the preselected tooth clamp (ch 18)
A
ligate with 18” piece of floss
6
Q
8A and W8A are clamps indicated for what deciduous teeth (Berry)
A
primary molars and smaller permanent first molars
7
Q
Which clamp is indicated for partially erupted teeth and why(Berry)
A
W8A or 8A, jaws of clamp or oriented cervically
8
Q
14A indicated for what teeth and their condition (Berry)
A
permanent first or second molars not fully erupted
9
Q
What is one disadvantage and one advantage of the slit dam technique (Berry)
A
less isolation but easier to place
10
Q
Is the clamp and dam placed as one unit in the slit dam technique (Berry)
A
clamp first then dam and frame placed as a unit
11
Q
How is the dam prepared for the slit dam technique (Berry)
A
hole punched for most posterior tooth and most anterior tooth, then connect the 2 holes by cutting a slit
12
Q
What tooth morphology helps hold the rubber dam in place (Berry)
A
cervical undercut on mesial of primary canine
13
Q
What is done with the edges of the rubber dam to improve isolation (Berry)
A
invert the edges
14
Q
How is the wing clamp used differently than a non- winged clamp (Berry)
A
winged clamp placed on most posterior hole in the dam, clamp, dam & frame placed as a unit
15
Q
What does the book say is indicated for Class I lesions (Ch 18)
A
conservative caries excavation and restoration using combo of bonding restorative and sealant materials
16
Q
Why is the proximal portion of a primary tooth Class II prep carried further buccally and lingually (Ch 18)
A
broad flat contacts of primary molars
17
Q
Most common mistake in the preparation of primary teeth (Berry)
A
over-extension
18
Q
What is the treatment of choice in primary teeth when excessive tooth structure must be removed (Berry)
A
Stainless Steel Crown
19
Q
4 desirable characteristics of primary tooth preparations (Berry)
A
conservative (politically)
Extended sufficiently to remove all carious tooth
structure
Adequate retention for resto material
Uniform depth pulpal floor and slightly rounded
20
Q
What is the benefit of composite resin &/or glass ionomer restorative material (Ch 18)
A
thermal insulation to the pulp
21
Q
Proximal lesions in a preschool child indicate what (Ch 18)
A
excessive caries activity
22
Q
One way to treat very small incipient lesions in conjunction with improved oral hygiene (Ch 18)
A
topical fluoride therapy
23
Q
For amalgam, what is indicated even if the occlusal surface is not cavitated (Ch 18)
A
minimal occlusal dovetail for retention
24
Q
For esthetic restorative materials (composite resin or glass ionomer) what is indicated if the occlusal surface is not cavitated (Ch 18)
A
only proximal prep, then can seal the occlusal (with or without enamelplasty)
25
What is the big deal with the anatomy of the Mandibular first primary molar and how it affects a cavity preparation (Berry)
has an oblique ridge that should not be crossed making the Class I prep more mesially placed
26
What is a consideration when prepping a Primary mandibular second molar on a 7 year old
make sure you are prepping the primary tooth and not a permanent mandibular molar (#19 or #30)
27
What is indicated if the marginal ridge has been broken through by caries, is a Class II or a Stainless Steel Crown indicated (Berry)
Stainless Steel Crown
28
What is the ideal width of the isthmus or the Class II preparation (Berry)
1/3 intercuspal width
29
How should the floor of the proximal box be designed in a pedo Class II preparation (Berry)
slightly rounded bucco-lingual
30
What determines the bucco-lingual extent of the proximal box in Class II prep (Berry)
amount of tooth in contact with adjacent tooth extent of carious lesion
31
What should be done with axio-pulpal line angle where the occlusal floor and proximal box meet (Berry)
Beveled
32
Which pulp horn is most easily hit in an occlusal preparation of a molar (Berry)
Mesial pulp horn
33
What must be used to avoid overhangs in Class II (Berry)
adapted to contours of tooth and wedged
34
What matrix band is popular in pedo as it is soft and easily adaptable to tooth contours and requires no extraoral apparatus (like a toffelmire) (Berry)
Condit’s T-band
35
What must be done once restoration is completed, dam apparatus removed, and occlusion is adjusted (Berry)
warn patient & accompanying adult to avoid lip, cheek, and tongue injury due to chewing while anesthetized
36
6 common errors in cavity preps (Berry) --> EXAM
1) fail to extend occlusal outline into susceptible pits and fissures
2) Fail to follow outline of cusps
3) Isthmus cut too wide
4) Flair of proximal walls too great
5) Angle formed by axial, B, L walls too great
6) Gingival contact not broken
37
What is indicated when mandibular primary incisors have extensive caries (Ch 18)
Extraction
38
What is another way to treat interproximal caries (class III) on mandibular primary incisors (Ch 18)
interproximal disked and topical fluoride varnish
39
What is frequent site of caries attack in patients at high risk for caries (Ch 18)
distal surface primary canine
40
What is shape of the Class III prep (Berry)
triangular
41
Which way should the dovetail go in a Class III prep and why (Berry)
gingival. Because primary incisal edge is thinner and would be more prone to fracture
42
What is indicated if the interproximal extension of a Class III gets extensive and undermines the incisal edge (Berry)
convert to Class IV or do an anterior crown
43
What can be used as a matrix for Class III (Berry)
T bands or mylar matrix
44
What is indicated if the Class V caries extend into the proximal contacts in molars (Berry)
Stainless Steel Crowns
45
Which has better success rate, stainless steel crowns or direct restorations (Berry)
Stainless Steel Crown
46
6 indications for Stainless Steel Crowns (Berry)
1) Large lesions on primary teeth
2) Rampant Caries
3) Following pulp therapy (pulpectomy/pulpotomy) 4) Teeth w/ developmental defects
5) Fractured teeth
6) Temporary restoration of young permanent teeth
47
On which tooth and why do large multi-surface lesions have a high direct restoration failure rate (Berry)
Primary Mandibular first molars. Funny shape does not retain restoration well
48
7 indications for Stainless Steel Crown on posterior teeth (Ch 18)
1) primary or young permanent teeth w/ extensive caries
2) Hypoplastic primary or permanent teeth not able to restore with a bonded restoration
3) Hereditary anomalies (Dentinogenesis imperfect) 4) Pulpotomy or pulpectomy restoration
5) Fractured tooth
6) Primary tooth to be an abutment for an appliance
7) Habit breaking or ortho appliance attachment
49
What must you ask when considering restoring a primary tooth with a Stainless Steel Crown (Berry)
length of time child will keep tooth
50
What restoration would be indicated for a General Anesthesia or Oral sedation with respect to a behavior problem child (Berry)
Stainless Steel crown to avoid restoring again.
51
Percentage of 2 surface amalgams needing replacement before age of 8 (Berry)
70-71.4%
52
Percentage of Stainless Steel Crowns that require further treatment (Berry)
11-12.8%
53
Order of longevity for restorative procedures in children (Berry)
SSC (70%/5yrs) > Amalgam (60%/5 yrs) > Composite (40%/32 mos) > GI (4%/4 yrs)
54
This plier is used in the middle portion of the crown, usually on the buccal and lingual surfaces to contour the crown to the shape of the tooth (Berry)
contouring pliers
55
This plier is used in the very bottom portion around the entire circumference of the crown to ensure better cervical adaptation (Berry)
Crimping pliers
56
What should be done first, the stainless steel crown prep or the caries excavation (Ch 18)
Crown prep first, then if any carious dentin remains it is excavated
57
What crown should be selected to cover the prep (Ch 18)
smallest crown that covers the prep
58
How far to reduce occlusal (Ch 18 and Berry)
1.0-1.5 mm clearance from opposing while maintaining occlusal contours
59
What should be done before doing proximal slices (Berry)
pulpotomy if indicated
60
What are the dimensions of the proximal slices (Ch 18)
near vertical carried gingivally breaking contact so an explorer can be passed freely b/w adjacent teeth making a feathered edge with no lip
61
What is the most important part of the preparation (Berry)
proximal reduction
62
What will prevent seating of the crown (Berry)
ledging at the margin
63
How far must extend proximal slices and why (Berry)
extend below gingiva to avoid ledging
64
Is there a buccal-lingual reduction on a stainless steel crown prep
No, want to keep that anatomy to aide crown fit
65
Advantages of the 3M Ion Crown or ESPE Prefabricated SSC ( Berry)
trimmed and crimped to save time and accurately duplicate anatomy for better fit and function
66
When is a Unitek SSC indicated (Berry)
significant space loss secondary to decay or the caries extend further gingivally than Ion crown covers
67
Character of the Unitek SSC (Berry)
flat axial surfaces requiring contouring
| Crown must be shortened and marginally adapted
68
Steps to fit SSC (Berry)
```
pick size
Adjust crown length
Adjust crown margin
Contour
Crimp
```
69
How seat a SSC (Berry)
lingual to buccal due to primary tooth buccal bulge
70
What is an indicator that the crown may be to big or the margin is not accurately crimped (Berry)
blanching of tissue
71
When adjusting the crown length, how far is the crown to sit subgingival (Berry)
1 mm below gingival crest
72
What does Crown contouring do (Berry)
reduces crown circumference
73
Purpose of Crimping (Berry)
ensure good cervical margin adaptation
74
How is crimping achieved (Berry)
cervical 1-2 mm crown turned under to provide “snap” on seating
75
2 common cements used to cement crown on (Berry)
polycarboxylate
| Glass ionomer
76
What can be used to aide seating crown(Berry)
child biting on stick
77
What must be checked for after seating crown (Berry)
contact
Occlusion
Subgingival and interproximal excess cement
78
Does SSC occlusion have to be perfect (Berry)
No, primary molars adjust themselves quickly
79
What would be a common problem for crown not seating proximally (Berry)
proximal ledge
80
What can be done with crown positioning if there is space loss (Berry)
rotate crown slightly or use flate beaked pliers to flatten contact point to reduce M-D width
81
Do SSC interfere with primary tooth exfoliation (Berry)
No, primary crown will come out with SSC
82
What is the years until tooth lost when a crown or alloy restoration not significantly different (Berry)
3 years
83
For what age and below are crowns significantly better (Berry)
< 5 yrs
84
Indications for Strip Crowns (Berry)
- extensive or multisurfaced caries
- Congenitally malformed teeth
- Discolored teeth
- Fractured teeth
- Sufficient crown material remains after caries removal to retain resin
85
Do Strip crowns require a Buccal and Lingual reduction and why (Berry)
Yes, to allow room for composite
86
When a strip crown form is trimmed, where does the cervical margin extend (Berry)
slightly below gingival crest
87
What are big risks for the strip crowns (Berry)
staining and breaking
88
What is ART (Ch 18)
Atraumatic Restorative Treatment. To prevent pain and preserve teeth in individual w/o access to regular or conventional oral health care
89
Amputation of the coronal portion of the pulp (Berry)
Pulpotomy
90
What is the status of the pulp tissue that is left in the roots after the pulpotomy (Berry)
vital
91
What is the thought behind leaving vital pulp tissue in the roots (Berry)
allows roots to resorb as normal and exfoliate
92
After unroof and remove coronal pulp from tooth, what is done next (Berry)
control bleeding
93
3 pulpal medicaments that can be used after bleeding is controlled and before tooth is restored (Berry)
Formocresol, Ferric Sulfate, MTA
94
How long should it take to control bleeding for a pulpotomy to be successful (Berry)
3-5 min
95
How should everything appear for a pulpotomy to be indicated (Berry)
blood is red and normal and canal tissue appears normal
96
Formocresol used how (Berry)
placed on pulp stumps for 5 min then covered with zinc oxide eugenol paste (IRM) and restored with SSC
97
5 effects of Formocresol (Berry)
- bactericidal effect
- Devitalizing effect
- Converts bacteria and pulp to inert compounds
- Inactivates oxidative enzymes in pulp
- Makes pulp inert and resistant to enzymated breakdown
98
What is Ferric Sulfate used for (Berry)
Control bleeding (15 sec) then cover pulp w/ zinc oxide eugenol and restore
99
4 requirements of a successful pulpotomy (Berry)
- eliminate infection in tooth
- Tooth preserved in healthy, non-pathogenic condition
- Arch space maintained
- Normal resorption of primary tooth and eruption of permanent successor
100
Removal of the tissue from the coronal pulp chamber and the root canals (Berry)
Pulpectomy
101
When does calcification of primary teeth begin(Piscitelli)
~3.5-4 months in utero
102
General eruption of the primary teeth (Piscitelli)
primary teeth erupt in typical sequence starting ~6-7mo (mand central) and ending at 26 months (max 2nd molar)
103
Which dentition shows more variability, primary or permanent (Piscitelli)
permanent
104
2 things to which primary occlusion adapts to (Piscitelli)
- skeletal growth
| - occlusal wear
105
Which teeth have more proprioception, primary or permanent (Piscitelli)
permanent
106
of the 3 planes of growth of the mouth, which is the first to stop: A-P, Vertical, Transverse
Transverse (~12 y.o)
107
which is the 2nd plane of growth to stop growing: A-P, Vertical, Transverse
Vertical
108
Which plane of growth continues throughout life (Piscitelli)
A-P
109
Who are more advanced at all stages of dental calcification and development, girls or boys(Piscitelli)
girls
110
Teeth do no begin to move occlusally until... (Piscitelli)
Crown form is completed
111
Are caries genetic (Piscitelli)
no
112
What largely determines tooth size (Piscitelli)
genetics
113
Which are rarer supernumerary teeth or congenitally missing teeth (Piscitelli)
Supernumeraries
114
Supernumerary teeth are more common in males or females (Piscitelli)
males
115
Dental arch width changes are timed more to dental development or skeletal growth (Piscitelli)
Dental development
116
When does dental arch circumference decrease (Piscitelli)
during late transitional and early permanent dentition
117
Why does dental arch circumference diminish as we get our permanent teeth (Piscitelli)
because the leeway space between C,D,E is taken up as 3,4,5, which are wider than their predecessors erupt into that space
118
What is the most important baby tooth and why (Piscitelli)
primary 2nd molars (AJ & KT, or the E’s in the Palmar notation). Distal Surface of primary 2nd molars determine initial permanent molar (3,14,19,30) occlusion
119
What can happen if the E’s (Primary Second Molars) are lost early (Piscitelli)
Permanent 1st molars will tip mesially and block out permanent 2nd bicuspids
120
Tooth that shows the greatest variability in development (Piscitelli)
3rd molars
121
What is the sequence for Primary teeth calcification and times (Piscitelli)
```
A Dorky Boy Can Eat (Palmer notation)
A (14 wks) [centrals]
D (15 wks) [1st molar]
B (16 wks) [laterals]
C (17 wks) [cuspids]
E (19 wks) [2nd molar]
```
122
When do A,D,B initiate calcification (Piscitelli)
6 wks
123
When do C,E initiate calcification (Piscitelli)
7 & 8 wks respectively
124
In what order do the cusps of the posterior teeth calcify (Piscitelli)
MB, ML, DB, DL
| My Big Mother Likes Dry Biscuits During Lunch
125
How many calcification centers does an anterior tooth have (Piscitelli)
one
126
When does the first permanent molar begin calcification (Piscitelli)
at birth
127
What is Piscitelli’s Rule of 3’s
find out when calcification ends, add 3 years for eruption, then 3 years for root closure in permanent
128
When do primary teeth roots complete (Piscitelli)
18 mos post eruption
129
When do permanent teeth roots complete (Piscitelli)
3 years post eruption
130
By 12 months, and average child has how many teeth (Piscitelli)
6-8
131
Which is more important: the timing of the eruption or the sequence of eruption (Piscitelli)
sequence because it helps determine tooth position in the arch
132
Why does Early Childhood Caries characteristically effect A, B, D, but skip the C’s (Palmer notation) (Piscitelli)
A,B,D erupt before C so exposed longer to insults
133
Common appearance for erupting tooth especially centrals and max 2nd molar, but requires no intervention (Piscitelli)
eruption hematoma
134
Premature teeth erupt prior to what age (Piscitelli)
3 months
135
Teeth present at birth (Piscitelli)
Natal teeth
136
Teeth present within first 30 days of life (Piscitelli)
Neonatal teeth
137
Which are more common, Natal or neonatal (Piscitelli)
Natal 3:1 Neonatal
138
What is a consideration for Natal and neonatal teeth (Piscitelli)
90% are true primary teeth so try to preserve
139
Are natal/neonatal teeth well formed and what is an associated finding (Piscitelli/ Ch 9)
not well formed, can be mobile due to poor root formation. Riga-fede disease (ventral tongue trauma from suckling)
140
2 syndromes that can have natal/neonatal teeth (Piscitelli)
```
Chondroectodermal dysplasia (Ellis-van Creveld)
Cleft Lip and Palate
```
141
3 structures in the newborn that can be confused for natal/neonatal teeth (Piscitelli)
Dental Lamina cysts
Bohn’s nodules
Epstein’s pearls
142
Cysts found on crest of baby’s alveolar ridge that can be confused for natal/neonatal teeth (Piscitelli)
Dental Lamina Cysts
143
cysts found on the buccal and lingual aspects of ridge and palate (away from midline raphe) that can be confused for natal/neonatal teeth (Piscitelli)
Bohn’s Nodules (Bohn’s Buccal)
144
Cysts found on the midline palatal raphe that can be confused for natal/neonatal teeth (Piscitelli)
Epstein’s Pearls (Pearls Palate)
145
What is the Baume classification based on (Piscitelli)
space between anteriors
146
Baume Type I (Piscitelli)
spaced anteriors
147
Baume Type II (Piscitelli)
no space between anteriors
148
The wide spaces mesial to the maxillary canines and distal to the mandibular canines (Piscitelli)
primate space
149
What is the primate space important for (Piscitelli)
canine and bicuspid eruption
150
What goes into the primate space of the opposing arch in primary occlusion (Piscitelli)
primary cuspid tips go into the primate space of the opposing arch
151
The total interdental spacing between primary teeth ________(decreases/increases) continually with age (Piscitelli)
decreases due to loss of Leeway space
152
Primary dentition Angle Classes of occlusion can be measured this way (Piscitelli)
primary molar terminal plane
153
Flush Terminal plane indicates what (Piscitelli)
the distal surface of the maxillary and mandibular 2nd molars are in line (most likely becomes Angle Class I)
154
Mesial Terminal Plane or Mesial Step means what (Piscitelli)
Distal of Max Molar is distal to the distal of the mand molar (if draw staircase down from distal of Max molar to the distal of the Mand Molar, the step would point mesial)(Most likely becomes Angle Class I)
155
Distal Terminal Plane or Distal Step means what (Piscitelli)
Distal of Max Molar is mesial to distal of Mand Molar (if drew staircase down from distal of Max molar to distal of Mand molar the step would go distal)(Most likely becomes Angle Class II)
156
Piscitelli says what Terminal Plane is most common (60%)
Mesial Step
157
Most common tooth to get Turner’s tooth and why (Piscitelli)
2nd premolar because E was sick
158
How do 1st perm molars erupt (Piscitelli)
mand erupt mesial and rotate distal in to occlusion guided by distal of Mand E, Max erupt distal and swing mesial into occlusion stopped by distal Max E
159
If the E (Palmer notation) is missing what 2 things will happen to the erupting Permanent 1st molar (Piscitelli)
will Tip mesial . anytime there is tipping there is Extrusion
160
What is the angle of primary incisors and their overbite/overjet (Piscitelli)
upright with little overbite or overjet
161
Permanent incisors angled how (Piscitelli)
Labial angulation w/ overbite and overjet
162
Leeway space of Nance (Piscitelli)
combined M-D width of deciduous canines and molars (C,D,E) differ from those of permanent canines and molars
163
How much Leeway space per each side maxillary arch and total Leeway Space of Nance for Maxilla(Piscitelli)
0. 9mm/half arch
| 1. 8 mm total Leeway Maxillary Arch
164
How much Leeway space per each side mandibular arch and total Leeway Space of Nance for Mandible(Piscitelli)
1. 7 mm/ half arch
| 3. 4 mm total Leeway Mandibular Arch
165
2 things that close Primate space(Piscitelli)
Eruption permanent incisors
| Eruption permanent molars
166
Why does the intercanine width change with the eruption of the mandibular incisors (Piscitelli)
Mand canines move distal into their primate space increasing slightly their intercanine width
167
If incisors erupt lingual to their deciduous predecessors, should anything be done, and what natural force will help push them into occlusion (Piscitelli)
don’t do anything. Tongue will push permanents labially
168
What is a way to determine if a canine will be impacted (Piscitelli)
if cuspid overlaps lateral on the radiograph, 80% chance cuspid will be impacted (b/c it is supposed to guide into place along distal root surface of lateral)
169
If have primate space and a flush terminal plane, what angle class will the permanent molar erupt into and how (Piscitelli)
eruptive force of permanent mand molar forces mandibular space closeds allowing for Class I = Early Mesial Shift
170
How does a permanent molar get into Class I occlusion if there is no primate space and the primary occlusion was Flush Terminal Plane (Piscitelli)
Late Mesial Shift = done when the E exfoliates from the mandible before the maxilla allowing that permanent first to move mesial to Class I
171
What are the width changes that occur between 6-13 years as the child goes from primary to mixed dentition to early permanent dentition (Piscitelli)
intercanine width increases
| Interarch width decreases
172
If there is a problem in the initiation of a tooth, what will be the clinical manifestation (Piscitelli)
problems in tooth number (Hyper/hypodontia)
173
If there is a problem in the proliferation of a tooth, what can be the clinical manifestation (Piscitelli)
problems in tooth number, size, proportion (Gemination/twinning)
174
Morphodifferentiation problems give what clinical manifestations (Piscitelli)
Size and Shape problems
175
Histodifferentiation problems give what clinical manifestations (Piscitelli)
problems of enamel (Amelogenesis imperfect) and dentin (dentinogenesis imperfect)
