W11 Advanced management of child + adolescent Flashcards
What is molar incisor hypomineralisation?
Demarcated QUALITATIVE defect of enamel, of system origin.
How does MIH present clinically?
Opacities + with discolouration, and enamel loss
What is the MIH hypotheses?
Fluoride - although insufficient evidence.
PIC What is this?
MIH
What are the clinical challenges of MIH?
Post-eruptive breakdown.
Caries.
Teeth may be hypersensitive.
Restoration retention
How do you diagnose early MIH?
Generally it will be in incisors and molars as they erupt at the same time. Higher risk if see it n pernamenets
What are the tx options for MIH?
Preventative measures. (remin).
Restos.
SSC
Exo
After early diagnosis how to you prevent post eruptive?
- Councelling parents re-diet, brushing, F- + CPP-ACP.
- Regular dental apps
- Duraphat
- RMGIC/GIC sealants
What are the benefits of SSC?
High durability, portect against further break down
When do you do exos for MIH?
When the long term prognosis is poor, referral for possible exo of permanent molars consult with orthdontic. (Timely exo is important)
What is Amelogensis Imperfecta??
Inherited defects of enamel - can affect both primary and permanent teeth.
Affect quality and quanity.
Teeth my be hypomineralised/hyperplastic
How do you identify Amelogenesis Imperfecta?
Different phenotypes.
What are some features of hypoplastic AI?
Thin enamel.
Anterior open bite.
Lack of contacts.
Delayed eruption
What are some features of hypomineralised AI?
Enamel may be of normal thickness, initially yellow to brown
What is AI management?
Genetic counselling, continued family support.
Early ortho assessment
Prevention (OH F- etc, xrays, resto).
Once developed veneers etc
What is fluorosis?
Fluorosis: developmental disturbance of dental enamel, caused by successive exposures o high concentrations of F- during dental development. Qualitative defect
What is fluorosis management ?
Remineralising (CPP-ACP).
Microabrasion to remove surface enamel.
Labial composite veneers
What is dentinogenesis Imperfecta?
inherited disorder of dentine. Autosomal dominant trait. May be associated with osteogenesis imperfeta
What are the clinical manifestations of dentinogenesis Imperfecta?
Amber, purplish-blue discolouration or opalescence. Enamel ma be lost after tooth erupt on.
What is the management of dentinogenesis Imperfecta?
Maintenance of dental health.
Provide pt with aesthetic apperance at early age.
Prevent vertical dimension loss.
Maintain arch length.
Promote normal growth of facial bones and TMJ
What is ectopic eruption and impact?
Disturbance in which the tooth does not follow it’s usual course.
Impacted: obstruction from pathway.
What tooth is most likely to be ecotopic?
Maxillary canines, + mandibular canines 11-12years.
You should be able to palpate the crown in the labial sulcud 9-10yrs
