W11 Advanced management of child + adolescent

Question 1

What is molar incisor hypomineralisation?

Answer 1

Demarcated QUALITATIVE defect of enamel, of system origin.

Question 2

How does MIH present clinically?

Answer 2

Opacities + with discolouration, and enamel loss

Question 3

What is the MIH hypotheses?

Answer 3

Fluoride - although insufficient evidence.

Question 4

PIC What is this?

Answer 4

MIH

Question 5

What are the clinical challenges of MIH?

Answer 5

Post-eruptive breakdown.
Caries.
Teeth may be hypersensitive.
Restoration retention

Question 6

How do you diagnose early MIH?

Answer 6

Generally it will be in incisors and molars as they erupt at the same time. Higher risk if see it n pernamenets

Question 7

What are the tx options for MIH?

Answer 7

Preventative measures. (remin).
Restos.
SSC
Exo

Question 8

After early diagnosis how to you prevent post eruptive?

Answer 8

1. Councelling parents re-diet, brushing, F- + CPP-ACP.
2. Regular dental apps
3. Duraphat
4. RMGIC/GIC sealants

Question 9

What are the benefits of SSC?

Answer 9

High durability, portect against further break down

Question 10

When do you do exos for MIH?

Answer 10

When the long term prognosis is poor, referral for possible exo of permanent molars consult with orthdontic. (Timely exo is important)

Question 11

What is Amelogensis Imperfecta??

Answer 11

Inherited defects of enamel - can affect both primary and permanent teeth.
Affect quality and quanity.

Teeth my be hypomineralised/hyperplastic

Question 12

How do you identify Amelogenesis Imperfecta?

Answer 12

Different phenotypes.

Question 13

What are some features of hypoplastic AI?

Answer 13

Thin enamel.
Anterior open bite.
Lack of contacts.
Delayed eruption

Question 14

What are some features of hypomineralised AI?

Answer 14

Enamel may be of normal thickness, initially yellow to brown

Question 15

What is AI management?

Answer 15

Genetic counselling, continued family support.
Early ortho assessment
Prevention (OH F- etc, xrays, resto).

Once developed veneers etc

Question 16

What is fluorosis?

Answer 16

Fluorosis: developmental disturbance of dental enamel, caused by successive exposures o high concentrations of F- during dental development. Qualitative defect

Question 17

What is fluorosis management ?

Answer 17

Remineralising (CPP-ACP).
Microabrasion to remove surface enamel.
Labial composite veneers

Question 18

What is dentinogenesis Imperfecta?

Answer 18

inherited disorder of dentine. Autosomal dominant trait. May be associated with osteogenesis imperfeta

Question 19

What are the clinical manifestations of dentinogenesis Imperfecta?

Answer 19

Amber, purplish-blue discolouration or opalescence. Enamel ma be lost after tooth erupt on.

Question 20

What is the management of dentinogenesis Imperfecta?

Answer 20

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

Question 21

What is ectopic eruption and impact?

Answer 21

Disturbance in which the tooth does not follow it’s usual course.
Impacted: obstruction from pathway.

Question 22

What tooth is most likely to be ecotopic?

Answer 22

Maxillary canines, + mandibular canines 11-12years.

You should be able to palpate the crown in the labial sulcud 9-10yrs