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Pediatric Dentistry - ABGD Oral Boards > ABGD - Oral Board Review > Flashcards

ABGD - Oral Board Review Flashcards

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1
Q

What is Lesion Sterilization and Tissue Repair (STR)?

A
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2
Q

What is the max dose of Articaine (Septocaine) for a child?

A

4.5 mg/kg

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3
Q

Describe Voice Control…

A
  • Alteration of volume, tone, pace
  • Could be viewed as aversive
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4
Q

In the Late Mixed dentition, if you are missing Multiple Molars, what appliances are you thinking?

A

Nance / Lower Lingual Holding Arch

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5
Q

When do permanent teeth begin Initiation?

A
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6
Q

What is a toxic dose of F for a todler and for an infant?

A
  • 50 mg for 10 kg toddler
  • 35 mg for 7 kg infant
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7
Q

What is the recommened F dose for Birth to < 6 months?

A
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8
Q

What is this a picture of?

A

Ectopic Eruption

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9
Q

In the world of Regenerative Endodontics, what can Growth Factors produce?

A
  • Proteins that signal cell proliferation, differentiation, and maturation
  • Currently come from root canal dentin
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10
Q

What system does Nitrous oxide effect?

A

Effects in CNS for anxiolysis

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11
Q

What is this?

A

Removable Acrylic Saddle Appliance

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12
Q

When does Mineralization occur for the primary dentition?

A
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13
Q

Describe Positive pre-visit imagery?

A
  • Provide positive visuals prior to appt
  • Allows relevant questioning
  • Sets early expectations
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14
Q

What is the recommend F dose for 3 years < 6 years?

A
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15
Q

Can Acidulated Phosphate Fluoride etch porcelain restorations? T/F

A

True!

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16
Q

What are these?

A

Epstein Pearls

Trapped epithelial remnants on mid palatal raphe

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17
Q

In the Late Mixed Dentition, if you are missing the 1st Molar, what appliance are you thinking?

A

None

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18
Q

What is the 3 mix for Lesion Sterilization and Tissue Repair?

A
  1. Metronidazole
  2. Miprofloxacin
  3. Minocyline
  • Clindaymycin + Iodoform
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19
Q

What are some examples of memory restructuring in regards to Visual reminders and positive verbal reinforcement?

A
  • Photo of pre-visit
  • “Do you remember when you opened so big and you were so brave?
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20
Q

For moderate to high risk caries recall - you would take BW xr how often?

A

Every 6 - 12 Months

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21
Q

What are some objectives of Pulp Therapy for primary teeth?

A
  • Maintain integrity and health
  • Retain primary tooth until normal exfoliation
  • Maintain Vitality of the pulp
  • Intergral for apexogenesis
  • Favorable crown/root
  • Thick dentin walls
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22
Q

What are some attributes of Calcium Hydroxide as a Vital Pulp Therapy Agent?

A
  • High solubility
  • Low compressive strength
  • Poor sealing ability
  • Cover with RMGI
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23
Q

What is an appropriate dose of Ibuprofen for a child > 12?

A
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24
Q

Is it a good idea to subject kids to pulp testing?

A
  • Pulp testing is difficult
  • EPT is scary
  • Thermal test confusing to kids
  • Pain is a sign of pulp distress
  • Utilize your radiographs
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25
What are 2 materials you can use for DPC on Primary teeth?
1. Mineral Trioxide Aggregate (MTA) 2. Calcium Hydroxide (CaOH2)
26
What is the most favorable eruption sequence for primary dentition?
Remember your kid!
27
What is Gemination?
Single pulp chamber w/bifid crown
28
What is the toxic level of F/kg?
5 mg/kg
29
What helps reduce F levels to very low...
* Reverse Osmosis * Distillation
30
Describe distraction regarding basic beahvior guidance...
* Video or television viewing * Video games * Holding a leg, pointing toes * Focs on setting alginate
31
Where are Primate Spaces in the Maxilla?
* Theya re mesial to the pirmary canines in the maxilla
32
In the Primary dentition, if you are missing a 2nd molar, think _____ for an appliance...
Distal Shoe
33
What material do you place just under the SSC?
IRM or hard set ZOE AAPD guideline allows amalgam or resin composite if exfoliation expected in \< 2 years
34
What are some communication tecniques when talking with parents?
* Patient and parent centered approach * Avoid Tell-Tell-Tell where only you speak * Become teacher to the parent * Find their level and communicate there with exchange of information
35
Regarding Regenerative Endodontic Procedures, what structures do they aim to replace when damaged?
* Dentin * Root structures * Cells of the pulp-dentin complex
36
What teeth are good cases for Pulpectomy?
* Primary incisors * Primary cuspids * Primary 2nd molars
37
How do you instrument/irrigate a tooth in need of Apexification?
* Local anes/RD * Remove coronal and redicular pulp * Hydrogen Peroxide * Sodium Hypochlorite * Saline
38
What is Vital Pulp Therapy?
Apexogenesis
39
What do you do after performing a Cvek Pulpotomy to restore?
* MTA (White) * Calcium Hydroxide * Restore with sealing restoration * Radiographs at 6, 12, months - Clinicians Discretion
40
What are the indications for a Distal Shoe?
41
For the Late Mixed dentition, if you are missing the 2nd molar, you are thinking ______________ for an appliance
Nance / Transpalatal Arch / Lower Lingual Holding Arch
42
What do you do to a tooth receiving Apexification at a 2 - 3 week follow up?
* Replace CaOH2 * Reassess closure in 6 months * Obturate with GP * Restore tooth
43
What are the indications for band and loop?
44
What is the best predictor of occlusion for the permanent occlusion?
Primary Canines
45
What are 2 things that describe Sodium Hypochlorite?
* Highly corrosive * Mutagenic
46
What is this?
Nance Appliance
47
What does a Cvek Pulpotmy allow?
* Partial Pulpotomy * Preserves pulp vitality * Allows apexogenesis
48
Describe Tell-Show-Do...
* Explain at appropriate level * Non-threatening demonstration * Proceed without deviation
49
What is another way to obturate a tooth receiving Apexification therapy?
* MTA (Coll-tape) * Apical 4 mm * Thermoplastic GP
50
Are young permanent teeth good candidates for pulpectomy?
No! Wide apices Thin roots Unfavorable crown/root ratio
51
What does Apexification help induce?
* Induce root end closure * Pulpectomy has poor prognosis
52
What is the clinical sequence for a Pulpotomy?
1. Anesthesia RD 2. Prepare tooth for SSC 3. Caries removal 4. Access pulp chamber 5. Amputate pulp to stump orifices 6. Achieve Hemostasis with wet cotton
53
What is the recommend F dose from 6 to at least 16 years?
54
When you have Transitional Dentition (first permanent tooth), what x-rays should you order?
Panoramic and BW Xr
55
What is the ideal N20 level set at? You want no more than what percent of N20?
* Ideal at 30% - 40% * No more than 50%
56
Describe Memory Restructing in regards to basic behavior guidance...
Difficult event memories turned positive * Visual reminders * Positive reinforcement through verbalization * Concrete examples * Sense of accomplishment
57
1.1% APF = \_\_\_\_\_\_\_
12,300 ppm
58
1.1% NaF = \_\_\_\_\_\_\_
5000 ppm
59
What is the recommended ppm of F in water?
.7 ppm
60
What is this?
61
When do Permanent Mandibular Teeth Erupt?
62
What is the max dose of Mepivacaine 3% in a child?
4.4. mg/kg
63
What is the goal of Apexogenesis?
Promote root development
64
What are some indications to do a Direct Pulp Cap on a permanent tooth...
* Early Traumatic Pulp Exposure * Machanical Pulp Exposure * Small Carious Exposure
65
When conducting Apexification, what do you do after irrigating?
* Dry canals * Calcium Hydroxide * Cotton * Zoe
66
In the wordl of Regenerative Endodontic Procedures, what can Stem Cells produce?
* Apical Papilla * Dental Pulp * Periodontal Ligament
67
When is the Initiation of development for the primary centrals, laterals, canines, 1st molars, and 2nd molars?
68
What are some justifications for SSC's?
* Extensive caries * Developmental defects * When failure with other materials is likely * If tooth is to be used for a space maintainer * High caries risk children * Treatment performed under seation or general anesthesia
69
After a Pulpectomy, what do you do aftter the obturation?
* Restore with SSC * Make radiograph * No overfill or underfill * Radiographic resolution within 6 months * Normal resorption and eruption of permeant tooth
70
What do you assess during an infants first dental exam?
* Oral assessment * Anticipatory guidance * Caries risk * Counseling on diet * Fluoride * Oral Hygiene * Habits
71
When can you re-enter a tooth receiving Apexification Treatment?
2 - 3 weeks
72
What is the recommened F dose for 6 months \< 3 years?
73
What is a fail safe rang efor delivering Nitrous Oxide and Oxygen Inhalation?
30% - 100% Oxygen
74
Regarding memory restructuring, what is an example of concrete example of sense of accomplishment?
* "Show me again how you opened your mouth!" * "Don't you remember how you helped us finish everything last time?"
75
For a Pulpotomy, how long do you use Forocresol?
* 1 min * MTA * Biodentine * Ferric Sulfate: 10-15 sec * NaOCl 5% sec * Electrosurgery or LASER
76
For a young permanent tooth with a non-vital pulp think...
Pulpectomy, Apexification, Endodontic Regeneration
77
What are the 3 different Occlusal Schemes for the Primary Dentition?
78
When is eruption for the primary max dentition?
79
What are indications for a Nance Appliance?
80
What are your obturation materials for the primary dentition?
* Calcium Hydroxide * Zinc oxide/Eugenol * ZOE/Formocresol * Iodoform/Calcium Hydroxide
81
Describe how you would conduct an Indirect Pulp Cap on a permanent tooth...
* RD or equivalent * Deep caries/no exposure * Stepwise not required * Remove caries around DEJ * Leave thin layer of affected dentin over pulp
82
What is the retention of Apexogenesis dependent on?
* Favorable crown/root * Thick dentin walls
83
When do you utilize Lesion Sterilization and Tissue Repair?
Necrotic/abscessed primary teeth
84
What is the Eruption Sequence for permanent max/man teeth after first molars have erupted?
* Max: 1 - 2 - 4 - 5 - 3 * Man: 1 - 2 - 3 - 4 - 5
85
What is this?
Transpalatal Arch
86
What are 2 guidelines regarding Parental presence/absence?
* Beneficial if parent supportive * Only have 1 parent in treatment room
87
5% NaF = ____ ppm = _____ mg/cc
22,500 ppm, 22.5 mg/cc
88
\_\_\_\_\_\_\_\_\_ is primary teeth is normal
Spacing
89
F ion 0.1% = \_\_\_\_\_\_
1000 ppm
90
Describe Direct Observation...
* Show video or allow observation of cooperative patient * Aids familiarization * Gives opportunity for questions
91
What is a good measurement to get before delivering local anesthsia to a child?
Accurate weight
92
Describe Ask - Tell - Ask...
* Ask about patient's visit and feelings about planned procedure * Tell - explain procedure at child's level * Ask again how they feel about planned tx and explain again if necessary * Confirm comfort and understanding
93
0.2% NaF = \_\_\_\_\_
900 ppm
94
What is considered success in Apexification Success?
* No root resorption * No periradiular pathosis * Continued eruption and Alveolar growth
95
How often do you order BW Xr in a high caries risk patient?
6-12 Months
96
What are some advantages of Nitrous Oxide and Oxygen Inhalation?
* Anxiolysis * Analgesia * Decrease in gag reflex * Ability to titrate
97
What teeth are often Congentially missing? In what order... 2nd premolars, max laterals, max 2nd premolars, 3rd molars
3rd molars \> man 2nd premolars \> max laterals \> max 2nd premolars
98
What is the goal of Space Maintenance?
* Holding the anterior-posterior or transverse dimension of the dental arches to minimize or prevent space loss and/or the development of a malocclusion
99
What percent of Ectopic Eruptions self correct?
66%
100
For pain management, kids under 4 are...
More sensitive, but less communicative
101
What are some circumstanes that would render Delaying tratment or deferring definitive treatment?
* Very young patients * Caries control restorations
102
In the Early Mixed Dentition, if you are missing the 2nd molar, think _______ as possible appliance therapy...
Nance / Transpalatal Arch / Band and Loop
103
What is the best way to diagnose Supernumeraries?
Max occlusal radiograph
104
For a Primary vital tooth think...
Liner, IPC, DPC, Pulpotomy
105
What are some Advantages of parental presence?
* Parents want to be there * Parent see our caring approach * Rapid informed consent for changes * Redcued patient anxiety (?) * Parent understanding for negative outcome
106
Describe Positive reinforcement and descriptive praise...
* Give appropriate feedback to guide behavior * Describe what is done well * "Thanks a lot for holding so stil and sitting on your hands big boy!"
107
What is the pH of Ferric Sulfate?
1
108
Describe the Frankl Behavioral Rating Scale?
* 1: Definitely Negative -- * 2: Negative: - * 3. Positive: + * 4: Definitely Positive: + +
109
What are some objectives of performing an Indirect Pulp Cap/Primary Tooth/Vital Pulp?
* More successful than pulpotomy * Stimulate healing and repair * Preserve vitality * Arrest advance of caries ie. DBA, RMGI, CAOH2, or ZOE
110
Describe the effect of Obturation Materials in the Primary Dentition...
* Dry canals and obturate * Resorbs at rate of tooth * Harmless to periodontium * Harmless to tooth germ * Resorbs if pressed beyond apex * Easily inserted/Removed * Strongly antiseptic
111
What is the most favorable eruption sequence for the Maxillary Permanent Dentition?
6-1-2-_4-5-3_-7-8
112
What is the recommendation for brushing and amount of tooth paste?
* Recommend twice daily brushing * Smear (rice size) at eruption of first tooth * Parents must supervise small children
113
What are indications for the Transpalatal Arch?
114
What is the most effective topical application of Fluoride?
Dentifrice
115
What are 2 sequelae of Nitrous oxide and oxygen inhalation?
* Nausea and vomiting * Diffusion hypoxia
116
2% NaF gel = _____ ppm
9040 ppm = 9 mg/cc
117
What is the clinical sequence of performing Lesion Sterilization and Tissue Repair?
* Pulpotomy * Canal orifice reservoir * Clean pulp chamber * 35% phosphoric acid * Hemostasis * 3Mix on chamber floor * Glass Ionomer * SSC
118
Regarding Professionally applied Gels/Foam - 1.23% APF = _______ ppm
12,300 ppm = 12.3 mg/cc
119
If you have open proximal contacts and no disease, do you need x-rays?
No x-rays needed for examination
120
What are the 3 pillars of Regenerative Endodontic Procedures?
1. Stem Cells 2. Scaffols 3. Growth Factors
121
What is the Mechanism of Action of Fluoride?
Topical * Inhibits Demineralization * Promotes Remineralization Antibacterial * Disrupts Enzyme Systems Systemic * Reduces acid solubility
122
Why use Formocresol for Pulpotomies?
* Used for \> 80 years for primary tooth pulpotomies * Standard for all techniques * Formaldehyde in high levels is carcinogenic * Formaldehyde is intermediate for amino acids and lipids, normally present at 2-3 mg/L of blood * Formocresol rapidly metabolized to formate and C02, and presents "inconsequential risk"
123
When should a child's first dental exam be?
First visit no later than 12 months of age
124
Does the pellicle inhibit F uptake?
No!
125
What does Distal step molars always lead to...
Class II
126
What can mishandled MTA lead to?
* Respiratory and skin irritant, ocular damage * Silica is human carcinogen
127
What type of pulp therapy can you perform in a non-vital tooth?
Apexification
128
What is the max doese of Lidocaine for a child?
4.4 mg/kg
129
Does a DPC on a primary tooth have a good prognosis?
* Poor prognosis * Must be clean, pin-point or mecahnical pulp exposure * Asymtomatic * No radiographic signs of pathosis * Minimal to no bleeding
130
When do Permanent Mandibular Teeth Mineralize?
131
What are some Contraindications for Nitrous Oxide and Oxygen Inhalation?
* First trimester of pregnancy * Nasal Obstruction (relative) * INability to accept nasal hood * Large meal within 2 hour of treatment
132
What are 3 examples of Advanced Bahvior Guidance techniques?
* Protective stabilization (Papoose) * Sedation * General Anesthesia
133
What clinical signs contribute to poor candidates for pulpotomies?
* Severe Toothache * Persistent Toothache * Abnormal Mobility * Percussion Pain
134
If a Varnish is placed, what should you adivse the pt to do?
Advise do not brush until the next day
135
If you have closed proximal contacts, what do you order x-ray wise?
Posterior BW and or selected periapical/occlusal views
136
What are some goals of Vital Pulp Therapy Liners?
* Preserve vitality * Promote healing * Minimize micro leakage i.e. DBA, GI, Calcium Hydroxide
137
When do Permanent Maxillary Teeth Erupt?
138
What are some examples of liners you could place on primary teeth with a vital pulp?
* DBA * GI * Ca (OH)2
139
What is this?
Band and Loop
140
What can the halo effect lead to?
Fluorosis Infant formula, juices, and other beverages...
141
What are some different appliances you can use to help treat Ectopic Eruption?
* Brass Wire * Elastomeric Orthodontic Separator * De-impactor * Humphrey appliance * Halterman appliance
142
What does the Scaffold facilitate in the world of Regenerative Endodontics?
* Matrix for organizing, proliferating, differentiating, revascularization * Blood clots * Natural or synthetic materials
143
What is the most ideal eruption sequence for the Permanent dentition in the mandible?
6-1-2-_3-4-5_-7-8
144
What is this?
Dental Lamina Cysts Remnants of dental lamina on crest of alveolar ridge
145
What is an Ectopic Eruption?
146
Is it a good idea to conduct a Pulpotmy on a seriously ill child, with cyclic or chornic granulocyte or PMN depression?
No! Best choice is extraction Can have life threatening sequelae from failed treatment
147
How do you instrument/irrigate a young permanent tooth for a pulpotomy?
* RD or equivalent * Sterile bur * Remove 2 -3 mm of pulp * Hemostasis * CHX or Sodium Hypochlorite
148
When do Maxillary teeth begin Mineralization?
149
What materials can you use for Indirect Pulp Therapy?
* DBA * RMGA * Calcium Hydroxide * GI * ZOE
150
For a Primary tooth with a non-vital pulp think...
Pulpectomy, Sterilization Tissue Repair
151
For the Primary Dentition, if you are missing a 1st molar, think \_\_\_\_\_\_as an appliance...
Band and Loop - Crown and Loop
152
What is the sequence for providing an Indirect Pulp Cap on a Primary Vital Tooth?
1. RD 2. Caries Remova 3. Do not expose pulp 4. Place IPC material 5. Restore with sealing restoration
153
What is Leeway Space?
* Permanent premolars are smaller than the primary molars that preced them * This is known as "Leeway Space"
154
What are these?
Bohn Nodules Mucous gland tissue on buccal/lingual maxillary ridge
155
What is Fusion?
Two separate pulp chambers
156
What body systems does F toxicity effect?
* GI * CNS \*Death in 4 hours
157
In the Early Mixed dentition, if you are missing the 1st molar - think _______ as appliance therapy...
Band and Loop / None
158
Describe Nonverbal Communication...
* Reinforces desired behavior * Raised eyebrows, smile * Speaking at eye level or looking down * Tokens, a "high five"
159
What can Leeway Space be used to alleviate?
Incisor Crowding
160
How long does it take caries to go to go through outer half of enamel?
Caries progresses through outer half of enamel in 1 year and another year through inner half for primary teeth
161
When do primary mandibular teeth erupt?
162
What are some advantages to differing definitive treatment?
* The younger a child, the fast one can see changes * Six months makes a huge difference in the life of a 3 or 4 year old
163
What is this?
Distal Shoe
164
In the Early Mixed Dentition, if you are missing multiple molars, think _________ as possible appliance therapy options...
Nance / Transpalatal Arch / Removable Acrylic Saddle Appliance
165
What measurement is ideal for OJ and OB?
2 mm
166
What is a lethal dose of F?
15 mg F/kg
167
What kind of kids would space maintainers NOT be a good idea for?
* Very sick/risky kids * Immunocompromised / High SBE risk / Blood dyscrasias * Uncooperative * Poor Oral Hygiene * Unreliable
168
For the young permanent tooth, how would you do a Direct Pulp Cap?
* RD or equivalent * MTA * Calcium Hydroxide/RMGI * Sealing Restoration
169
In the Primary dentition, if you are missing multiple molars, think ______ as an appliance...
Removable Acrylic Saddle Appliance
170
What are the indications for a LLHA?
171
What is the difference between ITR (Interim Therapeutic Restorations) and ART (Atraumatic Restorative Treatment)?
* ITR: True provisional with follow up * ART: No planned follow up
172
What type of exam do you do for an infant?
Lap exam
173
What are some considerations for Space Maintenance?
* Specific tooth that is lost * Time elapsed since the tooth was lost * Pre-existing occlusion * Favorable space analysis * Presence and root development of permanent successor * Amount of alveolar bone covering permanent successor * Health status * Cooperative ability * Active oral habits * Oral hygiene
174
What do cavity liners help accomplish in primary teeth?
* Thin liquid on cavity floor * Preserves pulp vitality * Promotes healing * Minimizes bacterial leakage
175
What Primary Occlusal Scheme is Ideal for Primary Occlusion?
Mesial Step with Cl I Canines
176
What is an appropate dose of Acetaminophen for a child \< 12 years of age?
177
Where are Primate Spaces in the Mandible?
* Primate spaces are distal to the primary canines in the mandible
178
Describe how you would conduct a Pulpectomy and what irrigants you would use...
* Canals debrided/shaped Disinfected: * NaOCl * Chlorhexidine * 3% Hydrogen Peroxide than NaOCl * _Must keep NaOCl inside canals only_
179
For a young permanent tooth with vital pulp think...
Liner, IPC, DPC, Pulpotomy (Cvek)

Pediatric Dentistry - ABGD Oral Boards (2 decks)

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