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Flashcards in Lecture 6 Deck (36)
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1

Lower permanent first molars tend to ___

Upper permanent firs molars tend to ___

Tip and drift mesially

Remain upright but drift mesial (around palatal root?)

2

What is the primary objective of pulp therapy in the primary dentition?

Prevent or eradicate infection and to maintain the integrity and health of the teeth and their supporting tissues

3

What are the other objectives of pulp therapy?

Prevent space loss and malocclusion

Aid in mastication

Preserve the primary tooth in the case of hypodontia

Prevent possible speech problems

Maintain esthetics (more important for parent)

Prevent aberrant tongue habits

Prevent potentially damaging psychosocial effects (getting bullied)

4

Primary molars can last ___ years if they are kept well

30-40

5

Which has a larger margin of error, second or first primary molars?

Second

6

What are some materials used for protective liners?

GLUMA (5% gluteraldyhyde and 35% HEMA. Useful as desensitized, cavity disinfectant, a resetting agent and an adhesion promoter.

Glass ionomer

RMGI

7

You can do an indirect pulp cap when the tooth has ___ or ___, when the deepest carious dentin is not removed to avoid a pulp exposure.

No pulpitis

Or reversible pulpits


Success rate depends most significantly on the diagnosis

8

True or false.. it is ok to leave affected dentin and infected dentin.

False. You may leave affected denting but you must remove all infected dentin

9

True or false... you may do an indirect pulp cap when there is radiographic evidence of pathologic external or internal root resorption or other pathologic changes

False

10

True or false.. you can do indirect pulp caps on teeth with reversible pulpitis

True

11

True or false.. MTA or calcium hydroxide can stimulate dentin formation

True

Primary teeth heal up better than permanent teeth

12

When is a protective liner indicated?

In a tooth with normal pulp when all caries is removed for a restoration. Protective liner can be placed in the deep areas of prep to minimize injury to pulp and promote pulp tissue healing and minimize post op sensitivity

13

What are some materials used for an indirect pulp cap?

Calcium hydroxide (GI or reinforced ZOE should be placed over it)

ZOE

MTA

RMGI

GI cement

14

Why must you place GI or ZOE over calcium hydroxide?

Calcium hydroxide has high solubility, making a poor seal and low compressive strength. ZOE/GI provides a better seal preventing microleakage

15

What materials are used in direct pulp caps?

Calcium hydroxide

MTA

(Remember that GI or ZOE should be placed over it)

16

If you are going to do a pulpotomy, what should you do before you excavate the careis?

Prepare the tooth for full coverage

17

What are some matierals used in a pulpotomy?

Formocresol - devitaliztion/fixation

Ferric sulfate and chlorhexidine - preservation

MTA - regeneration

Filling - ZOE(IRM)

*although the medicaments and materials may change, the access opening technique will remain the same

18

If you see that the coronal pulp doesn't bleed or doesn't stop bleeding, should you do a pulpotomy?

No, this means the inflammation has gone beyond coronal pulp, do a pulpectomy

19

What are the indications for a pulpectomy?

Primary tooth with irreversible pulpits or necrosis

Roots should exhibit minimal or no resorption

20

What materials are used in a pulpectomy?

ZOE

Iodoform paste - bacteriocidal, resoorbable

Although eh medicaments and materials may change, the access opening teachniques will remain the same

21

What are some contraindication to pulp therapy in primary teeth?

Close to exfoliation

PA abscess formation with swelling and drainage unless the tooth deemed important

Cellulitis (just extract it)

Unrestorable tooth

Medically complex pedo pts (transplants, cancer, immunosuppression)

22

What are the most important primary teeth to save?

Second primary molar prior to eruption of primary first molar (spacing issue)

This is really the only tooth you'd do pulp therapy on

23

Especially in young permanent teeth with immature roots, the pulp is integral to continue ___

Apexogenesis

24

True or false... a tooth without a vital pulp cannot remain clinically functional

False

25

True or false... symptomatic or asymptomatic irreversible pulpitis is incapable of healing

True

26

In permanent teeth, ___ and ___ tests may be helpful in diagnosing the pulp etiology

Electric pulp tests and thermal tests

27

What are the signs and symptoms of irreversible pulpitis or necrosis?

Hx of spontaneous unprovoked toothache

Sinus tract

Soft tissue inflammation not resulting from gingivitis or periodontitis

Excessive mobility not associated with trauma or exfoliation

Furcation/apical radiolucency

Radiographic evidence of internal/external resorption

28

What are the signs and symptoms of reversible pulpitis?

Provoked pain of short duration relieved by OTC analgesics

Pain caused by brushing or upon the removal of the stimulus and without signs or symptoms of irreversible pulpitis

29

Any planned treatment should include consideration of what 4 things?

The patients medical history

The value of each involved tooth in relation to the child's overall development

Restorablility of the tooth

30

Post operative clinical assessment generally should be performed every ___ months

6