Pedo Midterm Flashcards
1
Q
According to Dr Berry, what are 5 advantages of a rubber dam?
A
- Improved management
- Improved workingconditions
- Aseptic field forpulp treatment
- Protect patient
- Increased efficiency
2
Q
According to the textbook, what are five advantages of rubber dams?
A
- Saves time
- Aids management
- Controls saliva
- Provides protection
- Helps dentist educate parents
3
Q
When is a slit dam indicated?
A
Primary dentition quadrant restoration and no pulp therapy indicated
4
Q
If only one tooth requires work, is a slit dam indicated?
A
No. Just isolate that one tooth.
5
Q
What should be done to the preselected tooth clamp?
A
Ligate with 18” piece of floss
6
Q
8A and W8A are clamps indicated for what deciduous teeth?
A
Primary molars and smaller permanent first molars
7
Q
Which clamp is indicated for partially erupted teeth and why?
A
W8A or 8A, jaws of clamp or oriented cervically
8
Q
The 14A clamp is indicated for what teeth and their condition?
A
Permanent first or second molars not fully erupted
9
Q
What is one disadvantage and one advantage of the slit dam technique?
A
Less isolation but easier to place
10
Q
Is the clamp and dam placed as one unit in the slit dam technique?
A
Clamp first then dam and frame placed as one unit.
11
Q
How is the dam prepared for the slit dam technique?
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?
A
cervical undercut on mesial of primary canine
13
Q
What is done with the edges of the rubber dam to improve isolation?
A
Invert the edges
14
Q
How is the wing clamp used differently than a non- winged clamp?
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?
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?
A
Broad flat contacts of primary molars
17
Q
What is the most common mistake in the preparation of primary teeth?
A
over-extension
18
Q
What is the treatment of choice in primary teeth when excessive tooth structure must be removed?
A
Stainless steel crown
19
Q
What are 4 desirable characteristics of primary tooth preparations?
A
- Conservative
- 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?
A
Thermal insulation to the pulp
21
Q
What do proximal lesions in a preschool child indicate?
A
Excessive caries activity
22
Q
What is one way to treat very small incipient lesions in conjunction with improved oral hygiene?
A
Topical fluoride therapy
23
Q
For amalgam, what is indicated even if the occlusal surface is not cavitated?
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?
A
Only do the proximal prep, then you 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?
It 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?
Stainless steel crown
28
What is the ideal width of the isthmus or the Class II preparation?
1/3 intercuspal width?
29
How should the floor of the proximal box be designed in a pedo Class II preparation?
Slightly rounded buccal-lingually
30
What determines the bucco-lingual extent of the proximal box in Class II prep?
Amount of tooth in contact with adjacent tooth and the extent of carious lesion
31
What should be done with axio-pulpal line angle where the occlusal floor and proximal box meet?
Beveled
32
Which pulp horn is most easily hit in an occlusal preparation of a molar?
Mesial
33
What must be used to avoid overhangs in Class II?
Matrix is adapted to contours of the tooth and a wedge is utilized
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)?
Condit’s T-band
35
What must be done once restoration is completed, dam apparatus removed, and occlusion is adjusted?
Warn patient and accompanying adult to avoid lip, cheek, and tongue injury due to chewing while anesthetized
36
What are 7 common errors in cavity preps?
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
7. Axial wall not conforming to the proximal contour of the tooth and the mesial-distal width of the gingival floor is too great
37
What is indicated when mandibular primary incisors have extensive caries?
Extraction
38
What is another way to treat interproximal caries (class III) on mandibular primary incisors?
Interproximal disked (???) and topical fluoride
39
What is frequent site of caries attack in patients at high risk for caries?
Distal surface of primary canine
40
What is the shape of a class III prep?
Triangular
41
Which way should the dovetail go in a Class III prep and why?
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?
Convert to Class IV or do an anterior crown
43
What can be used as a matrix for Class III?
T bands or mylar matrix
44
What is indicated if the Class V caries extend into the proximal contacts in molars?
Stainless Steel Crowns
45
What is the name of Dr. Berry’s niece?
Rebekkah
46
What is the name of Dr. Berry’s dog?
Bentley McLovin
47
Which has better success rate, stainless steel crowns or direct restorations?
Stainless Steel Crown
48
What are 6 indications for Stainless Steel Crowns?
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
49
On which tooth and why do large multi-surface lesions have a high direct restoration failure rate?
Primary Mandibular first molars. Funny shape does not retain restoration well
50
What are 7 indications for Stainless Steel Crown on posterior teeth?
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
51
What must you ask when considering restoring a primary tooth with a Stainless Steel Crown?
What is the length of time the child will keep tooth?
52
What restoration would be indicated for a General Anesthesia or Oral sedation with respect to a behavior problem child?
Stainless steel crown (to avoid restoring again)
53
What percentage of 2 surface amalgams needing replacement before age of 8?
70-71.4%
54
What percentage of Stainless Steel Crowns that require further treatment?
11-12.8%
55
From longest to shortest, put the relative restoration materials in order.
SSC (70%/5yrs) > Amalgam (60%/5 yrs) > Composite (40%/32 mos) > GI (4%/4 yrs)
56
What 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?
Contour plier
57
What plier is used in the very bottom portion around the entire circumference of the crown to ensure better cervical adaptation?
Crimping pliers
58
What should be done first, the stainless steel crown prep or the caries excavation?
Crown prep first, then if any carious dentin remains it is excavated
59
What size crown should be selected to cover the prep?
The smallest crown that covers the prep
60
When prepping for a stainless steel crown, how far should you reduce the occlusal?
1.0-1.5 mm clearance from opposing while maintaining occlusal contours
61
When prepping for a stainless steel crown, what should be done before performing the proximal slices?
Pulpotomy (if indicated)
62
When prepping for a stainless steel crown, what are the dimensions of the proximal slices?
Near vertical carried gingivally breaking contact so an explorer can be passed freely b/w adjacent teeth making a feathered edge with no lip
63
What is the most important part of the preparation for a stainless steel crown?
Proximal reduction
64
What may prevent seating of the crown?
ledging
65
When prepping for a stainless steel crown, far must extend proximal slices and why?
Extend them below the gingival in order to avoid ledging.
66
Is there a buccal-lingual reduction on a stainless steel crown prep?
No, want to keep that anatomy to aide crown fit
67
What are the advantages of the 3M Ion Crown or ESPE Prefabricated SSC?
Trimmed and crimped to save time and accurately duplicate anatomy for better fit and function
68
When is a Unitek SSC indicated?
Significant space loss secondary to decay or the caries extend further gingivally than Ion crown covers
69
What are the characteristics of the Unitek stainless steel crown?
Flat axial surfaces requiring contouring Crown must be shortened and marginally adapted
70
What are the steps to fitting the stainless steel crown?
1. Pick size
2. Adjust crown length
3. Adjust crown margin
4. Contour
5. Crimp
71
What is the procedure for seating the stainless steel crown?
Lingual to buccal due to primary tooth buccal bulge
72
What is an indicator that the crown may be to big or the margin is not accurately crimped?
Blanching of the tissue
73
When adjusting the crown length, how far should the crown to sit subgingivally?
1 mm below gingival crest
74
What does crown contouring do?
Reduces the circumference of the crown
75
What is the purpose of crimping?
Crimping ensures good cervical margin adaptation
76
How is crimping achieved?
Cervical 1-2 mm crown turned under to provide “snap” on seating
77
What are 2 common cements used in cementing crowns?
1. Polycarboxylate
| 2. Glass ionomer
78
What can be used to aide seating crown?
Child biting on a stick
79
After seating the crown, what should be checked?
1. Contact
2. Occlusion
3. Subgingival and interproximal excess cement
80
Does stainless steel occlusion have to be perfect?
No, primary molars adjust themselves quickly
81
What would be a common problem for crown not seating proximally?
Proximal ledging
82
What can be done with crown positioning if there is space loss?
Rotate crown slightly or use flate beaked pliers to flatten contact point to reduce M-D width
83
Do stainless steel crowns interfere with primary tooth exfoliation?
No, primary crown will come out with SSC
84
What is the years until tooth lost when a crown or alloy restoration not significantly different?
3 years
85
For what age and below are crowns significantly better?
5 years old
86
What are indications for Strip Crowns?
1. Extensive or multisurfaced caries
2. Congenitally malformed teeth
3. Discolored teeth
4. Fractured teeth
5. Sufficient crown material remains after caries removal to retain resin
87
Do Strip crowns require a Buccal and Lingual reduction and why?
Yes, to allow room for composite
88
When a strip crown form is trimmed, where does the cervical margin extend?
Slightly below gingival crest
89
What are big risks for the strip crowns?
Staining and breaking
90
What is ART?
Atraumatic Restorative Treatment. To prevent pain and preserve teeth in individual w/o access to regular or conventional oral health care
91
What is the term for amputation of the coronal portion of the pulp?
Pulpotomy
92
What is the status of the pulp tissue that is left in the roots after the pulpotomy?
Vital
93
What is the thought behind leaving vital pulp tissue in the roots?
It allows roots to resorb as normal and exfoliate
94
During a pulpotomy, after unroofing and removing the coronal pulp from the tooth, what is done next?
Control bleeding
95
What are 3 pulpal medicaments that can be used after bleeding is controlled and before tooth is restored?
Formocresol, Ferric Sulfate, MTA
96
How long should it take to control bleeding for a pulpotomy to be successful?
3-5 minutes
97
How should everything appear for a pulpotomy to be indicated?
Blood is red and normal and canal tissue appears normal
98
How is formocresol used?
Placed on pulp stumps for 5 min then covered with zinc oxide eugenol paste (IRM) and restored with a stainless steel crown
99
What are 5 effects of formocresol?
1. Bactericidal effect
2. Devitalizing effect
3. Converts bacteria and pulp to inert compounds
4. Inactivates oxidative enzymes in pulp
5. Makes pulp inert and resistant to enzymated breakdown
100
What is Ferric Sulfate used for?
Control bleeding (15 sec) then cover pulp w/ zinc oxide eugenol and restore
101
What are 4 requirements of a successful pulpotomy?
1. Eliminate infection in tooth
2. Tooth preserved in healthy, non-pathogenic condition
3. Arch space maintained
4. Normal resorption of primary tooth and eruption of permanent successor
102
What is the term for removal of the tissue from the coronal pulp chamber and the root canals?
Pulpectomy
103
When does calcification of primary teeth begin?
~3.5-4 months in utero
104
What is the general eruption of the primary teeth?
Primary teeth erupt in typical sequence starting ~6-7mos(mand central) and ending at 26 months (max 2nd molar)
105
Which dentition shows more variability, primary or permanent?
Permanent
106
What are 2 things primary occlusion adapts to?
1. Skeletal growth
| 2. Occlusal wear
107
Which teeth have more proprioception, primary or permanent?
Permanent
108
Of the 3 planes of growth of the mouth, which is the first to stop: A-P, Vertical, Transverse?
Transverse (~12 y.o)
109
Of the 3 planes of growth in the mouth, which is the 2nd plane of growth to stop growing: A-P, Vertical, Transverse?
Vertical
110
Which plane of life continues throughout life?
Anterior-Posterior
111
Who are more advanced at all stages of dental calcification and development, girls or boys?
Girls
112
Teeth do no begin to move occlusally until when?
Crown form is completed
113
Are caries genetic?
No
114
What largely determines tooth size?
Genetics
115
Which are rarer: supernumerary teeth or congenitally missing teeth?
Supernumerary teeth
116
Supernumerary teeth are more common in males or females?
Males
117
Dental arch width changes are timed more to dental development or skeletal growth?
Dental development
118
When does dental arch circumference decrease?
During late transitional and early permanent dentition
119
Why does dental arch circumference diminish as we get our permanent teeth?
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
120
What is the most important baby tooth and why?
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
121
What can happen if the E’s (Primary Second Molars) are lost early?
Permanent 1st molars will tip mesially and block out permanent 2nd bicuspids
122
What is the tooth that shows the greatest variability in development?
3rd molars
123
What is the sequence for Primary teeth calcification and times?
```
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]
```
124
When do A,D,B initiate calcification?
6 wks
125
When do C,E initiate calcification?
7 & 8 wks respectively
126
In what order do the cusps of the posterior teeth calcify?
MB, ML, DB, DL
| My Big Mother Likes Dry Biscuits During Lunch
127
How many calcification centers does an anterior tooth have?
One
128
When does the first permanent molar begin calcification?
At birth
129
What is Piscitelli’s Rule of 3’s?
Ffind out when calcification ends, add 3 years for eruption, then 3 years for root closure in permanent
130
When do primary teeth roots complete?
18 mos post eruption
131
When do permanent teeth roots complete?
3 years post eruption
132
By 12 months, an average child has how many teeth?
6-8
133
Which is more important: the timing of the eruption or the sequence of eruption?
Sequence because it helps determine tooth position in the arch
134
Why does Early Childhood Caries characteristically affect A, B, D, but skip the C’s (Palmer notation)?
A,B,D erupt before C so they are exposed longer to insults
135
What is the common appearance for an erupting tooth (especially centrals and max 2nd molar) but requires no intervention?
Eruption hematoma
136
Premature teeth erupt prior to what age?
3 months
137
What is the term for teeth present at birth?
Natal Teeth
138
What is the term for teeth present within first 30 days of life?
Neonatal teeth
139
hich are more common, Natal or neonatal?
Natal 3:1 more common
140
What is a consideration for Natal and neonatal teeth?
90% are true primary teeth so try to preserve them if possible
141
Are natal/neonatal teeth well formed and what is an associated finding?
Not well formed, can be mobile due to poor root formation. Riga-fede disease (ventral tongue trauma from suckling)
142
What are 2 syndromes that can have natal/neonatal teeth?
1. Chondroectodermal dysplasia (Ellis-van Creveld)
| 2. Cleft Lip and Palate
143
What are 3 structures in the newborn that can be confused for natal/neonatal teeth?
1. Dental Lamina cysts
2. Bohn’s nodules
3. Epstein’s pearls
144
What are cysts found on the crest of baby’s alveolar ridge that can be confused for natal/neonatal teeth?
Dental Lamina Cysts
145
What is the term for cysts found on the buccal and lingual aspects of ridge and palate (away from midline raphe) that can be confused for natal/neonatal teeth?
Bohn’s Nodules (Bohn’s Buccal)
146
What is the term for cysts found on the midline palatal raphe that can be confused for natal/neonatal teeth?
Epstein’s Pearls (Pearls Palate)
147
What is the Baume classification based on?
Space between anteriors
148
What does Baume Type I entail?
Spaced anteriors
149
What does Baume Type II entail?
No space between anteriors
150
What are the wide spaces mesial to the maxillary canines and distal to the mandibular canines?
Primate space
151
What is the primate space important for?
Bicuspid eruption
152
What goes into the primate space of the opposing arch in primary occlusion?
Primary cuspid tips go into the primate space of the opposing arch
153
The total interdental spacing between primary teeth ________ (decreases/increases) continually with age?
Decreases due to loss of Leeway space
154
Primary dentition Angle Classes of occlusion can be measured how?
Primary molar terminal plane
155
Flush Terminal plane indicates what?
The distal surface of the maxillary and mandibular 2nd molars are in line (most likely becomes Angle Class I)
156
Mesial Terminal Plane or Mesial Step means what?
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)
157
Distal Terminal Plane or Distal Step means what?
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)
158
Piscitelli says what Terminal Plane is most common (60%)?
Mesial Step
159
Most common tooth to get Turner’s tooth and why?
2nd premolar because E was sick
160
How do 1st perm molars erupt?
MandIbular erupt mesial and rotate distal into occlusion guided by distal of mandibular E, maxillary erupt distal and swing mesial into occlusion stopped by distal Max E
161
If the E (Palmer notation) is missing what 2 things will happen to the erupting permanent 1st molar?
Will Tip mesial . anytime there is tipping there is extrusion
162
What is the angle of primary incisors and their overbite/overjet?
Upright with little overbite or overjet
163
Permanent incisors angled how?
Labial angulation w/ overbite and overjet
164
What is the Leeway space of Nance?
Combined M-D width of deciduous canines and molars (C,D,E) differ from those of permanent canines and molars
165
How much Leeway space per each side maxillary arch and total Leeway Space of Nance for Maxilla?
0. 9mm/half arch
| 1. 8 mm total Leeway Maxillary Arch
166
How much Leeway space per each side mandibular arch and total Leeway Space of Nance for Mandible?
1. 7 mm/ half arch
| 3. 4 mm total Leeway Mandibular Arch
167
What are 2 things that close primate space?
Eruption permanent incisors
| Eruption permanent molars
168
Why does the intercanine width change with the eruption of the mandibular incisors?
Mand canines move distal into their primate space increasing slightly their intercanine width
169
If incisors erupt lingual to their deciduous predecessors, should anything be done, and what natural force will help push them into occlusion?
Don’t do anything. Tongue will push permanents labially
170
What is a way to determine if a canine will be impacted?
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)
171
If a patient has primate space and a flush terminal plane, what angle class will the permanent molar erupt into and how?
The eruptive force of permanent mandibular molar forces mandibular space closes allowing for Class I = Early Mesial Shift
172
How does a permanent molar get into Class I occlusion if there is no primate space and the primary occlusion was Flush Terminal Plane?
Late Mesial Shift = done when the E exfoliates from the mandible before the maxilla allowing that permanent first to move mesial to Class I
173
What are the width changes that occur between 6-13 years as the child goes from primary to mixed dentition to early permanent dentition?
1. Intercanine width increases
| 2. Interarch width decreases
174
If there is a problem in the initiation of a tooth, what will be the clinical manifestation?
Problems in tooth number (Hyper/hypodontia)
175
If there is a problem in the proliferation of a tooth, what can be the clinical manifestation?
Problems in tooth number, size, proportion (Gemination/twinning)
176
Morphodifferentiation problems give what clinical manifestations?
Size and Shape problems
177
Histodifferentiation problems give what clinical manifestations?
Problems of enamel (Amelogenesis imperfect) and dentin (dentinogenesis imperfect)
178
Mineralization and Maturation problems occur when during development and manifest how?
Post eruptive, some A.I., fluorosis, localized hypomineralization, interglobular dentin
179
If you are missing the primary tooth, will you have the permanent tooth?
No
180
List in order starting with most common, the teeth often found missing.
3rd Molars > Mand 2nd PM > Max Laterals > Max 2nd PM
181
What is the most commonly missing tooth in the permanent dentition?
Maxillary laterals
182
What are the most frequent microdonts?
Peg laterals > 2nd PM > 3rd molars
183
Hyperdontia, Hypodontia, Anodontia are problems associated with what histopathology : Initiation, Proliferation, Morphodifferentiation, Apposition?
Initiation and Proliferation
184
Microdontia, macrodontia, conjoined teeth are problems associated with what histopathology : Initiation, Proliferation, Morphodifferentiation, Apposition?
Proliferation and Morphodifferentitation
185
Enamel hypoplasia, dentinal dysplasia, hypercementosis, enamel pearls are problems associated with what histopathology : Initiation, Proliferation, Morphodifferentiation, Apposition?
Apposition
186
Dens in dente/Dens invaginitis, Dens evaginitis/Talon cusp, Taurodontism, Dilaceration are problems associated with what histopathology : Initiation, Proliferation, Morphodifferentiation, Apposition?
Morphodifferentiation
187
What type of developmental defect has a single pulp, split crown, will result in the mouth having a greater than usual number of clinical crowns and is more common in primary teeth?
Gemination
188
What is a single bud with supernumerary image and 2 separate crowns?
Twinning
189
What type of developmental defect has 2 separate pulp chambers, but clinically have correct # clinical crowns and is more common in primary teeth?
Fusion
190
What is the term for fusion that occurs after root formation is completed?
Concrescence
191
What is a congential anomaly that frequently has delayed toot eruption?
Trisomy 21 (Down Syndrome)
192
What are oral characteristics of Trisomy 21?
Smaller max and mand causing protruding tongue, dental crowding, higher rate gingivitis, lower caries rate
193
What is a congenital syndrome with mandibular prognathism caused by increased mandibular length and short cranial bases, delayed development of dentition (sometimes primary dentition at age 15), presence of supernumerary teeth. And they can touch their shoulders in front of them?
Cleidocranial dysplasia
194
Deficient thyroid gland function will cause early or delayed tooth eruption?
Delayed (hypothyroid = Cretinism)
195
Deficient pituitary gland function will cause early or delayed tooth eruption?
Delayed (hypopituitary = low growth hormone)
196
Would a pituitary dwarf or an achondroplastic dwarf have a crowded arch?
Achondroplastic dwarf
197
What should you do if you see a dental anomaly in one area of the dentition?
Look for it elsewhere
198
What is an abortive attempt by a single tooth bud to divide. One bud, one tooth, one root canal?
Gemination
199
What is a union of normally discrete teeth. Two teeth, Dentin Union, separate root canals
Fusion
200
What is the term for fusion of two teeth along the root surface. Two teeth, Cementum union, separate root canals?
Concresence
201
Gemination occurs during what stage of tooth growth cycle and which set of teeth is it more common in?
1. Proliferation
| 2. Primary dentition
202
What will be the crown morphology of a tooth that fused late in tooth development?
One tooth almost 2x normal size or tooth withbifid crown
203
What is the term for Complete cleavage of a tooth bud resulting in the formation of a supernumerary tooth?
Twinning
204
What is the term for elongation of the pulp at the expense of the root. Body of the tooth is enlarged while the roots are reduced in size. Increase pulp exposure risk for cavity prep?
Taurodontism
205
Dens in Dente/Dens Invaginatus/Tooth within a tooth is verified how?
Radiograph
206
Dens in dente most common in what tooth?
Permanent maxillary lateral incisor
207
What is a clinical indicator of Dens in dente?
Deep lingual pits on maxillary permanent lateral incisor
208
What is the treatment for Dens in dente?
Seal or restore the invagination
209
What non-genetic things can cause anomalies of structure and texture of tooth?
insults during tooth formation
210
Autosomal dominant incomplete penetrance trait more common in permanent dentition with a higher frequency in Asians, deaf and blind, but missing third molars is not considered this (instead considered variant of normal)?
Hypodontia
211
What is seen more in primary dentition: hypodontia/hyperdontia or germination/fusion?
germination/fusion
212
What is the frequency of missing teeth (other than 3rd molars)?
Mand 2nd PM 33%
Max Lat Inc 27%
Max 2nd PM 15%
Mand Lat Inc 12%
213
What is an autosomal recessive syndrome with polydactyl, short stature and cardiac anomalies, that has missing teeth (Hypodontia)?
Chondroectodermal dysplasia (Ellis-vanCreveld syndrome)
214
What is an autosomal dominant syndrome with missing maxillary incisors (hypdontia) and degeneration of the anterior chamber of the eye?
Rieger Syndrome
215
What is a syndrome that can be X-linked or autosomal recessive presenting with nose anomalies (either long or broad nasal tip and long nasal philtrum), cleft lip and palate, digital anomalies, and missing teeth (Hypodontia)?
Oro-facial digital syndrome
216
In Ectodermal dysplasia, what are the 4 most commonly affected tissues?
Hair (Tricodysplasia)
Teeth (Hypodontia)
Nails (Onchodysplasia)
Sweat glands(dyshydrosis)
217
To reach a diagnosis of ectodermal dysplasia, one of what three conditions must be met?
2 or more ectodermal tissues involved (hair, teeth, nails, skin/sweat glands)
Genetic diagnosis
1st degree affected relative
218
What are some common oral findings with ectodermal dysplasia?
Multiple missing or all teeth missing Conical, peg shaped teeth, esp Canine/incisor Lack of alveolar process development
219
What is an oral treatment for hypodontia and/or altered teeth of ectodermal dysplasia?
Denture for the child
220
What are the most common permanent teeth in ectodermal dysplasia?
Total 4-14 teeth, more in the maxilla. Maxillary Central, maxillary canines, Max and mand 1st molars commonly present
221
What syndromes are associated with Hypodontia?
Can Robert Order Hummus? Chondroectodermal dysplasia/Ellis van Creveld Rieger syndrome
Orofacial digital syndrome
Hypohidrotic Ectodermal Dysplasia
222
What is the genetics for Hypohidrotic Ectodermal Dsyplasia?
X-linked recessive
223
Is hyperdontia more common in males or females?
Males
224
What is the most common supernumerary tooth?
Maxillary anterior mesiodens
225
What is the most common way to get Hyperdontia?
Autosomal dominant with lack of penetrance
226
What is an autosomal dominant syndrome with multiple odontomas (Hyperdontia), malignant intestinal polyps?
Gardner’s syndrome
227
What is an autosomal dominant syndrome of variable expression presenting with Hyperdontia, hypoplastic clavicles, and acorn shaped skull?
Cleidocranial dysplasia
228
Is cleft lip and palate due to straight genetics?
No. Multifactorial inheritance: genetics and environment
229
Where are extra teeth most common in Cleft Lip and Palate and why?
In area of bony sutures due to splintering of developing tooth bud
230
What are 3 syndromes associated with Hyperdontia?
Girls Can Clean Gardner’s Syndrome
| Cleidocranial Dysplasia Cleft Lip and palate
231
What are 3 broad categories of Amelogenesis Imperfecta?
Hypoplastic
Hypocalcified
Hypomature
232
The defective tooth structure in Amelogenesis Imperfecta is limited to what?
enamel
233
What is the enamel type and tooth appearance of Hypoplastic Amelogenesis Imperfecta?
1. Hard thin enamel
| 2. Small teeth, occasionally tapered (think diastemas)
234
What is the problem with the enamel in Hypoplastic Amelogenesis Imperfecta?
Enamel matrix imperfectly formed, but is calcified
235
What is the enamel type and tooth appearance of Hypocalcified Amelogenesis Imperfecta?
Normal thickness enamel but soft & abrades easily Pitted surface
Moth eaten radiograph
236
What is the problem with the enamel in Hypocalcified Amelogenesis Imperfecta?
Matrix normal thickness but calcification deficient making enamel soft
237
What is the enamel type and tooth appearance of Hypomature Amelogenesis Imperfecta?
Soft enamel of normal thickness
Fractures and flakes easily
Can’t tell enamel from dentin on radiographs
238
What is the only distinguishing difference between Hypocalcified and Hypomature Amelogenesis Imperfecta?
Radiograph
Hypocalcified = moth eaten
Hypomature = no diff b/w dentin and enamel
239
What is the A.I. type that is X-linked dominant?
Hypoplastic A.I.
240
What is the A.I. type that is X-linked recessive?
Hypomature A.I.
241
What are 3 types of Dentinogenesis Imperfecta?
Type I
TypeII
Type III
242
This Dentinogenesis Imperfecta type always occurs with Osteogenesis Imperfecta?
Type I
243
If pt has osteogenesis imperfect does that mean they will have D.I.?
No
244
Which dentition is more severly affected in Type I D.I.?
Primary
245
This D.I. type never occurs with O.I. and is also called Hereditary Opalescent Dentin?
Type II
246
This D.I. type is found in racial isolates in Maryland.
Type III or Brandywine type
247
Type III D.I. has what radiographic appearance?
Shell teeth
248
Normal dentin formation is confined to a thin layer next to enamel and cementum, followed by a layer of disorderly dentin containing few tubules. The roots are short and the primary teeth may exfoliate
Shell teeth
249
What is major difference in pt’s clinical appearance between Type I and type II D.I.?
Type I has characteristics of O.I. (Blue sclera, presenile deafness, acorn skull, growth deficiency)
250
What is the tooth difference in Type I and type II D.I.?
Type II affects both primary and permanent dentition equally while type I affects primary dentition more severly
251
What is the basic dentinogenesis Imperfecta clinical appearance in primary dentition?
Primary or permanent teeth reddish brown to gray opalescent. Primary enamel breaks off and dentin abrades easily giving a polished dentin surface
252
What is the basic Dentinogenesis Imperfecta radiographic appearance?
Slender roots
Bulbous crowns
Pulp chamber small or entirely absent Multiple root fractures, especially in older pts
253
Does Hereditary Opalescent Dentin (type II D.I.) show high penetrance in a family?
Yes
254
What is a viable treatment option in Type II D.I.?
Implants b/c bone is good (no osteogenesis imperfect as in type I)
255
What are 2 types of Dentin dysplasia?
Radicular/Type I Coronal/ Type II
256
What dentition is affected in Radicular Dentin dysplasia (Type I)?
Primary and permanent
257
Where is the usual appearance of radicular Dentin Dysplasia (type I)
Short pointed roots
| Absent pulp or chevron shaped pulp in crown
258
Clinical crown appearance in Radicular Dentin Dysplasia (type I)
Normal size and shape
259
What dentition is affected in Coronal dentin dysplasia (type II)?
Primary. Permanent appears normal
260
What other genetic disorder does Coronal dentin dysplasia (type II) resemble?
1. Dentinogenesis Imperfecta
2. Opalescent primary dentition and obliterated
pulp chambers
261
What is the characteristic shape of a pulp chamber of Coronal Dentin dysplasia (Type II)?
Thistle tube
262
What is the most common inherited abnormality of renal tubular transport?
Hypophosphatemia/ Vit D resistant rickettsia
263
What and when is the clinical appearance of hypophosphatemia/ Vit D resistant rickettsia?
2nd year life, short stature and bowing of legs in boys (X linked dominant)
264
What gender is hypophosphatemia more common in?
Girls twice a likely as boys
265
What tooth problem associated with hypophosphatemia/ Vit D resistant rickettsia?
Large pulp chambers and pulpal extensions to the enamel in primary and permanent teeth
266
What would be clinical clue for hypophosphatemia/ Vit D resistant rickettsia?
Spontaneous tooth abscess
267
What is a localized arrest of tooth development with unknown cause giving rise to only outline of crown being evident and called Ghost Teeth?
Regional odontodysplasia
268
Does Regional Odontodysplasia cross the midline?
No, usually limits to a quadrant
269
If a tooth looks submerged below occlusal plane, suspect that it is?
Ankylosed
270
What is the most common tooth ankylosed?
Mand primary molars or traumatized permanent incisors
271
What is a spicule of bone overlying erupting permanent molar that requires no treatment?
Eruption sequestration
272
What is usually found on the maxillary molar furcation and requires no treatment, but can contribute to periodontitis?
Enamel pearl
273
What conditions are associated with apposition problem?
```
Dentinal dysplasia (Type I and II)
Regional Odontodysplasia
Enamel pearl
Compound Odontoma
Complex odontoma
Hypercementosis
```
274
What conditions are associated with histodifferentiation problems?
Dentinogenesis Imperfecta Type I and II
275
An anyklosed tooth would be associated with what problem type?
Eruption
276
Premature teeth would be associated with what problem type?
Proliferation
277
When would extraction versus disking of premature tooth be indicated?
Extract if loose and worried about aspiration
| Disk if sound and want to treat or avoid Riga-Fede
278
Hypoplastic A.I. is associated with what problem type?
Histodifferentiation
279
Hypomature A.I is associated with what problem type?
Apposition
280
Hypocalcified A.I is associated with what problem type?
Calcification
281
What is apposition?
Result of layer like deposition of nonvital extracellular secretion in the form of a tissue matrix by odontoblasts/ameloblasts
282
Histodifferentiation and Morphodifferentiation occur at what stage of tooth development?
Bell Stage: differentiation dental papilla cells to odontoblasts and IEE cells to ameloblasts
283
A deficiency in initiation (Bud Stage) or Proliferation (Cap Stage) will result in what number of teeth?
Hypodontia
284
What are 4 things a dental team must assess?
1. Developmental level
2. Dental attitudes
3. Temperament
4. Predict child’s reaction to treatment
285
What term implies a sequential unfolding that may involve changes in size, shape, function, structure or skill?
Development
286
What is the term for a child’s total physical growth and efficiency from the moment of conception until adulthood?
Physical development
287
What is the most frequent pediatric behavior seen, treated with straightforward tell-show-do (TSD)
Cooperation
288
What is the label given to a child that does not have the ability to cooperate or communicate either due to age, or a specific mental, physical, or emotional problem
Lacking cooperative ability
289
What is the label given to a child that has the ability to communicate and cooperate and whose uncooperative behavior can be modified?
Potentially cooperative ability
290
What is another term for a child lacking cooperative ability when indicating that the child’s young age precludes them from cooperation?
Pre-cooperative
291
What is a nonspecific feeling of apprehension, worry, uneasiness or dread whose source may be unknown?
Anxiety
292
What is a feeling of fright or dread related to an identifiable source?
Fear
293
What is any persistent and irrational fear of something specific, such as and object or situation?
Phobia
294
When did a majority of reported dental anxiety (50.9%) occur?
Childhood onset related to direct experience
295
What are 4 causes of dental fear and dental behavior management problems?
1. General emotional status
2. Parental dental fears
3. Previous dental treatment
4. Experiences of Pain
296
What are 4 cultural variables affecting child’s behavior?
1. Society standards
2. Community standards
3. Family standards
4. Parenting styles
297
Do all fearful children also present as a behavior management problem?
No, only minority of BMP children are fearful
298
What is the key to decision of parent being in the operatory?
It is controversial, but either way make policy clear to parent before treatment
299
If parent is to be in the operatory, they should be told they are expected to act as what?
Silent observers
300
All decisions regarding behavior must be based on what?
Risk vs benefit
301
Who shares in the decision making process regarding treatment?
Parents must be informed and get consent
302
What is the difference between consent and assent?
Consent implies understanding and voluntary accordance while assent is to give in or acquiesce
303
What is the best way to attain informed consent and truly make the parent feel informed : forms and videos or oral presentation of the information?
Oral presentation
304
What are 2 types of defensive mechanisms?
1. Active (childlike)
| 2. Passive (adultlike)
305
What is the concept of acceptable behavior?
I have no idea. I think this was a typo.
306
What behavior control increases the possibility of a particular behavior occurring?
Positive reinforcement
307
Should reinforcement be immediate or delayed?
Immediate
308
What is meant by avoiding a power struggle and what should be the nature of the choices given?
Give choices so child feels in control, but only choices they are not allowed to say no to. E.g ask if they want to brush their teeth or have you brush their teeth. Either way, a toothbrush is going in their mouth.
309
Do not give a child a choice if....?
You can't live with the answer
310
What are 3 types of basic behavior techniques?
1. Tell Show Do (TSD)
2. Nitrous Oxide sedation
3. Voice control
311
What are 5 types of advanced behavior techniques?
1. Passive restraint
2. Hand over mouth
3. Oral premdication
4. Active restraint
5. General anesthesia
312
Does voice control have to be yelling?
No it could be a whisper but the goal is to get attention and establish authority
313
When would voice control be contraindicated?
When child can't understand or cooperate
314
Why do Tell Show Do?
Teach patient and shape response through desensitization
315
What is an example of Nonverbal communication with Behavior management?
Walk in happy
316
Motivational interviewing has what type of listening?
Active or reflective listening
317
What is most acceptable behavior management accepted by parents?
Tell-show-do
318
What is the most acceptable way to evaluate and record a child’s behavior?
Frankl Behavioral Rating Scale
319
What is a shortcoming of the Frankl scale?
Does not communicate sufficient clinical info on uncooperation E.g, “-“ is not as good as “-, tears”
320
Frankl rating 4 (++)
Definitely positive
321
Frankl rating 3 (+)
Positive. Cautious but compliant.
322
Frankl rating 2 (-)
Negative. Reluctant, uncooperative, some negative attitude
323
Frankl rating 1 ( - - )
Definitely Negative. Refusal, crying, fearful
324
What is the purpose of the written and oral functional inquiry?
Learn about patient and parent concerns and gather info to estimate cooperation of child
325
What are some examples of Tell Show Do and innocuous language?
```
Rubber Dam Clamp = tooth ring
Rubber dam = raincoat
Nitrous = happy gas or flavored air
Local anesthesia = Mr. Bubbles
Sealant = Paint
Etch = Blue Shampoo
```
326
What are 6 fundamentals of behavior guidance?
1. Positive approach
2. Team attitude
3. Organization
4. Truthfulness
5. Tolerance
6. Flexibility
327
What is the term for caries activity in any primary tooth in a child younger than 6 yrs old having a distinctive pattern, with many teeth affected and the caries developing rapidly?
Early Childhood Caries
328
What is the typical pattern for ECC?
Maxillary anterior teeth, Max and mand first primary molars, sometimes mandibular canines
329
What is the definition of ECC from the book?
The presence of one or more decayed (non-cavitated or cavitated), missing (due to caries) or filled tooth surfaces in any primary tooth in a child 71 months or younger or children younger than 3 yrs any sign of smooth surface caries indicates Severe-ECC
330
What primary teeth are usually not affected by ECC?
Mandibular incisors
331
Dental Caries is what type of disease and what does it require?
Infectious disease
Susceptible host/tooth
Cariogenic Microflora
Carbohydrate source Exposure time
332
What cycle does the dynamic disease process of dental caries follow?
Demineralization in low pH and remineralization in high pH
333
Which has better evidence for oral health promotion: health education, Motivational interviewing, MI paste vaccinations?
Motivational interviewing
334
What are methods to increase the Oral Health Literacy of identified at risk families for Early Childhood Caries?
Communicate w/o using dental jargon
No more than 3 new concepts/visit
Use demonstration aides
Have pt repeat back instructions in own words
335
What are risk factors for Early childhood Caries?
```
Frequent fermentable carb consumption
Poor oral hygiene
Lack of fluoride
Low socio-economic status & cultural factors Enamel defects
Chronic medical condition
```
336
Why is fluoride important for caries prevention?
inhibits bacterial metabolism
Inhibits demineralization
Enhances remineralization
337
What is a low birth weight baby and what does it do for ECC risk?
Less than 1500g, 3.3 lbs. Hypoplastic enamel ismore susceptible to caries
338
What are some ECC risks for special needs children?
May require frequent feeding
May have aversion to oral care
Delayed motor skills
Meds
339
What are things to look for in ECC risk assessment?
```
Visible plaque
Early tooth eruption (0-6 mos)
Visible decay/ white spot lesions/ enamel hypoplasia I
nappropriate feeding habits
Increased sugar intake
Lack of fluoride
Xerostomia (e.g. Asthma meds)
Caregiver or sibling with decay
```
340
Knee to knee exam indicated for children up to what age?
0-3 years
341
What is a brief counseling approach that focuses on the skills needed to motivate others?
Motivational interviewing
342
Provides a framework for prevention that goes beyond caries to address all aspects of children’s oral health according to developmental milestones?
Anticipatory guidance
343
What should be told to parents about why baby teeth matter?
function, esthetics, maintain space for permanent teeth, no missed school due to tooth pain, positive self image
344
Is there any evidence that teething is associated with fever and/or diarrhea?
No
345
If patient presents with anterior open bite from non-nutritive sucking, when is intervention indicated?
When permanent central incisors erupt
346
Anterior open bite can self-correct before what age?
4 years old
347
When does non-nutritive sucking start?
29th week of gestation
348
What age is the highest risk for dental trauma?
2-5 years old
349
What is brushing guidance for a child under 2 years old?
Clean teeth with cloth or soft toothbrush 1x day, no toothpaste
350
What is brushing guidance for a 2-5 year old?
Brush with pea size fluoride toothpaste, caregiver performs
351
What is brushing guidance for a child over the age of 6?
Brush with fluoridated toothpaste 2xday, caregiver performs or supervises
352
When should flossing start?
When teeth begin to touch
353
What are the requirements for an acceptable child dentifrices?
Contain fluoride
Low abrasion
ADA acceptance seal
354
How long should patients brush?
1 minute
355
What are the toothbrush specifications for a child?
1. Soft bristles
2. Small head
3. Thicker handle
356
Where does demineralization normally occur and why?
along gingival margin b/c that’s where plaque accumulates
357
How is fluoride antibacterial?
Concentrates in plaque and disrupts enzyme systems
358
How does fluoride help systemically?
Improves enamel crystallintiy, reduces acid solubility
359
What does fluoride do in the Demin/Remin cycle?
Inhibits demineralization, promotes remineralization
360
What is the Ideal amount of fluoride in water?
1 mg/L
361
What are 4 sources of fluoride?
1. Water
2. Diet
3. Casual ingestion of dentifrices
4. Prescribed supplements
362
If a child 6m<3 yrs gets less than 0.3ppm Fluoride, what should their supplement be?
0.25
363
Is a prophy required before placing a fluoride varnish?
No
364
If rubber cup prophylaxis completed what must follow?
Fluoride application
365
What is the benefit of topical fluoride varnish?
Eliminates risk of toxicity that exists w/ traditional fluoride treatments. Can be put on infants and young children
366
What are instructions following fluoride varnish application?
Soft, non-abrasive diet for rest of day, don’t brush teeth until tomorrow, alright to drink water right away
367
When is the prenatal period and how long does it last?
Conception to birth, 40 weeks
368
What is the time span of infancy?
1st 2 years of life
369
A birth is considered premature when it occurs before which week of pregnancy?
36 weeks
370
How long does "childhood" last for girls? Boys?
Girls: 2 to 10
Boys: 2 to 12
371
How long does adolescence last for girls? Boys?
Females: 10-18 yrs Males: 12-20 yrs
372
What is the term for a proportionate change in size or number?
Growth
373
What is the term for Increasing complexity and development (behavioral and physical)?
Development
374
What is the term for Changes in height, weight, sensory capacity and motor development?
Physical development (e.g. crawling to walking)
375
What is the term for a wide range of mental abilities-learning, language, memory, reasoning and thinking?
Intellectual development
376
What is another term for our feelings: how we deal with situations and the way we get along with other people?
Personality and Social Development
377
What is the term for split growth where body parts grow at own rate and reach maturity independently but in coordinated fashion?
Asynchronous growth
378
What growth pattern do we have?
Cephalocaudal growth- head growth first, then growth moves down body
379
What are some factors affecting growth?
```
Genetics (biggest factor)
Sex
Race
Maternal size
Socioeconomic status
Nutrition
Endocrine
```
380
What is the name of the curve that shows not all tissues grow at the same rate and its shape?
Scammon curve, S-shaped
381
What are 2 periods of rapid growth in humans?
infancy, early childhood, adolescent spurt (i realize there are three things listed here. oh well)
382
Neural tissue completes at what early age?
6-7 yrs
383
Which tissue decreases with age?
Lymphoid
384
Multiple births result in what for successive children?
Smaller infant weight and increased premature delivery
385
What is a pronounced deceleration of the growth of bones and soft tissues of the body that results from deficiency of this hormone and from what structure is it released?
Growth hormone from pituitary gland
386
Can the growth deficiencies associated with limited growth hormone from pituitary problems be corrected?
Yes with hormone replacement therapy
387
What will insufficient levels of thyroid hormone result in?
Mental deficiency and dwarfism
388
What is a measure by which individual accumulates organized knowledge and the use of that knowledge to solve problems and modify behavior?
Cognition
389
What is true of cognitive development?
All children move through in same order, no stages are skipped, rate at which move through stages varies
390
Does age alone indicate development level?
No
391
Birth to 3 month child would show what communication?
Recognize voice, vary cry to indicate needs
392
A 4-6 month old child would show what type of communication?
Move eyes toward sound, babbles p,b,m
393
7 month – 1yr child communication
Peekaboo, 1-2 words by 1st birthday
394
1-2 yr old child communication
Follow simple commands, put 2 words together
395
2-3 yr old child communication
Follow 2 requests, use f,g,t,d,n sounds
396
What age is a child that answers simple questions and can use sentences with 4 or more words?
3-4 year old
397
What is the age of a child that pays attention to a short story and answers simple questions, communicates easily with other children and adults?
4-5 year old child
398
What are the Myers Brigg testing categories for 2/3 of children temperament?
Easy child
Difficult child
Slow to warm up child
399
Do all kids fit into the Myers Brigg temperament patterns?
No, 1/3 do not
400
What is different in fear of a 4-6 year old versus a 10-12 yrs?
4-6 year old fears an ugly person while a 10-12 year old child fears bodily harm
401
What are 2 ways to prevent or treat fears?
1. systemic desensitization (gradually expose to fearful object)
2. Modeling (observe fearlessness in others)
402
What is the cause of Trisomy 21 (Down Syndrome)?
3 #21 chromosomes
403
What are 2 common sicknesses in Down Syndrome patient?
Frequent conjunctivitis
| Frequent upper respiratory infections (can have increased prevalence of periodontal disease )
404
What are 2 reasons not to extract a natal/neonatal tooth?
1. Actually a primary tooth (85-90%)
| 2. If it is a supernumerary tooth, it can leave a sinus tract down to the developing tooth bud
405
What is the difference between natal and neonatal teeth?
Natal present at birth, while neonatal erupt withing 1st 30 days
406
What are 3 names for similar structures that are commonly mistaken for neonatal/natal teeth?
Bohn’s nodules, Dental Lamina cysts, Epstein pearls
407
What is the term for displacement or malposition of erupting tooth?
Ectopic eruption
408
What is the most common cause of ectopic eruption?
Crowding
409
What is the most common ectopically erupted tooth?
Maxillary 1st molar
410
In what demographic are ectopic eruption more prevalent?
Patient with cleft lip/palate
411
Do the majority of ectopic eruptions self correct, and what are the factors?
Yes, 60-70%, if pt <7yrs old dentally and if locked in only by the enamel or dentin of the adjacent tooth
412
What are 4 times when an ectopic molar would not self correct?
1. Child > 7 yrs old
2. Permanent molar locked in PULP of primary 2nd molar,
3. Severe mesial angulation of permanent molar (>3mm)
4. 2nd primary molar mobile
413
What is the treatment if the 1st permanent molar is partially erupted but locked in enamel or dentin of distal Primary 2nd molar (E)?
Disk distal of E (will lose some leeway space)
Ortho separator to unlock “6” (Palmer)
Halterman appliance
414
What is a Halterman appliance?
Band and distalizer on E, w/ button bonded on occlusal of “6” as mesial as possible
415
Ectopic eruption of Permanent Lateral incisor causing early exfoliation of primary canine can cause what?
Midline shift to affected side and no room for permanent canine to erupt into
416
What is the treatment for ectopic eruption of Permanent lateral incisor?
Extract contralateral primary canine to balance midline, put in lower lingual holding arch (LLHA) to stop lingual tilt incisors, ortho and possible serial extractions
417
If ectopic eruption of mandibular permanent centrals lingual to primaries, what is indicated?
Let primaries exfoliate, if not out by 8-8.5 yrs old, EXT the primary mandibular centrals
418
If ectopic eruption of Max permanent central incisors lingual to primaries, what is indicated?
Extract primary central incisors ASAP to prevent anterior crossbite.
419
How do permanent canines tend to erupt in relation to over-retained primary canines?
Erupt facially (high & outside primary canines)
420
How do premolars tend to erupt in relation to over-retained primary molars?
Inferiorly and facially to primary molars
421
Tooth eruption is keyed to what?
Root development
422
Permanent incisors erupt when how much of root is complete?
1⁄2 or more of root developed
423
Permanent canines and premolars erupt when how much of root is complete?
2/3 of root developed
424
Is the impetus of tooth eruption known?
No
425
What is the definition of over-retained primary tooth?
Permanent tooth on one side erupted and contralateral primary tooth not replaced w/in 6 months
426
What are 3 causes of delayed eruption of permanent teeth?
Trauma leading to primary tooth infection Pathology (mesiodens) Syndromes (Down, Cleidocrancial dysplasia)
427
Treatment for (over)retained primary tooth and when must go in and get it?
Extract retained. If permanent not erupted in 6-12 months, expose surgically and get it down with ortho
428
What is the term for fusion of tooth to bone that can happen at any time during tooth eruption caused by a localized obliteration of the PDL, can be fibrous or bony, and can be all along root or just a point?
Ankylosis
429
What does an ankylosed tooth look like clinically?
Looks submerged
430
Ankylosis of primary teeth usually a result of what?
Trauma, luxation or reimplantation of avulsed tooth
431
What is the most common primary tooth to ankylose?
Mandibular primary 1st molar
432
Will the ankylosed primary tooth exfoliate normally?
Yes
433
What is a consideration with an ankylosed primary mandibular molar?
Space loss if crown is below contact area of adjacent teeth
434
What are treatment options for primary ankylosed tooth?
Luxate to break the ankylosis
Bonded resin build ups
Extract and space maintenance
435
What is the most common impacted tooth after 3rd molars?
Maxillary canines
436
What is the criteria for high probability of maxillary canine impaction (80%)?
If permanent canine overlaps pulp of permanent lateral incisor on panoramic of mixed dentition
437
What is the treatment if see an overlapping canine over lateral on the pan?
Extract primary canines
438
What is the key to treatment/prevention of impacted maxillary canines?
Early diagnosis via Panoramic radiograph while repeating Dr Carter’s mantra “No Rads to the Gnads.”
439
What should you wait on before doing a Frenectomy?
Delay until permanent incisors and canines have erupted
440
When is a Frenectomy done in conjunction with ortho: before or after?
After ortho to see if still necessary once the ortho has closed the diastema
441
Abnormal maxillary frenum can cause what?
Diastema
442
What is the technical term for tongue tied?
Ankyloglossia
443
Indicaitons for Frenectomy to relieve Ankyloglossia?
Pull on lingual attached gingival (can lead to Perio)
Speech difficulties
Feeding difficulties
Pain
444
What is a general rule for early or late exfoliation of primary teeth and the eruption of their successors?
The earlier you take out the primary tooth, the later the permanent tooth will come in and vice versa
445
If lose primary molar 5 or younger (usually lose between 9-12 years) what will be the eruption of the corresponding premolar?
Delayed
446
What is the most important factor in digit/pacifier sucking habits and their affect on anterior open bite?
Duration
447
What are the 3 overal factors influencing the anterior openbite associated with pacifier/digit sucking habits?
1. Duration
2. Frequency
3. Intensity
448
What all happens orally with a sucking habit?
1. Anterior open bite
2. Palate constricts causing posterior crossbite
3. Severe overjet
449
What is the cutoff age for cessation of sucking habit and ability of body to self-correct orally, IF THE OPEN BITE IS NOT SKELETAL?
4 yrs old or younger
450
What is key to successful cessation of sucking habit?
Child must want to stop
| Only use positive reinforcement
451
What are the purpose of habit appliances?
Only as reminders
452
What is treatment for sucking habit 0-4 yr old?
Parent pulls thumb/pacifier out after child asleep
453
What is treatment for sucking habit in 5-8 yr old?
Positive reinforcement/appliance therapy
454
What is treatment for sucking habit over 8 yr old?
Appliance therapy/ortho
455
What are 2 reminder appliances for habit cessation?
Bluegrass
| Tongue Crib
456
What do Bluegrass and crib appliance do?
decrease satisfaction by keeping thumb/pacifier from getting all the way in mouth. Also keep tongue back to allow lips to push overjett lingually.
