PEDs OSCE

Question 1

What occurs when space is lost in dentition that should be present?

Answer 1

Greater chance of decay
Ectopic Eruption
Abnormal Eruption Patterns
Malocclusion

Question 2

What complications occur with early loss of primary teeth?

Answer 2

Supraeruption
Mesial/Distal drift
Change in arch dimensions (length & circumference)
Ectopic or blocked eruption of permanent teeth
Increased chance of ortho in future

Question 3

Prior to placing space maintainers, what should you consider?

Answer 3

Motivation & Dental Hx
Space Available
Occlusion or malocclusion
Development stage

Don’t Place if:
* Bad Hygiene
* Permanent teeth should erupt w/in 1 year
* High caries risk

Question 4

When shouldn’t we use space maintainers?

Answer 4

Cosmetic issue not clinical issue

Question 5

Lose 1st primary molars too early

Answer 5

Early: Band & Loop
Late: Lower Lingual Holding Arch

Question 6

Band & Loop fabrication process

Answer 6

1. Fit band, crown, modified crown
2. Scan or impress
3. Remove band and seat or send t lab
4. Solder .036 wire to band
5. Cement

Should be wide enough for tooth to erupt through

Question 7

Loss of 2nd Primary Molars before 1st perm molars erupt

Answer 7

Distal shoe from primary 1st molar

Once 1st perm molars erupt, switch to:
* reverse Band & Loop
* Lingual arch
* Transpalatal arch
* Nance appliance

Question 8

Lose 2nd primary molars after 1st perm molars erupted

Answer 8

LLHA-Mandible if incisors have erupted

TPA or Nance-Maxilla, incisors dont have to be present
* must be passive, hygienic, not impinge soft tissue

Question 9

When should we use lower lingual holding arches?

Answer 9

after incisors have erupted

hold leeway space, “e” space
Hold multiple spaces unilaterally or bilaterally

Question 10

What is a transpalatal (TPA) and Nance Appliance?

Answer 10

Upper Arch
can use before eruption of incisors

Question 11

What can occur with loss of canines?

Answer 11

Midline Shift
Increase OJ & OB
Loss of arch dimensions (Length & Circumference)

Question 12

After placing an oral appliance, what is required?

Answer 12

Check for:
* tooth movement, not passive
* Loose or broken appliance
* Decay
* gingival issues
* Dental development

Question 13

What can you do if patient looses 6 year molars early?

Answer 13

3rd molar transplantation

Need:
* socket for transplanted tooth
* immature 3rd molar
* Cooperation
* good Hygiene
* Healthy Patient

Question 14

Eruption Sequence

Answer 14

Question 15

What space is normal in pediatric dentition?

Answer 15

Primate spaces
Leeway spaces

Question 16

Primate Spaces

Answer 16

Mesial to upper canines
Distal to lower canines

Lose at 6 y.o.

Question 17

When is the ugly duckling stage?

Answer 17

age 7-11

Question 18

Leeway Space

Answer 18

MD width of primary molars + canine is wider than…
MD width of permanent canine + premolars

Mandible: 1.7-2.5 mm per side
Maxilla: 0.9-1.5 mm per side

Lose at 11-12 y.o.

Question 19

What are alternatives to space maintenance?

Answer 19

regaining space maxes at 3 mm

Space management=Proactive
Space maintenace-reactive
Space regaining-retroactive

Question 20

When is space maintenance unnecessary after primary teeth are lost?

Answer 20

No bone present b/w primary and perm tooth

avg tooth erupts with 2/3 root formation

Question 21

If a primary molar is lost after age 7, what happens to the eruption of the perm premolar?

Answer 21

Accelerated eruption of premolar
* No space maintainer if 1st perm molars have stable occlusion

Question 22

If a primary molar is lost before age 7, what happens to the eruption of the perm premolar?

Answer 22

Delayed premolar eruption

Maintain

Question 23

When does space close after primary tooth loss?

Answer 23

1st 6 months
most is due to tipping

Question 24

What can increase space loss w/primary tooth loss?

Answer 24

active eruption of adjacent perm teeth

Question 25

What is the significance of ectopic erupting incisors?

Answer 25

Question 26

What is the significance of ectopic erupting premolars?

Answer 26

Distal Eruption:
* Mandibular 2nd premolar-Most common
* resorbs distal root of primary 2nd molar

B or L Eruption:
* Very common
* Ext Primary Molar if not ready to exfoliate in a few weeks

Question 27

What is the significance of ectopic erupting molars?

Answer 27

Mesial Eruption
* Impacted under Distal of primary 2nd molar
* Spacer
* Halterman Apppliance

Maxilla-most common