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Pedo- Exam 1 > Stephens Columns > Flashcards

Stephens Columns Flashcards

1
Q

5 Advantages of Rubber Dam (dr berry)

A 
improved management 
Improved working conditions 
Aseptic field for pulp treatment 
Protect patient
Increased efficiency
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2
Q

5 advantages of rubber Dam (chat 18)

A 
saves time
Aids management
Controls saliva
Provides protection
Helps dentist educate parents
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3
Q

When is a slit dam indicated (Ch 18)

A

primary dentition quadrant restoration and no pulp therapy indicated

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4
Q

If only one tooth requires work, is a slit dam indicated( Ch 18)

A

No, just isolate that tooth

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5
Q

What should be done to the preselected tooth clamp (ch 18)

A

ligate with 18” piece of floss

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6
Q

8A and W8A are clamps indicated for what deciduous teeth (Berry)

A

primary molars and smaller permanent first molars

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7
Q

Which clamp is indicated for partially erupted teeth and why(Berry)

A

W8A or 8A, jaws of clamp or oriented cervically

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8
Q

14A indicated for what teeth and their condition (Berry)

A

permanent first or second molars not fully erupted

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9
Q

What is one disadvantage and one advantage of the slit dam technique (Berry)

A

less isolation but easier to place

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10
Q

Is the clamp and dam placed as one unit in the slit dam technique (Berry)

A

clamp first then dam and frame placed as a unit

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11
Q

How is the dam prepared for the slit dam technique (Berry)

A

hole punched for most posterior tooth and most anterior tooth, then connect the 2 holes by cutting a slit

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12
Q

What tooth morphology helps hold the rubber dam in place (Berry)

A

cervical undercut on mesial of primary canine

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13
Q

What is done with the edges of the rubber dam to improve isolation (Berry)

A

invert the edges

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14
Q

How is the wing clamp used differently than a non- winged clamp (Berry)

A

winged clamp placed on most posterior hole in the dam, clamp, dam & frame placed as a unit

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15
Q

What does the book say is indicated for Class I lesions (Ch 18)

A

conservative caries excavation and restoration using combo of bonding restorative and sealant materials

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16
Q

Why is the proximal portion of a primary tooth Class II prep carried further buccally and lingually (Ch 18)

A

broad flat contacts of primary molars

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17
Q

Most common mistake in the preparation of primary teeth (Berry)

A

over-extension

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18
Q

What is the treatment of choice in primary teeth when excessive tooth structure must be removed (Berry)

A

Stainless Steel Crown

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19
Q

4 desirable characteristics of primary tooth preparations (Berry)

A

conservative (politically)
Extended sufficiently to remove all carious tooth
structure
Adequate retention for resto material
Uniform depth pulpal floor and slightly rounded

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20
Q

What is the benefit of composite resin &/or glass ionomer restorative material (Ch 18)

A

thermal insulation to the pulp

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21
Q

Proximal lesions in a preschool child indicate what (Ch 18)

A

excessive caries activity

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22
Q

One way to treat very small incipient lesions in conjunction with improved oral hygiene (Ch 18)

A

topical fluoride therapy

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23
Q

For amalgam, what is indicated even if the occlusal surface is not cavitated (Ch 18)

A

minimal occlusal dovetail for retention

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24
Q

For esthetic restorative materials (composite resin or glass ionomer) what is indicated if the occlusal surface is not cavitated (Ch 18)

A

only proximal prep, then can seal the occlusal (with or without enamelplasty)

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25
Q

What is the big deal with the anatomy of the Mandibular first primary molar and how it affects a cavity preparation (Berry)

A

has an oblique ridge that should not be crossed making the Class I prep more mesially placed

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26
Q

What is a consideration when prepping a Primary mandibular second molar on a 7 year old

A

make sure you are prepping the primary tooth and not a permanent mandibular molar (#19 or #30)

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27
Q

What is indicated if the marginal ridge has been broken through by caries, is a Class II or a Stainless Steel Crown indicated (Berry)

A

Stainless Steel Crown

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28
Q

What is the ideal width of the isthmus or the Class II preparation (Berry)

A

1/3 intercuspal width

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29
Q

How should the floor of the proximal box be designed in a pedo Class II preparation (Berry)

A

slightly rounded bucco-lingual

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30
Q

What determines the bucco-lingual extent of the proximal box in Class II prep (Berry)

A

amount of tooth in contact with adjacent tooth extent of carious lesion

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31
Q

What should be done with axio-pulpal line angle where the occlusal floor and proximal box meet (Berry)

A

Beveled

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32
Q

Which pulp horn is most easily hit in an occlusal preparation of a molar (Berry)

A

Mesial pulp horn

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33
Q

What must be used to avoid overhangs in Class II (Berry)

A

adapted to contours of tooth and wedged

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34
Q

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) (Berry)

A

Condit’s T-band

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35
Q

What must be done once restoration is completed, dam apparatus removed, and occlusion is adjusted (Berry)

A

warn patient & accompanying adult to avoid lip, cheek, and tongue injury due to chewing while anesthetized

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36
Q

6 common errors in cavity preps (Berry) –> EXAM

A

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

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37
Q

What is indicated when mandibular primary incisors have extensive caries (Ch 18)

A

Extraction

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38
Q

What is another way to treat interproximal caries (class III) on mandibular primary incisors (Ch 18)

A

interproximal disked and topical fluoride varnish

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39
Q

What is frequent site of caries attack in patients at high risk for caries (Ch 18)

A

distal surface primary canine

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40
Q

What is shape of the Class III prep (Berry)

A

triangular

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41
Q

Which way should the dovetail go in a Class III prep and why (Berry)

A

gingival. Because primary incisal edge is thinner and would be more prone to fracture

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42
Q

What is indicated if the interproximal extension of a Class III gets extensive and undermines the incisal edge (Berry)

A

convert to Class IV or do an anterior crown

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43
Q

What can be used as a matrix for Class III (Berry)

A

T bands or mylar matrix

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44
Q

What is indicated if the Class V caries extend into the proximal contacts in molars (Berry)

A

Stainless Steel Crowns

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45
Q

Which has better success rate, stainless steel crowns or direct restorations (Berry)

A

Stainless Steel Crown

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46
Q

6 indications for Stainless Steel Crowns (Berry)

A

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

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47
Q

On which tooth and why do large multi-surface lesions have a high direct restoration failure rate (Berry)

A

Primary Mandibular first molars. Funny shape does not retain restoration well

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48
Q

7 indications for Stainless Steel Crown on posterior teeth (Ch 18)

A

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

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49
Q

What must you ask when considering restoring a primary tooth with a Stainless Steel Crown (Berry)

A

length of time child will keep tooth

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50
Q

What restoration would be indicated for a General Anesthesia or Oral sedation with respect to a behavior problem child (Berry)

A

Stainless Steel crown to avoid restoring again.

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51
Q

Percentage of 2 surface amalgams needing replacement before age of 8 (Berry)

A

70-71.4%

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52
Q

Percentage of Stainless Steel Crowns that require further treatment (Berry)

A

11-12.8%

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53
Q

Order of longevity for restorative procedures in children (Berry)

A

SSC (70%/5yrs) > Amalgam (60%/5 yrs) > Composite (40%/32 mos) > GI (4%/4 yrs)

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54
Q

This 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 (Berry)

A

contouring pliers

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55
Q

This plier is used in the very bottom portion around the entire circumference of the crown to ensure better cervical adaptation (Berry)

A

Crimping pliers

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56
Q

What should be done first, the stainless steel crown prep or the caries excavation (Ch 18)

A

Crown prep first, then if any carious dentin remains it is excavated

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57
Q

What crown should be selected to cover the prep (Ch 18)

A

smallest crown that covers the prep

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58
Q

How far to reduce occlusal (Ch 18 and Berry)

A

1.0-1.5 mm clearance from opposing while maintaining occlusal contours

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59
Q

What should be done before doing proximal slices (Berry)

A

pulpotomy if indicated

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60
Q

What are the dimensions of the proximal slices (Ch 18)

A

near vertical carried gingivally breaking contact so an explorer can be passed freely b/w adjacent teeth making a feathered edge with no lip

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61
Q

What is the most important part of the preparation (Berry)

A

proximal reduction

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62
Q

What will prevent seating of the crown (Berry)

A

ledging at the margin

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63
Q

How far must extend proximal slices and why (Berry)

A

extend below gingiva to avoid ledging

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64
Q

Is there a buccal-lingual reduction on a stainless steel crown prep

A

No, want to keep that anatomy to aide crown fit

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65
Q

Advantages of the 3M Ion Crown or ESPE Prefabricated SSC ( Berry)

A

trimmed and crimped to save time and accurately duplicate anatomy for better fit and function

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66
Q

When is a Unitek SSC indicated (Berry)

A

significant space loss secondary to decay or the caries extend further gingivally than Ion crown covers

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67
Q

Character of the Unitek SSC (Berry)

A

flat axial surfaces requiring contouring

Crown must be shortened and marginally adapted

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68
Q

Steps to fit SSC (Berry)

A 
pick size
Adjust crown length 
Adjust crown margin 
Contour
Crimp
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69
Q

How seat a SSC (Berry)

A

lingual to buccal due to primary tooth buccal bulge

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70
Q

What is an indicator that the crown may be to big or the margin is not accurately crimped (Berry)

A

blanching of tissue

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71
Q

When adjusting the crown length, how far is the crown to sit subgingival (Berry)

A

1 mm below gingival crest

72
Q

What does Crown contouring do (Berry)

A

reduces crown circumference

73
Q

Purpose of Crimping (Berry)

A

ensure good cervical margin adaptation

74
Q

How is crimping achieved (Berry)

A

cervical 1-2 mm crown turned under to provide “snap” on seating

75
Q

2 common cements used to cement crown on (Berry)

A

polycarboxylate

Glass ionomer

76
Q

What can be used to aide seating crown(Berry)

A

child biting on stick

77
Q

What must be checked for after seating crown (Berry)

A

contact
Occlusion
Subgingival and interproximal excess cement

78
Q

Does SSC occlusion have to be perfect (Berry)

A

No, primary molars adjust themselves quickly

79
Q

What would be a common problem for crown not seating proximally (Berry)

A

proximal ledge

80
Q

What can be done with crown positioning if there is space loss (Berry)

A

rotate crown slightly or use flate beaked pliers to flatten contact point to reduce M-D width

81
Q

Do SSC interfere with primary tooth exfoliation (Berry)

A

No, primary crown will come out with SSC

82
Q

What is the years until tooth lost when a crown or alloy restoration not significantly different (Berry)

A

3 years

83
Q

For what age and below are crowns significantly better (Berry)

A

< 5 yrs

84
Q

Indications for Strip Crowns (Berry)

A
  • extensive or multisurfaced caries
  • Congenitally malformed teeth
  • Discolored teeth
  • Fractured teeth
  • Sufficient crown material remains after caries removal to retain resin
85
Q

Do Strip crowns require a Buccal and Lingual reduction and why (Berry)

A

Yes, to allow room for composite

86
Q

When a strip crown form is trimmed, where does the cervical margin extend (Berry)

A

slightly below gingival crest

87
Q

What are big risks for the strip crowns (Berry)

A

staining and breaking

88
Q

What is ART (Ch 18)

A

Atraumatic Restorative Treatment. To prevent pain and preserve teeth in individual w/o access to regular or conventional oral health care

89
Q

Amputation of the coronal portion of the pulp (Berry)

A

Pulpotomy

90
Q

What is the status of the pulp tissue that is left in the roots after the pulpotomy (Berry)

A

vital

91
Q

What is the thought behind leaving vital pulp tissue in the roots (Berry)

A

allows roots to resorb as normal and exfoliate

92
Q

After unroof and remove coronal pulp from tooth, what is done next (Berry)

A

control bleeding

93
Q

3 pulpal medicaments that can be used after bleeding is controlled and before tooth is restored (Berry)

A

Formocresol, Ferric Sulfate, MTA

94
Q

How long should it take to control bleeding for a pulpotomy to be successful (Berry)

A

3-5 min

95
Q

How should everything appear for a pulpotomy to be indicated (Berry)

A

blood is red and normal and canal tissue appears normal

96
Q

Formocresol used how (Berry)

A

placed on pulp stumps for 5 min then covered with zinc oxide eugenol paste (IRM) and restored with SSC

97
Q

5 effects of Formocresol (Berry)

A
  • bactericidal effect
  • Devitalizing effect
  • Converts bacteria and pulp to inert compounds
  • Inactivates oxidative enzymes in pulp
  • Makes pulp inert and resistant to enzymated breakdown
98
Q

What is Ferric Sulfate used for (Berry)

A

Control bleeding (15 sec) then cover pulp w/ zinc oxide eugenol and restore

99
Q

4 requirements of a successful pulpotomy (Berry)

A
  • eliminate infection in tooth
  • Tooth preserved in healthy, non-pathogenic condition
  • Arch space maintained
  • Normal resorption of primary tooth and eruption of permanent successor
100
Q

Removal of the tissue from the coronal pulp chamber and the root canals (Berry)

A

Pulpectomy

101
Q

When does calcification of primary teeth begin(Piscitelli)

A

~3.5-4 months in utero

102
Q

General eruption of the primary teeth (Piscitelli)

A

primary teeth erupt in typical sequence starting ~6-7mo (mand central) and ending at 26 months (max 2nd molar)

103
Q

Which dentition shows more variability, primary or permanent (Piscitelli)

A

permanent

104
Q

2 things to which primary occlusion adapts to (Piscitelli)

A
  • skeletal growth

- occlusal wear

105
Q

Which teeth have more proprioception, primary or permanent (Piscitelli)

A

permanent

106
Q

of the 3 planes of growth of the mouth, which is the first to stop: A-P, Vertical, Transverse

A

Transverse (~12 y.o)

107
Q

which is the 2nd plane of growth to stop growing: A-P, Vertical, Transverse

A

Vertical

108
Q

Which plane of growth continues throughout life (Piscitelli)

A

A-P

109
Q

Who are more advanced at all stages of dental calcification and development, girls or boys(Piscitelli)

A

girls

110
Q

Teeth do no begin to move occlusally until… (Piscitelli)

A

Crown form is completed

111
Q

Are caries genetic (Piscitelli)

A

no

112
Q

What largely determines tooth size (Piscitelli)

A

genetics

113
Q

Which are rarer supernumerary teeth or congenitally missing teeth (Piscitelli)

A

Supernumeraries

114
Q

Supernumerary teeth are more common in males or females (Piscitelli)

A

males

115
Q

Dental arch width changes are timed more to dental development or skeletal growth (Piscitelli)

A

Dental development

116
Q

When does dental arch circumference decrease (Piscitelli)

A

during late transitional and early permanent dentition

117
Q

Why does dental arch circumference diminish as we get our permanent teeth (Piscitelli)

A

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

118
Q

What is the most important baby tooth and why (Piscitelli)

A

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

119
Q

What can happen if the E’s (Primary Second Molars) are lost early (Piscitelli)

A

Permanent 1st molars will tip mesially and block out permanent 2nd bicuspids

120
Q

Tooth that shows the greatest variability in development (Piscitelli)

A

3rd molars

121
Q

What is the sequence for Primary teeth calcification and times (Piscitelli)

A 
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]
122
Q

When do A,D,B initiate calcification (Piscitelli)

A

6 wks

123
Q

When do C,E initiate calcification (Piscitelli)

A

7 & 8 wks respectively

124
Q

In what order do the cusps of the posterior teeth calcify (Piscitelli)

A

MB, ML, DB, DL

My Big Mother Likes Dry Biscuits During Lunch

125
Q

How many calcification centers does an anterior tooth have (Piscitelli)

A

one

126
Q

When does the first permanent molar begin calcification (Piscitelli)

A

at birth

127
Q

What is Piscitelli’s Rule of 3’s

A

find out when calcification ends, add 3 years for eruption, then 3 years for root closure in permanent

128
Q

When do primary teeth roots complete (Piscitelli)

A

18 mos post eruption

129
Q

When do permanent teeth roots complete (Piscitelli)

A

3 years post eruption

130
Q

By 12 months, and average child has how many teeth (Piscitelli)

A

6-8

131
Q

Which is more important: the timing of the eruption or the sequence of eruption (Piscitelli)

A

sequence because it helps determine tooth position in the arch

132
Q

Why does Early Childhood Caries characteristically effect A, B, D, but skip the C’s (Palmer notation) (Piscitelli)

A

A,B,D erupt before C so exposed longer to insults

133
Q

Common appearance for erupting tooth especially centrals and max 2nd molar, but requires no intervention (Piscitelli)

A

eruption hematoma

134
Q

Premature teeth erupt prior to what age (Piscitelli)

A

3 months

135
Q

Teeth present at birth (Piscitelli)

A

Natal teeth

136
Q

Teeth present within first 30 days of life (Piscitelli)

A

Neonatal teeth

137
Q

Which are more common, Natal or neonatal (Piscitelli)

A

Natal 3:1 Neonatal

138
Q

What is a consideration for Natal and neonatal teeth (Piscitelli)

A

90% are true primary teeth so try to preserve

139
Q

Are natal/neonatal teeth well formed and what is an associated finding (Piscitelli/ Ch 9)

A

not well formed, can be mobile due to poor root formation. Riga-fede disease (ventral tongue trauma from suckling)

140
Q

2 syndromes that can have natal/neonatal teeth (Piscitelli)

A 
Chondroectodermal dysplasia (Ellis-van Creveld)
Cleft Lip and Palate
141
Q

3 structures in the newborn that can be confused for natal/neonatal teeth (Piscitelli)

A

Dental Lamina cysts
Bohn’s nodules
Epstein’s pearls

142
Q

Cysts found on crest of baby’s alveolar ridge that can be confused for natal/neonatal teeth (Piscitelli)

A

Dental Lamina Cysts

143
Q

cysts found on the buccal and lingual aspects of ridge and palate (away from midline raphe) that can be confused for natal/neonatal teeth (Piscitelli)

A

Bohn’s Nodules (Bohn’s Buccal)

144
Q

Cysts found on the midline palatal raphe that can be confused for natal/neonatal teeth (Piscitelli)

A

Epstein’s Pearls (Pearls Palate)

145
Q

What is the Baume classification based on (Piscitelli)

A

space between anteriors

146
Q

Baume Type I (Piscitelli)

A

spaced anteriors

147
Q

Baume Type II (Piscitelli)

A

no space between anteriors

148
Q

The wide spaces mesial to the maxillary canines and distal to the mandibular canines (Piscitelli)

A

primate space

149
Q

What is the primate space important for (Piscitelli)

A

canine and bicuspid eruption

150
Q

What goes into the primate space of the opposing arch in primary occlusion (Piscitelli)

A

primary cuspid tips go into the primate space of the opposing arch

151
Q

The total interdental spacing between primary teeth ________(decreases/increases) continually with age (Piscitelli)

A

decreases due to loss of Leeway space

152
Q

Primary dentition Angle Classes of occlusion can be measured this way (Piscitelli)

A

primary molar terminal plane

153
Q

Flush Terminal plane indicates what (Piscitelli)

A

the distal surface of the maxillary and mandibular 2nd molars are in line (most likely becomes Angle Class I)

154
Q

Mesial Terminal Plane or Mesial Step means what (Piscitelli)

A

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)

155
Q

Distal Terminal Plane or Distal Step means what (Piscitelli)

A

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)

156
Q

Piscitelli says what Terminal Plane is most common (60%)

A

Mesial Step

157
Q

Most common tooth to get Turner’s tooth and why (Piscitelli)

A

2nd premolar because E was sick

158
Q

How do 1st perm molars erupt (Piscitelli)

A

mand erupt mesial and rotate distal in to occlusion guided by distal of Mand E, Max erupt distal and swing mesial into occlusion stopped by distal Max E

159
Q

If the E (Palmer notation) is missing what 2 things will happen to the erupting Permanent 1st molar (Piscitelli)

A

will Tip mesial . anytime there is tipping there is Extrusion

160
Q

What is the angle of primary incisors and their overbite/overjet (Piscitelli)

A

upright with little overbite or overjet

161
Q

Permanent incisors angled how (Piscitelli)

A

Labial angulation w/ overbite and overjet

162
Q

Leeway space of Nance (Piscitelli)

A

combined M-D width of deciduous canines and molars (C,D,E) differ from those of permanent canines and molars

163
Q

How much Leeway space per each side maxillary arch and total Leeway Space of Nance for Maxilla(Piscitelli)

A
  1. 9mm/half arch

1. 8 mm total Leeway Maxillary Arch

164
Q

How much Leeway space per each side mandibular arch and total Leeway Space of Nance for Mandible(Piscitelli)

A
  1. 7 mm/ half arch

3. 4 mm total Leeway Mandibular Arch

165
Q

2 things that close Primate space(Piscitelli)

A

Eruption permanent incisors

Eruption permanent molars

166
Q

Why does the intercanine width change with the eruption of the mandibular incisors (Piscitelli)

A

Mand canines move distal into their primate space increasing slightly their intercanine width

167
Q

If incisors erupt lingual to their deciduous predecessors, should anything be done, and what natural force will help push them into occlusion (Piscitelli)

A

don’t do anything. Tongue will push permanents labially

168
Q

What is a way to determine if a canine will be impacted (Piscitelli)

A

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)

169
Q

If have primate space and a flush terminal plane, what angle class will the permanent molar erupt into and how (Piscitelli)

A

eruptive force of permanent mand molar forces mandibular space closeds allowing for Class I = Early Mesial Shift

170
Q

How does a permanent molar get into Class I occlusion if there is no primate space and the primary occlusion was Flush Terminal Plane (Piscitelli)

A

Late Mesial Shift = done when the E exfoliates from the mandible before the maxilla allowing that permanent first to move mesial to Class I

171
Q

What are the width changes that occur between 6-13 years as the child goes from primary to mixed dentition to early permanent dentition (Piscitelli)

A

intercanine width increases

Interarch width decreases

172
Q

If there is a problem in the initiation of a tooth, what will be the clinical manifestation (Piscitelli)

A

problems in tooth number (Hyper/hypodontia)

173
Q

If there is a problem in the proliferation of a tooth, what can be the clinical manifestation (Piscitelli)

A

problems in tooth number, size, proportion (Gemination/twinning)

174
Q

Morphodifferentiation problems give what clinical manifestations (Piscitelli)

A

Size and Shape problems

175
Q

Histodifferentiation problems give what clinical manifestations (Piscitelli)

A

problems of enamel (Amelogenesis imperfect) and dentin (dentinogenesis imperfect)

Pedo- Exam 1 (1 decks)

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