36 Questions
What is a characteristic of pulp horns in primary teeth compared to permanent teeth?
They are higher in proportion and located closer to the dentino-enamel junction
What is the shape of pulp chambers in primary teeth similar to?
The shape of the crown from an occlusal view
What is a reason to restore primary teeth?
To restore aesthetics where applicable
What is a risk of restorative therapy?
All of the above
What is a clinical criterion for deciding when to restore caries lesions?
Both A and B
What should be considered in a comprehensive treatment plan for restorative treatment?
The developmental status of the dentition
Why are pulp chambers of primary mandibular molar teeth typically larger than those of primary maxillary molars?
It is not specified why, but it is a characteristic
What is a characteristic of the root canal system of fully developed primary molars?
It is extremely tortuous and complex
What is one of the requirements of ideal restorative materials?
Preserving the anatomy of the occlusal surface
What is a benefit of Glass Ionomer Cements (GICs)?
They adhere to dental hard tissues
What is the maximum time for mixing Glass Ionomer Cements (GICs)?
40 seconds
Why is it important to protect Glass Ionomer Cements (GICs) from moisture contamination?
It leads to increased solubility and poor esthetics
What happens to Glass Ionomer Cements (GICs) when they undergo desiccation?
They shrink and craze
What is the role of the 'amalgamator' in mixing Glass Ionomer Cements (GICs)?
Not mentioned in the text
What is a significant factor to consider when choosing a restorative material?
Patient's caries risk
Why might a restoration in a first primary molar in a 9-year-old child require less durability?
Because the tooth will be lost sooner
What is an advantage of using GICs in caries control?
They release fluoride to help prevent future caries
Why might stainless steel crowns be used in some cases?
Because they eliminate the need for future re-treatment
What is a consideration when treating uncooperative children?
Using amalgam, which can tolerate moisture contamination
Why might GICs be used in the management of caries in anterior primary teeth?
Because they can help slow the carious process and restore aesthetics
What is a consideration when treating patients with physical or intellectual disabilities?
Providing the highest standard of dentistry possible
What is an advantage of using materials like stain SSCs in patients with physical or intellectual disabilities?
They are durable and can last a long time
What can glass ionomers act as?
A reservoir of fluoride
What is a disadvantage of glass ionomers?
Increased setting time
What are glass ionomers recommended for?
Small anterior proximal lesions
What can glass ionomers be used as?
A luting cement
What is a use of glass ionomers in high-risk patients?
Class III and V restorations
What is the purpose of using a 'sandwich technique' with glass ionomers?
To improve wear resistance
What is NOT a recommended use of conventional glass ionomers?
Class II restorations in primary molars
What is a benefit of using glass ionomers?
Fluoride release
What is an advantage of Resin Modified Glass Ionomer?
It has a similar coefficient of thermal expansion as dentin
What is a disadvantage of Resin Modified Glass Ionomer?
It is not as strong as composite or amalgam
In which type of restorations can Resin Modified Glass Ionomer be recommended?
Class I, II, III, and V restorations in primary teeth and class I, III, and V restorations in permanent teeth
What is an advantage of Resin Modified Glass Ionomer compared to composite resin?
It is more caries preventive
What is a limitation of using Resin Modified Glass Ionomer in permanent teeth?
The evidence is insufficient to support its use as a long-term restorative material
What is a potential application of Resin Modified Glass Ionomer?
Cervical restorations with good retention rate
Study Notes
Pulp and Root Canal Systems
- In primary teeth, the size of the pulp relative to the crown is larger.
- Pulp horns are higher in proportion and are located closer to the dentino-enamel junction and to the outer surface of the crown.
- Mesial pulp horns are higher than distal pulp horns.
- Pulp chambers are shaped comparably with the shape of the outline of the crown from an occlusal view.
- Pulp horns are present under each cusp of the primary molars.
- The pulp chambers of primary mandibular molar teeth are normally larger than the pulp chambers of primary maxillary molars.
- The root canal system of fully developed primary molars is extremely tortuous and complex.
Restoring Primary Teeth
- Reasons to restore primary teeth:
- Repair or limit the damage of dental caries
- Protect and preserve remaining pulp and tooth structure
- Ensure adequate function
- Restore aesthetics (where applicable)
- Provide ease in maintaining good oral hygiene
- Prevent the shifting of teeth due to loss of tooth structure
- Risks of restorative therapy:
- Reducing the longevity of teeth by making them more susceptible to fracture
- Recurrent lesions
- Restoration failure
- Pulp exposure during caries excavation
- Future pulpal complications
- Iatrogenic damage to adjacent teeth
Deciding to Restore Caries Lesions
- Clinical criteria for deciding to restore caries lesions:
- Visual detection of enamel cavitation
- Visual identification of shadowing of the enamel
- Radiographic recognition of enlargement of lesions over time
- Restorative treatment should be part of a comprehensive treatment plan, considering:
- Developmental status of the dentition
- Caries-risk assessment
- Patient's oral hygiene
- Anticipated parental compliance and likelihood of timely recall
- Patient's ability to cooperate for treatment
Choosing Restorative Materials
- Factors to consider when choosing restorative materials:
- Age of the child
- Caries risk
- Cooperation of the child
- Restorative situation
- Ideal restorative material should:
- Restore aesthetics
- Maintain physical strength of the crown
- Preserve the anatomy of the occlusal surface and interarch relation with opposing and adjacent teeth
- Prevent further ingress of bacteria or their byproducts into the micro spaces between the restoration and teeth
- Ensure long-term adhesion between the restoration and tooth
Restorative Materials
- Types of restorative materials:
- Glass Ionomer
- Resin Modified Glass Ionomer
- Compomers
- Composite
- Amalgam
- Stainless Steel Crowns (SSCs)
- Composite Resin Strip Crowns
Glass Ionomer
- Composition: silicate glass-powder and polyacrylic acid
- Setting reaction: acid-base reaction between two components
- Properties:
- Adhesion to dental hard tissues
- Chemical cure
- Fluoride release
- Limitations:
- Sensitive to moisture contamination
- Desiccation causes shrinkage and crazing
- Not recommended for stress-bearing areas
- Low wear resistance
- Not as esthetic as composite
Resin Modified Glass Ionomer
- Composition: addition of resin monomers or co-monomer to glass-ionomer formulation
- Advantages:
- Increased mechanical properties
- Physiochemically bonds to tooth structure
- Biocompatible
- Fluoride release (anticariogenic action)
- Minimal polymerization shrinkage
- Disadvantages:
- Not as strong as composite or amalgam
- Less fluoride release than glass ionomer
Factors to consider when performing dental restorations in children, including parental compliance, patient cooperation, and material choice. Age and durability of restorations are also discussed.
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