Pediatric Dentistry Quiz

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Questions and Answers

What are the main advantages of using a Rubber Dam for the patient?

  • Protection from swallowing/aspirating foreign objects and assists the child in keeping the mouth open
  • Protection from swallowing/aspirating foreign objects and softer tissue protection
  • Assists in keeping the mouth open and a more comfortable dental treatment
  • Protection from swallowing/aspirating foreign objects, soft tissue protection and a more comfortable dental treatment (correct)

What are the advantages of using a Rubber Dam for the dentist?

  • Moisture control, saliva & blood contamination, protection from air born infections, and better accessibility and visibility (correct)
  • Moisture control, protection from airborne infection and better accessibility and visibility
  • Moisture control, saliva & blood contamination and protection from air born infections
  • Moisture control, saliva & blood contamination and better accessibility and visibility

What are the contraindications for using a Rubber Dam?

  • A patient with an upper respiratory tract infection and a latex allergy
  • A patient with an upper respiratory tract infection and a patient who breaths through their mouth
  • A patient with a latex allergy and a patient who breathes through their mouth
  • All of the above are contraindications (correct)

What type of clamps are use for primary incisors?

<p>00 and 0 Ivory (C)</p> Signup and view all the answers

What type of clamps are used for the first permanent molar?

<p>14Α Ivory (A)</p> Signup and view all the answers

What are the most common Rubber Dam placement methods?

<p>Clamp + Elastic sheet or Rubber Dam frame (B)</p> Signup and view all the answers

What is one of the main morphological differences between primary and permanent teeth?

<p>Primary teeth have a smaller crown size and a buccal and lingual surface that converge to the occlusal surface (D)</p> Signup and view all the answers

What are the modifications for adhesive cavity preparations in primary teeth as compared to permanent teeth?

<p>There are modifications in both primary and permanent teeth (D)</p> Signup and view all the answers

Which of the following conditions would be a contraindication for performing a pulpectomy in a primary tooth?

<p>Non-cooperative patient (C), Medically compromised patient (D)</p> Signup and view all the answers

A pulpectomy is indicated in primary teeth when the pulp is:

<p>Irreversibly inflamed or non-vital (D)</p> Signup and view all the answers

What is the recommended working length for a pulpectomy in a primary tooth?

<p>2 mm from the apex (B)</p> Signup and view all the answers

Which of the following obturation materials for primary teeth has the highest prevalence of hypoplastic anomalies for the crown of permanent teeth?

<p>ZnO-E (A)</p> Signup and view all the answers

Which of the following is NOT a clinical finding that would suggest pulpectomy is necessary in primary teeth?

<p>Vital pulp with reversible pulpitis (A)</p> Signup and view all the answers

What is the recommended success rate for a pulpotomy with MTA in primary teeth over 2 years?

<p>90% (C)</p> Signup and view all the answers

What is the recommended success rate for a pulpectomy in a primary tooth using ZOE within 18 months?

<p>92% (B)</p> Signup and view all the answers

What is the recommended success rate for a pulpectomy in a primary tooth using ZOE/Iodoform/CH within 18 months?

<p>93% (D)</p> Signup and view all the answers

Which of the following is NOT a recommended obturation material for pulpectomy in primary teeth?

<p>MTA (B)</p> Signup and view all the answers

What is the primary indication for using LSTR (Long-Term Space-Maintenance Retention) for primary teeth?

<p>Primary teeth with irreversible pulpitis and root resorption &gt; 1/3 (A)</p> Signup and view all the answers

Which of the following pulpal management methods is appropriate for deep caries with a vital, restorable tooth, exhibiting no signs of periapical or intra radicular pathology?

<p>Indirect pulp capping (C)</p> Signup and view all the answers

Which of the following is a major challenge associated with performing a pulpectomy in primary teeth?

<p>Ensuring the permanent tooth bud is not damaged during the procedure (B)</p> Signup and view all the answers

Which pulpal management method has the highest success rate in primary teeth according to the provided content?

<p>Pulpectomy with ZOE (18 months) (B)</p> Signup and view all the answers

What is a significant shortcoming of using ZOE as an obturation material in primary molars?

<p>It can increase the risk of hypoplastic anomalies in the permanent teeth (A)</p> Signup and view all the answers

Which obturation material is a combination of zinc oxide, barium sulphate, and iodoform?

<p>Endoflas (A)</p> Signup and view all the answers

Which condition is NOT an indication for using full coverage crowns when restoring anterior primary teeth?

<p>Healthy enamel (A)</p> Signup and view all the answers

What is a key disadvantage of using strip crowns for restoring anterior primary teeth?

<p>Technique sensitive (D)</p> Signup and view all the answers

Which of the following is an advantage of using strip crowns for restoring anterior primary teeth?

<p>Excellent parental satisfaction (B)</p> Signup and view all the answers

What materials are recommended for restoring class III cavities in anterior primary teeth?

<p>Composite, RMGI (D)</p> Signup and view all the answers

When restoring class V cavities in anterior primary teeth, which materials are NOT recommended?

<p>Amalgam (B)</p> Signup and view all the answers

Which is NOT an indication for prefabricated stainless steel crowns in pediatric dentistry?

<p>Cosmetic enhancement (D)</p> Signup and view all the answers

What indicates that a stainless steel crown (SSC) may be necessary for a 9-year-old patient?

<p>Fracture risk due to remaining tooth structure (C)</p> Signup and view all the answers

For a restoration that requires an isthmus distance greater than ½ the intercuspal distance, which crown type is likely indicated?

<p>Prefabricated stainless steel crown (C)</p> Signup and view all the answers

What is the primary characteristic of cavitation that necessitates operative intervention?

<p>Cavity extending into the pulp (D)</p> Signup and view all the answers

Which statement correctly describes the prevalence of cavitation after tooth separation for primary teeth?

<p>60% prevalence after separation (D)</p> Signup and view all the answers

What type of lesions does resin infiltration mainly address?

<p>Buccal and interproximal smooth surface early carious lesions (D)</p> Signup and view all the answers

Which of the following is NOT true regarding determining cavitation status?

<p>Cavitation must always be clinically detectable. (B)</p> Signup and view all the answers

Which anatomical area has the highest prevalence of cavitation after tooth separation?

<p>Outer 1/3 of dentin (A)</p> Signup and view all the answers

What type of cement is recommended for cementing a Stainless Steel Crown (SSC)?

<p>Resin Modified Glass Ionomer Cement (RMGI) (B)</p> Signup and view all the answers

What is the recommended application frequency for Silver Diamine Fluoride (SDF)?

<p>Every 6 months for 2 years (D)</p> Signup and view all the answers

Which of the following is NOT a clinical effect of SDF?

<p>Tooth whitening (A)</p> Signup and view all the answers

What is the cut-off category for diagnosing a cavitated caries lesion when using the International Caries Detection Assessment System (ICDAS) II?

<p>ICDAS 5 (A)</p> Signup and view all the answers

According to the ICDAS II, what are the characteristics of an ICDAS 3 carious lesion?

<p>Localized enamel breakdown (without clinical visual signs of dentinal involvement) (C)</p> Signup and view all the answers

What does SMART stand for in the minimally invasive treatment approach for cavities?

<p>Silver Modified Atraumatic Restorative Treatment (A)</p> Signup and view all the answers

Which of the following steps is NOT part of the Hall technique for treating carious primary molars?

<p>Apply topical fluoride varnish to the affected tooth (B)</p> Signup and view all the answers

How many categories are used to evaluate caries in the ICDAS?

<p>6 categories (C)</p> Signup and view all the answers

Which of these advantages is TRUE for stainless steel crowns (SSC) for primary teeth?

<p>Less prone to fractures (A), No secondary caries (B), Minimal maintenance (C), Long term durability (D)</p> Signup and view all the answers

What is a common disadvantage of using stainless steel crowns (SSC) for primary teeth?

<p>Poor esthetics (A)</p> Signup and view all the answers

Which of the following situations is NOT a contraindication for placing a stainless steel crown (SSC) on a primary molar?

<p>Teeth with a large, deep cavity that can be restored with other materials (D)</p> Signup and view all the answers

According to the provided information, which restorative material has the highest annual failure rate?

<p>Amalgam (D)</p> Signup and view all the answers

What is an advantage of the Hall Crown technique compared to traditional stainless steel crowns (SSC)?

<p>Hall crowns require less tooth preparation (A)</p> Signup and view all the answers

Which of the statements is TRUE about the Hall Crown technique, based on the provided information?

<p>It is a common procedure in the UK, where SSCs are less popular (A)</p> Signup and view all the answers

What is a potential disadvantage of using the Hall Crown technique?

<p>Discomfort during the placement process (D)</p> Signup and view all the answers

What does the provided information suggest about the success rate of the Hall Crown technique?

<p>It has a high success rate, with most crowned teeth remaining asymptomatic after several years (D)</p> Signup and view all the answers

Flashcards

Resin infiltration

A non-invasive procedure for managing early enamel and dentin lesions without drilling.

ICDAS II R1

The stage of tooth decay where the enamel is affected, but the cavity is not yet visible to the naked eye.

ICDAS II R3

The stage of tooth decay where the outer 1/3 of the dentin is affected, but the cavity is not yet visible to the naked eye.

ICDAS II R6

The stage of tooth decay where the cavity is visible to the naked eye and can be seen clinically.

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Tooth separation

A technique where teeth are separated slightly to better access and treat interproximal lesions.

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What is SMART?

A treatment for caries using silver diamine fluoride (SDF) and placing a glass ionomer (GIC) restoration.

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Is 38% SDF recommended in Pediatric Dentistry?

38% SDF is recommended for caries prevention in pediatric dentistry.

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What are the clinical effects of SDF?

Caries arrest, prevention of demineralization, and management of hypersensitivity.

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What is the Hall Technique?

A technique for restoring primary molars with a prefabricated stainless steel crown.

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What does ICDAS stand for?

ICDAS stands for International Caries Detection and Assessment System.

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How many categories is caries evaluated in ICDAS?

6 categories.

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What are the characteristics of an ICDAS 1 carious lesion?

The first visual change in enamel, seen only after prolonged air drying.

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What are the characteristics of an ICDAS 3 carious lesion?

Localized enamel breakdown without clinical signs of dentin involvement.

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Rubber Dam

A thin, flexible sheet of rubber used to isolate teeth during dental procedures.

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Rubber Dam Clamp

An instrument used to hold the rubber dam sheet in place around the tooth.

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Rubber Dam Frame

A rubber dam frame helps to create a tight seal around the teeth. It makes the procedure easier for the dentist by keeping the area dry and clean.

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Forceps

A tool used to hold and manipulate small objects, such as tissue samples or rubber dam clamps.

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Clamps

A tool used to hold or secure objects, often used to hold tissues or rubber dam clamps during procedures.

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Ivory Clamps 00, 0, 1A, 3A

Primary incisors and canines (primary teeth), also known as baby teeth, are commonly placed using these clamps.

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Ivory Clamps 14A, 14, 8A, 2A and SS White 27, 208, 26 and B2

Primary molars (baby teeth) and first permanent molars are commonly placed using these clamps.

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Morphological Differences: Primary vs. Permanent Teeth

The shape and size of primary teeth differ from permanent teeth, influencing the way cavities are prepared.

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When are full coverage crowns indicated for primary anterior teeth?

Full coverage crowns are indicated when restoring anterior primary teeth with multiple carious surfaces, incisal edge involvement, extensive cervical decalcification, pulp therapy, or hypoplastic enamel.

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What are the disadvantages of strip crowns for primary teeth?

Strip crowns are thin, prefabricated crowns that might be used for anterior primary teeth. However, they have disadvantages, such as compromised durability, technique sensitivity, and potential loss of the crown.

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What are the advantages of strip crowns for primary teeth?

Strip crowns can provide good esthetics, with multiple shade options. They can be fitted in crowded spaces and are easy to repair. This leads to high parental satisfaction.

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What materials are used for restoring Class III cavities in primary teeth?

Composite resin, resin-modified glass ionomer (RMGI), and conventional glass ionomer (GIC) are recommended materials for restoring Class III cavities in anterior primary teeth.

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What materials are used for restoring Class V cavities in primary teeth?

Composite, conventional GIC, and RMGI are recommended materials for restoring Class V cavities in anterior primary teeth.

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What are the indications for stainless steel crowns (SSCs)?

Stainless steel crowns (SSCs) are used in pediatric dentistry for both primary and permanent teeth. They are suitable for multisurface cavities, hypoplastic teeth, endodontically treated teeth, and as interim restorations in cases where a bonded restoration is not possible.

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When prepping # 84 distally on a 9 year old patient, the isthmus distance is over ½ the intercuspal distance. Should you place a SSC?

A stainless steel crown might not be the best choice if the distance between the cusps of the tooth is less than half the distance between the cusps of the opposing tooth. You might consider alternative restorative treatments.

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What makes SSCs a good option for restoring teeth?

SSCs act as a strong, durable, and protective restoration for both primary and permanent teeth.

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What are the benefits of Stainless Steel Crowns (SSC)?

Stainless steel crowns (SSC) are a common choice for restoring primary teeth, offering multiple advantages compared to other materials. They provide a long-lasting, durable solution that effectively protects the tooth from further damage.

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Why are Stainless Steel Crowns (SSC) less prone to fractures?

SSCs are known for their resistance to fractures, making them reliable for protecting weakened primary teeth. This durability ensures they effectively serve their purpose until the natural tooth is ready to exfoliate.

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How does dual retention benefit Stainless Steel Crowns (SSC)?

SSCs offer two important retention mechanisms: chemical bonding to the tooth structure and a precise fit that physically holds the crown in place. This dual retention system strengthens the restoration and minimizes the risk of dislodgement.

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Why are Stainless Steel Crowns (SSC) less moisture sensitive?

Unlike some other restorative materials, SSCs are less susceptible to damage caused by moisture. This makes them a reliable option even in the presence of saliva, ensuring long-term stability and effectiveness.

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What is the key benefit of the Hall Crown technique?

The Hall Crown technique is a simplified approach to crown placement that avoids the need for extensive tooth preparation, caries removal, and anesthesia. It offers a less invasive and potentially more comfortable procedure for young patients.

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What challenges are associated with the Hall Crown technique?

While the Hall Crown technique offers advantages in terms of reduced preparation and anesthesia, it can lead to discomfort during certain stages. The placement of band separators and the biting down process can cause temporary discomfort, which is generally manageable but should be considered.

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What are the trade-offs when considering Stainless Steel Crowns (SSC) for a child?

The decision to use SSCs for a child often involves weighing their potential advantages and disadvantages. While SSCs provide excellent protection and durability, they may not be the most aesthetically pleasing option. This trade-off should be discussed with parents and guardians to make the most appropriate choice for the child.

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Pulp position in Primary vs Permanent Teeth

The pulp in primary teeth is closer to the outer surface compared to permanent teeth.

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Pulp Shape in Primary vs Permanent Teeth

In primary teeth, the pulp is typically shaped like a ribbon, while in permanent teeth, it's less ribbon-like.

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Accessory Canals in Primary vs Permanent Teeth

Primary teeth have a greater abundance of accessory canals that can lead directly into the interradicular furcation area. This makes them more vulnerable to infections.

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Pulp Repair Potential in Primary vs Permanent Teeth

The pulp in primary teeth has a higher capacity for repair compared to permanent teeth.

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Apical Foramen Size in Primary vs Permanent Teeth

The apical foramen in primary teeth is relatively larger compared to permanent teeth. This contributes to a greater inflammatory response in primary teeth.

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Nerve Fiber Termination in Primary vs Permanent Teeth

In primary teeth, nerve fibers end in the odontoblastic area, while in permanent teeth, they may extend beyond this area into predentin. This explains why pain in primary teeth is more localized.

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Indications for Indirect Pulp Capping

The presence of deep caries in a primary tooth that is restorable with no signs of pulp pathology or periapical inflammation.

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Indications for Direct Pulp Capping

The pulp is visibly exposed, minimal bleeding, and the tooth is restorable. The pulpitis is reversible.

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Indications for Pulpotomy

A tooth with deep caries, pulp exposure greater than 1 mm, reversible pulpitis, and no signs of periapical or intra radicular pathology.

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Indications for Pulpectomy

This procedure is indicated when the pulp is exposed, there's no hemostasis from the amputated pulp stumps, and pulp vitality is compromised.

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Indications for Pulpectomy in Primary Teeth

Root resorption less than 1/3 of the root, a restorable tooth, and a cooperative patient.

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Pulpectomy in Second Primary Molars

The primary molar's neighbor (the permanent molar) hasn't erupted yet, thus preserving space and function.

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Pulpectomy in Anterior Primary Teeth

Pulpectomy in anterior primary teeth is chosen based on aesthetic considerations.

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LSTR (Limited Service Time Restoration)

A treatment option for primary teeth with a necrotic pulp or a pulp with irreversible pulpitis, when root resorption is beyond 1/3 and the remaining time in the mouth is less than 12 months.

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Removal of Pulpal Tissue in Pulpectomy

The removal of pulpal tissue from the canal using rimers.

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Study Notes

Pediatric Dentistry Review Pedo II F 2023

  • Presented by Katerina Kavvadia DDS, MS, PhD, Diplomate ABPD and Konstantina Taoufik DDS, MS, PhD, of the European University Cyprus School of Dentistry.

Morphologic & Histologic Differences in Primary vs. Permanent Teeth

  • Primary teeth are smaller in all dimensions and have thinner enamel compared to permanent teeth.
  • Pulp exposure risk is higher, especially in the mesial pulp horn.
  • Interproximal boxes are extended into proximal self-cleansing areas of interproximal surfaces rather than contact points. This helps to avoid recurrent caries.
  • Primary teeth have longer and thinner roots, diverging outward to make space for the permanent tooth germ.
  • Root resorption and exfoliation are physiologic processes.
  • Pulp in primary teeth is closer to the outer surface. Mesial is closer than distal. Pulp is porous: accessory canals lead directly into interradicular furcation. Pathology often affects the interradicular area, unlike the less affected permanent teeth.

Pulp Differences

  • Apical foramen is enlarged in primary teeth, but restricted in permanent teeth.
  • Inflammatory response is higher in primary teeth, Lower in permanent teeth
  • Nerve fibers terminate in primary teeth at the odontoblastic area, while they extend beyond pre-dentin in permanent teeth.
  • Localized orofacial infection is less localized in primary teeth.
  • Pulp horns are nearer to the occlusal surface in primary teeth.
  • Repair potential of pulp is high in primary teeth but less in permanent teeth.

Tooth Isolation in Pediatric Dentistry

  • Essential tools & materials for placing rubber dam include: elastic sheet, punch, forceps, clamps, dental floss, rubber dam frame, and excavator.
  • Advantages for patients include: protection from swallowing foreign objects, protection of soft tissues, assistance in keeping mouth open and creating a more comfortable experience.
  • Advantages for dentists include: moisture control, preventing saliva & blood contamination, creating an aseptic environment, better accessibility & visibility, higher quality adhesive restorations, and less fogging of the mirror.
  • Contraindications for rubber dam use include: upper respiratory tract infection, congestion, epilepsy, mouth breathing and latex allergy (only regarding latex sheet).

Clamps in Pediatric Dentistry

  • Specific clamps are used for anterior and posterior primary teeth.
  • Specific clamp types are listed, alongside the teeth they're used for.

Rubber Dam Placement Methods

  • Common methods include clamp + elastic sheet + rubber dam frame.

Restorative Materials in Pediatric Dentistry

  • Materials advised for primary teeth: Composite and RMGI.
  • Materials advised for Class III cavities: Composite and RMGI.
  • Materials advised for Class V cavities: Composite, conventional GIC and RMGI.
  • Success rates of CL I and CL II primary molar fillings when placed under rubber dam, over 4 years in service: 93.6%.

Bisphenol A (BPA)

  • Trace amounts of BPA derivatives are released from dental resins and are detectable up to 3 hours in saliva.
  • Some BPA derivatives may pose health risks due to their estrogenic properties.
  • BPA exposure reduction can be achieved by cleaning filled surfaces with pumice and cotton roll and rinsing with water.
  • Using a rubber dam can reduce potential exposure to BPA.

Retrieval Practice Questions & Answers

  • Various retrieval practice questions and answers related to pediatric dentistry topics from restorative materials to rubber dam, and dental issues like cavities.

Tooth Isolation Methods

  • Methods include: Rubber Dam, Dry Angle, Cotton Roll holder and Isolite.

ICDAS II

  • The ICDAS II caries diagnostic criteria system is used for diagnosing and evaluating various types of caries.
  • Six categories are used to evaluate dental caries.
  • A numerical value for caries diagnosis is determined at different levels of cavity and dentin depth.

Pit and Fissure Management

  • Management of healthy pits & fissures: Monitoring and topical fluoride.
  • Management of moderate caries: Therapeutic sealant or PRR.
  • Management of advanced caries: Selective caries removal (vital teeth) and restoration.
  • Recommended Materials for sealing: Glass ionomer, Resin composite

Surgical Methods

  • Vital pulp management: Includes indirect pulp capping, direct pulp capping, pulpotomy, pulpectomy and LSTR.
  • Non-vital pulp management: Includes extraction.
  • Indications for pulpectomy: Irreversible inflamed or non-vital pulp, restorable tooth, root resorption <1/3 of root and cooperative patient (2nd primary molars in particular, and anteriors for aesthetics).

Splinting

  • Splinting is required for certain types of trauma in permanent teeth, including extrusion, lateral luxation, intrusion, root fracture, alveolar fracture.
  • Splinting is indicated for 4 weeks in injuries like lateral luxation and alveolar fracture.

Pulp/Dental Trauma Treatment

  • Indicators for enamel-dentin-pulp fracture treatments: Direct pulp capping (DPC) and Cvek pulpotomy

Other Notes

  • Methods of performing RCT procedures and restorative materials recommended for different types of damage and their effectiveness/success rates.
  • Challenges in pulpectomy: Avoid damaging furcation or tooth bud through apex, non-cooperative patients, and medically compromising patients.
  • The LSTR (laser) alternative treatment involves disinfection, for managing irreversible pulpitis (root resorption >1/3) with remaining serving time in the oral cavity up to 12 months.

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