Lecture 7 advanced treatment approaches pdf.pdf

Course 7: Advanced treatment approaches in pediatric dentistry Advanced treatment in pediatric patient 13.11.2023 Advanced treatment in pediatric patient 13.11.2023 Restorative treatment in pediatric patient 10.10.2022 A thin unsupported carious enamel that could be easily removed by ha...

Course 7: Advanced treatment approaches in pediatric dentistry Advanced treatment in pediatric patient 13.11.2023 Advanced treatment in pediatric patient 13.11.2023 Restorative treatment in pediatric patient 10.10.2022 A thin unsupported carious enamel that could be easily removed by hand instruments is observed at the mesial of the 51 (Fig. 15.7b). By breaking the enamel, both cavities could be cleaned up to firm dentin, while all carious tissue was removed from the enamel-dentin junction (Fig. 15.7c). The cavities were filled in with chemically activated high-viscosity glass ionomer (Fuji IX®, GC America), and the restorations’ final Considering the inactivity of the carious lesions and that aesthetics was the concern, composite resin was considered the most suitable restorative material for this specific case. Local anaesthesia was required before placing the rubber dam. Carious tissue was removed using a low-speed bur. All teeth were cleaned up to firm dentin. Pulp exposure was not observed. Restorative Materials in Pediatric Dentistry There was no evidence of superiority among restorative treatments using Compomer, Resin Modified Glass Ionomer Cements, Amalgam and Resin Composite. In clinical decision-making, choosing one of these materials will depend on the professional ability, the individuality, and the patient’s wish. Factors such as aesthetic requirement, friendly technique, caries activity, type of substrate, and cavity to be restored also should be considered for selecting the restorative material Advanced treatment in pediatric patient 13.11.2023 An 11-year-old male patient. Dental examination revealed stained pits and fissures in the mandibular first permanent molars. Interproximal radiographs were taken and the presence of a dentin carious lesion under the “intact” occlusal fissure was observed in the left mandibular first permanent molar (36). As the patient presented negative (-) behavior towards dental treatment, the stamp technique was chosen as restorative option, aiming for quality and efficiency, using bulk-fill packable resin (Filtek™ Bulk Fill - 3M ESPE, Campinas, Brazil) Case: (Minimal Intervention in a Primary Molar with a Failed Restoration) defective restoration in a first primary molar. During restorative procedures, relative isolation of the operatory field was provided with cotton rolls to promote moisture control. Based on the philosophy of minimal intervention, no anesthesia was performed, and selective carious tissue removal was done by using low-speed stainless steel burs and hand excavators up to firm dentin. To restore the cavity, a simplified restorative system was placed, by using a self-etching adhesive (Scotchbond Universal; 3 M), associated with an easy one-step placement bulk fill composite (Filtek™ Bulk Fill; 3 M ESPE), which provides good handling and adaptation. This technique involves eliminating additional composite layers and multiple steps, providing less timeconsuming and patient-friendly restorations dentin hardness can be subjective, manipulation with dental instruments can help differentiate soft (infected), firm (affected), and hard (healthy) dentin. Soft dentin can be deformed by pressing an instrument into it, and it can easily be removed by gently scraping its surface with minimal force. Firm, leatherlike dentin does not deform when an instrument is placed into it, but it can be scraped off with medium pressure. Hard dentin requires a strong force to engage the dentin, and it cannot be removed without a sharp cutting edge or bur. A “scratchy” sound can be heard when dragging an explorer across hard dentin.