Çıkmış Soruları - Indications and Contraindications for Dentistry PDF

indications SSC contraindinations Tell snow dot Indications contraindications of fissure sealants GIC SSC S fluoride gel application steps Protective resin Pulpotomy criteria indications Frankel be...

indications SSC contraindinations Tell snow dot Indications contraindications of fissure sealants GIC SSC S fluoride gel application steps Protective resin Pulpotomy criteria indications Frankel behavior table Flexural strength compomerd Pulpotomy application steps of Formocresol Types of GIC usage of GIC Extraction indications S basic behavior techniques t of ft get ppm FL releasing materials 3 criteria to consider inradio before vitalpulp treatment Pulpotomy materials cavity diff in Perm7 Primary Extraction indications if ideal restoration can't be provided in tooth w substance loss Extraction space maintaine if 1 tooth's roots are completely resorted attached to mucosa w very little contact if Permanent took germ underneath has completed formation i tooth's roots have not bee resorbed In Int or Ext resorption After a failed endo treatment If there's Extensive Bone destruction If there's a granuloma or follicular cyst If the crown of 1 tooth is severelydestroyed caries have progressed to bifurcation area extending more than coronal of bifurcation area Ankylosed i teeth Primary teeth that are causing Cervical Adenopathy Contra indications of Extraction If malignency is suspected if its extracted Tumorgrowth expansion 99 w tooth extraction trauma if radiotherapy will be applied to jaw w suspected malignancy then teeth that will cause infection are indicated for extraction Precautions taken w Patients that have blood disorder like Hemophilia Consult Hematologist before extraction cuz coagulation time Prone to hemorrhage ble Prophylaxis done to Patients w Acute systemic infections Diseases that need to be controlled before extraction Acute oral diseases Acute Necrotizing Ulcerative Gingivitis Acute Herpetic Stomatitis Acute DentoAlveolar Abscess what happens if we irritate Permanent tooth germ under Extracted i tooth Displacement of Geum change in Eruption direction Ankylosis if spread of infection to developing follicle or physical irritation to Ameloblasts Hypoplasia of Perment tooth choose appropriate size of forceps for tooth to be removed  General principles of tooth extraction in children Preoperative assessment Thorough medical history and informed consent for the procedure. Evaluate the tooth to be extracted both clinically and radiographically. Identify potentially difficult root anatomy and the proximity of other important structures prior to extraction. Be aware of implications for the permanent successor. Clearly identify the tooth to be extracted and confirm again prior to extraction. explain the feeling Profound local anaesthesia is vital. Explain the feeling of ‘numbness’ and the sensation associated with luxation of the tooth prior to commencing the procedure. should you consider Sedatige area when If the child will be unable to cope with the extraction(s) then sedation or general anaesthesia should be considered. Ideally, the decision to sedate a child should be made at the assessment appointment NOT once the child has become upset during the procedure.  If small apical root fragments remain after an extraction, they may be left to resorb, as attempted removal may damage the permanent successor !!!  if Nickelallergy stainless steel crowns i crown Fatf Previously shaped Nickel chromium crowns easily adapted on teeth for posterior primaryteeth w 99substance loss when i teeth can't be restored w amalgam or other resto materials Preparred in 6 sizes for both Perm 1 teeth Longest lasting resto type cue completed Ssc resto must last lifetime of tooth Indications Teeth w Large 2 or sided cariouslesions can't be restored w other restomater Grosslybroken downteeth Bruxism when functional cusps are lost To restore i molars after pulp treatments whichwould weaken tooth SSCpreserves it when carious lesion extends to approximal surface C A is lost checked w Probe testwhere it easily passes from Buccal Lingual surface Dentition of children w High caries risk Protecting tooth from decay esp w Activecaries Applied to kids w mental retardation under general anesthesia Applied to a persistent to toothbelow occlusion to restore occlusion prevent extensionof antagonist Applied to it Permteeth w severe dental defects like Hypoplasia or Amelogenesisimperfect steps tooth prep shape SSC InteSsc Toothprep minimal one if indicated 97 substance loss already occlusal surface reduced by 1 1.15mm wflame 67 Anatomical lines of tubercles preserved as much aspossible Prepped by inclining towards 113 of Buccal Lingual surfaces Interproximalreduction Tapered finediamond bur held slightly conv to longaxisof too Done so thatprobe can easilypass thru CA w o a finish line cut in cervicalarea checked w probe Most ideal crown is selected based on MD dimension of tooth Shaping SSC SSC is shaped w forceps acc to anatomy of tooth Retention is gain by alignment of Sss to cervical area of tooth crown edges smoothened w stone rubber crown mustenter gingiva by 1mm must restore MD distance occlusal rs must preserve physiological diastemas Luting SSC w GIC or Polycarboxylate cement if tooth is restored w GIC before Ssc placement then crown mustalso be bonded w GIC Vaseline is applied to collar area of crown to prevent GIC from being affected by moisture during setting period overflowing cement residues are cleaned 2C indications Decayed i molar pulpal path or 2Clinical Symptos Glass Ionomer cement a fluoro Alumino silicate glass powder dissolved in Polyacrylic acid liquid Needs polish es or lightcuring bonding agent as like light curved resinsegfgnef.mg ing Advantages Theraputi material due to fl content Anticaviogenic Serveas ft reservoirs long term Fl release Releases fl in steady levels Fl recharging ability from ext resources Directly binds to tooth Expansion coefficient is close to that of Dentin's Biocompatible Easy to apply frequently used despite moisture sensitivity Not soideal aesthetics contraindications of GIC in class 4 cavity prep in Restos require 99 placement in Labial surface in teeth w Large tubercle losses unreacted glassarticles compositeresins  Cavity principles in Primary teeth Morphologicalcharacteristics of 10 Primary teeth = Smaller + rounder than permanent teeth MD width of crowns = MORE than CO dimension ○ = short clinical crown length ○ = difficult to provide support + retention for applied restorationsˢt o Crowns are narrow in cervical area ○ This constriction = difficult to prepare step (Gingival base) in class 2 cavity Narrow occlusal surface ○ Buccal + lingual surfaces lean towardsistanolar each other towards occlusal ○ Esp. 1 Molars st Contact points = Large + flat surface ○ In permanent teeth = small points Dentin is thinner in primary ○ = Pulp chamber wider than permanent ○ Pulp horns closer to outer surface esp. Mesial horns = easily perforated Width of enamel layer = Narrower than permanent teeth’s ○ Also becomes gradually thinner towards cervix like Permanent teeth QClass 1 cavity principles for Amalgam restorations Cavity boundaries cover all Carious lesions + Retentive fissures Intact tooth tissue NOT removed Cavity depth = 1.5 mm from enamel→pulp ○ = 0.5 mm removed from dentin Labio-lingual width of cavity ○ ⅓ - ¼ of distance b/w tubercles Internal angles of cavity + curvatures = Slightly rounded ○ To ↓ Amalgam pressure In primary molars ○ If caries is limited to only pits + Enamel ridge separating pits is intact = 2 Small occlusal cavities prepared ○ In Maxillary Caries in distal fossa usually continue w/ Lingual developmental groove = require Occluso-palatal cavity Class 2 cavity principle for Amalgam restorations Occlusal cavity according to class 1 rules Buccal + Lingual margins of proximal box cavity = in Easily cleaned area Proximal surfaces should NOT touch adjacent tooth ○ Checked w/ Sond test Probe Width of isthmus ○ ⅓ of distance b/w tubercles Esg ○ Narrow isthmus = Fracture resistance to tooth + Preserves marginal integrity of restorating  Classification of GIC acc to Clinical uses: ○ Type 1: Luting cement = Space maintainer ○ Type 2: As restorative material Aesthetic-enhanced restorative cements ○ Type 3: Cavity + base materials Fast-setting base material + fissure sealant Classification of GIC acc to Hardening reactions: ○ Conventional GIC ○ Resin-modified GIC ○ Polyacid modified composite resins = Compomers Usage areas of GICs Q 1 ○ As Fissure sealant in occlusal pits ○ To close occlusal fissuresissuesw/ initial lesions unital lesions ○ In Permanent restorations of 1° teeth As fissure sealantwhen isolation is not possible in○Erosionlesions In Temporarywrestorations o cavity prep of permanent teeth As○ Permanent In erosion lesions w/o restoration of cavity Primaryprep teeth ○ In pediatric ation of patients Permanent teen I Ii ○ In patients p who can’t cooperate in○ I patients w/can't Patients who cooperate special health problems where traditional method is not possible in○ In caseswwhere Patients special health treatment must bewhere problems traditional treatment not possible postponed is In cases where treatment mustbebefore making permanent restorations in children w/ ↑↑ cavities ○ For caries control purposes postponed ○ Use GIC as a feature sealant when isolation is NOT possible Contradictions ○ Class IV (4) cavity restorations ○ Restorations involving large tubercle losses ○ Restorations w/ ↑↑Large placement in labial area Successful treatment ○ A suitable tooth surface must be created ○ Manipulation ac to setting time GIC is alternative to amalgam restorations Resin-modified GIC HEMA Bis GMA GIS on+ HEMA + BIS-GMA Polyanylie aid is modified w ↑ Resistance to breakage + wear ↑ working time ↓ early moisture sensitivities fluoride-releasing Condensable (high viscosity) GIC Fuji IX in ART techniques Fluoride-releasing Permanent restoration of 1° teeth Temporary restorations of permanent teeth EQUIA system  Fissure sealants + Protective resin restoration application methods Pits + fissures w/ High-risk caries formation can be prevented by bonding + covering them w/ organic material needs humidiftified safer Most accepted pit + fissure sealants → Resin-based sealants ○ ↑ effective in preventing caries when applied to occlusal surfaces of Permenent molars in children + adolescents GI sealants ○ Used on partially-erupted molars ○ In cases where technically-precise resin-based sealant application is difficult due to age/obstacle Fissure sealant indications Dental indications ○ 1° molars, Permanent molars + PM w/ deep + narrow pits and fissures ○ Incisors w/ lingual pits and fissures ○ Caries-free teeth clinically + radiographically ○ Post teeth w/ initial caries, discolored, or non-cavitated lesions = colored pits and fissures w/ opaque enamel lesion + little decalcification Patient indications ○ Medium + high caries risk ○ Poit and fissure caries or resto to omary + permenent teeth of children + adolscenrs ○ Applied yo pemenent teety of children + young sdults w/ medical, phycial, or psychological needs Ideal ages to apply fissure sealants: 3-4 to Primary molars 6-7 to permanent 1st molars 10-11 to Premolars 12-13 to permenet 2nd molars Fissure sealant unnecessary in: 4 years passed since eruption + no caries Self cleaning shallow pits and fissures Application steps of resin-based fissure sealants RBFS: UDMA or Bis-GMA ○ Monomers polymerized by either Chemical activator + initiator Light w/ specific nm + intensity ○ Come as: Unfilled, colorless or tinted transparent Filled, opaque, tooth-colored, or white materials Isolation + cleaning surface Etching, Washing, Drying SEEMS Applying sealant agent + polymerization Reevaluation Q Isolation + cleaning surface Pits + fissure must be adequately antscleaned w/ polishing brush and dried of excess moisture 4 iiiii iii Well-cleaned surface = Good retention Pits fissures adequately cleaned Dried of excessmoisture Acid etching Provides good retention = irregular surface created on enamel surface = Microporosities created 2 Etching washing ○ Allows Drying covering material to flow + form resin tags Acid etching w 35 371 orthophosphoric acid in margins grooves 2 mm away from margins 35-37% orthophosphoric acid in grooves + 2 mm away from 1520sec ○ Margins30sec in Primary of sealant etinent removed 15-20 sec acid etchingby washing — 30 sec for 30sec teeth in primary enamel○ is airdrieddue to prismless layer Extended Now looks appears white Itchalky due to ↓ functional activity in last stage of Amelogenesis Etching creates Then washed for 30 secmicroporosities irregular surface on enamel allows material to flow form resin tags w/ compressed air stream Air drying 3 Applying sealant ○ Nowagent looks FrostyPolymerization / Chalky-white on surface Fluorhydroxyapatite-rich applyed enamel covering allmaypits fissures make sureto etching be resistant no bubbles form = ↑ Time No overflow Palatal pits of uppermolars Buccal pits of Lower molars are covered Application of sealant agent Polymerization Fissure check forsealant voids distributed polymerization into grooves excess on surface to Occlusion is adjustedcover all pits + fissures ○ Makingmust centrin stop sure no beaironbubbles Enamel are Retention present + no overflow is checked by trying to remove cover w Probe Palatal pits of Upper molar + Buccal all pits of lower molars if weak adhesion repeat steps Then polymerization 4 Reevaluation sealed ○teeth Check for polymerization voids + excess must be checked periodically ○ Adjust occlusion using articulation paper 5 lot of sealants need to be repaired yearly ○ All centric stops must be on enamel organic material mineral content in Primary teeth retention of sealants ○ Retention checked by removing cover w/ probe ○ If weak/insufficient adhesion = repeat all steps Sealed teeth must be checked periodically 5-10% of sealants need to be replaced/repaired yearly ↑ Organic material + ↓ Mineral content in prisms of primary tooth enamel = ↓ Retention of sealant These is the primary method to prevent caries’ development  Q Application techniques of fissure sealants Non-invasive ○ FS applied in teeth w/o any radiographic or clinical caries Invasive ○ FS applied in deep + narrow pits + fissures ○ On discolored enamel but Hard surface ○ Made by abrading + widening fissures w/ flame-tipped bur Enameloplasty Preventative ○ Alternative resto for young permanent teeth ○ Requires minimal tooth prep for caries removal + adjacent susceptible fissures ○ Small carious pits ○ Here, restorations NOT likely to be subjected to substantial stresses that otherwise are might wear resin Preventative  Pulp treatments in Primary teeth Vital pulp therapies Preserve vital pulp ○ IMP for tooth to remain in mouth cuz acts as a biosensor that detects tooth’s nutrition, defense, and patho stimuli Aim: ○ Eliminate pulp-irritating factors ○ Stimulate 3° Dentin formation ○ Both = ensure vital function of tooth in mouth In Primary teeth, pulp treatments are done to: Retain primary teeth in function until they fall out, or at least for the time they’re needed for occlusal development First step: Diagnosis + Treatment plan afraid need as with Clinical findings + symptoms Patho or Physio  periraditular changes tooth furcation a Frea Bonetissue must show complained Periopical Surrounding Proximity of lesion to Pulp condition of 1 roots Physio or patho resorption underlying toothgerm Presence size degreeof development Panorama Periopical or Bitewing radiographs False Indications for Vital pulp treatments Normal pulp ○ Asymptomatic + positive results to viability tests Reversible pulpitis ○ Pulp can heal Symptomatic + Asymptomatic Irreversible pulpitis 00 ○ Vital + inflamed pulp can NOT heal Necrotic pulp Factors affecting pulp treatment decision for primary teeth or not Patient + parents do theywanna keep tooth Q ○ Cooperation + desire + motivation level to maintain oral health and hygiene Patient’s caries activity, stage of tooth development, and comprehensive prognosis of treatment Remaining dentin thickness: Minimum distance of healthy dentin that separates Pulp + Carious lesion In carious dentin Best barrier against pathological + iatrogenic damage iBonding strength of Resto material → Dentin affects it restorativematerial ttetshebondingstrenghoftooth.ca Pulp treatments in primary teeth Vital pulp therapy ○ Pulp capping head twiodontim Indirect pulp capping _case noexposure healthy Direct pulp capping iatrogenic 0.5 1mm perforations.PE ygfgpenfffurded 69 ○ Pulpotomy devensible Pull Partial removal of pulp amputation of corona perforation surrounded by Éh pulp RCT / Pulpectomy irreversible pulpitis or necrosis Pulp capping Applied to vital Primary + Permanent teeth w/ Hyperemia Primary teeth Permanent teeth w Hyperemia p Clinically Healthy ital Jen have deep dentin caries periodontal tissues Healthy periodontium = Healthy Periodontium osectives Objectives: Intact lamina dura ie i Intact periodontial tissues S ○ Stop decay’s progression mann ○ Maintain tooth vitality NO bone destruction ○ Promote pulpbacterial minimize micro leakage tissue healing + 3° Dentin formation avoidbacterial ○ Minimize postsurgical symptoms like Pain tenderness microleakage swelling Patient's symptoms that of Reversible pulpitis or Hyperemia ○ Avoid post-treatment symptoms: Tenderness, pain, or swelling sensitivity to thermal chemical stimuli Patient’s symptoms aing.ae iijI jdssat i'j ○ Pain due to thermal or Not chemical stimuli (Hot, cold, sweet, sour} s'evere short duration ○ Pain goes away w/ disappearance of stimulus Radiological findings Short-duration a NOT severe in E n'omit Gradually ↓ then goes away e ketones no boneloss Radiologically ○ Deep dentin caries very close to pulp but haven’t infiltrated yet ○ Healthy lamina dura + periodontal tissues ○ NO bone destruction in periapical tissues or furcation area Indirect pulp capping Covering of decalcified/demineralized affected dentin layer w/ biocompatible restorative material b/w + infected 91m vital pulp tissuedenies there High risk of pulp perforation is a very sma Tayer dentin is To prevent possible pulp perforation during caries removal of teeth w/ deep dentin caries w/o pulp patho left for it be deliberately to be removed later degeneration or periapical bag Objectives p This○layer contains Stop caries’ vey few caviogenic bacteria development decalcified ow we cover ○ this Biocompatible material This would reduce v affected To allow for remineralization acdentin ofmy carious eentinpadentin ayfja gw pi g nd ○ Allow reparative formation peffolatiot Done to prevent pulp Reminiralize in Deep demineralized dentinal affected caries dentin NO dentin by stimulating pulp degeneration sclerosis ordisease objectives High risk of easy pulp perforation deep dentinal caries’ removal mineral in if very small amount of curious lesion of carious dentin is removed in of deminivalized affected dentin by dentin sceteros This very small layerfor Allow Reparative can be deliberately left forformation Dentin a while to be removed later nd ○ Basic principle of indirect pulp capping ○ Thisresult to contains deepest layer very fewtests pulp vitality cariogenic bacteria Corona material ○ After caries loss removal,atsmall restorable level soft or hard colored dentin can be left in deepest part to not NO pulp exposure threaten pulp ○ Covering this w/ biocompatible materials ↑↑ reduce bacteria = ↑ Pulp healing ii iii ii Indications ○ Positive result Radiographically Normal to vitality tests periradicular tissues ○ NO spontaneous pain ○ NO pain on percussion + palpation ○ NO advanced periodontal disease ○ Coronal material loss at restorable level ○ Normal radiographs intra + periradicular tissues  Contraindications calcification ○ Spontaneous + long-term pain Pulp ○ Sensitivity on percussion periodontium ○ Pathological mobility Diseased ○ Swelling/fistula Pain Z ○ Thickened periodontal membrane 1051 ○ Periapical or periradicular bone loss Bone ○ Int or Ext resorption resorption ○ Pulp calcifications Materials for indirect pulp capping ○ ZOE, GIC, RSGI, MTA, Calcium hydroxide, Dentin bonding agents Calcium hydroxide: ↑Solubility + ↓Compressive strength + ↓ Covering = Necessary to covered w are cover toGIC it w/ prevent micro leakage exDycal to create a layer preventing microleakage Dentinbonding agents Direct pulp capping Applied to pulp thats mechanically opened after removing carious dentin or perforated due to iatrogenic reasons Area where pulp is opened by be surrounded by solid clean, healthy dentin Should NOT be larger than 0.5-1 mm Color of bleeding: light red ○ Stopped in 3-5 min ○ Shouldn't be too intense Indications ○ Very limited in primary teeth Normal pulp after mechanical or traumatic opening Limited r space fpr pulp capping material due to size of µ primary teeth Liner or base applied, then resto Factors affecting success ○ Correct diagnosis ○ Isolation + sterile work or bacterial/saliva contamination = Failure ○ Size + location of pulp perforation (must be less than 1 mm) If in a well-blooded area like pulp horns = ↑ Healing potential a ○ Formation of a thick clot layer at point of perforation Clot prevents direct contact of capping material + pulp Antibacterial + tissue healing effect is prevented Destruction products formed by necrosis elements of clot = food source for bacteria = Inflammation + infection ○ Restoration SSC Best: Stainless steel crowns resin material To prevent 2° pulp damage w/ microleakage Resin, amalgam, and GIC also used Ghgam ○ Age of tooth ↑ age = ↑ Fibrosis + ↓ Blood supply = Inability to provide effective response against bacteria = ↓ healing O Stage of start of physiological resorption = Old age of primary tooth O  perforated.int o ↓ Blood supply due to ↑ opening of apical foramen Caries ↑ aging of teeth = ↓ Healing chance 0911ft AAPC does NOT recommend direct pulp capping for caries-exposed primary teeth Rarely used in primary teeth Pulpotomy Otomy = to cut Partial pulp amputation Removal of pulp tissue from pulp chamber + applying long-term clinically successful medicament 3 Used in pulp perforation surrounded by carious dentin ○ Occurs during removal of caries in deep dentinal caries in primary teeth I dutocav.es Aim: IMmMfMMhEKIIEIITIe ○ In cases of vital pulp perforations due to caries ○ To protect Root pulp Which is healthy + not infected To heal canal mouths by excising coronal pulp which has an initial inflammatory reaction = Reversible pulpitis = Hyperemia ○ Amputate coronal pulp + preserve vitality of radicular pulp facilitating normal exfoliation of primary tooth Q Indications ○ In mechanical perforations larger than needle head ○ In perforations smaller than needle head but carious lesion surrounds perforation ○ Vital teeth in mechanical perforations that develop at several points Clinical examination ○ Deep → Very deep dentinal caries w/ no open pulp 9 ○ Deep dentin caries very close to pulp or radiologically in contact w/ pulp ○ Reversible pulpitis’ symptoms ○ Operative, bleeding in vital pulp, and canal mouths must meet physiological criteria  Fisture Clinically IMP points Local anesthesia + Rubber dam Ceiling of pulp chamber must be completely lifted ○ Amputated up too entrance of canal w/ Sharp disc-shaped excavator or steel round bur large enough to extend into mouth of each canal Q Amputation materials + methods Pulpotomy materials Fixatives Necrosis ○ Formocresol bindsto Proteins ftp.reso ○ Glutaraldehyde glutavaldehyde Protective ± Regenerative application methods ○ Electrosurgery methods regenerative ○ Laser surgery I Materials ○ Calcium hydroxide Idea a pennan materials ○ Ferric sulfate ○ MTA sulfate ○ Sodium Hypochlorite ○ Formocresol Sodiumhypochlorite formocreid Q Formocresol pulpotomy Formocresol: potent germicide drug that binds protein in vital pulp + causes necrosis + fixation where its applied ○ Causes only a small part of tissue to remain vital; rest is fixed ○ = Semimortal/ Nonvital technique Direct contact w/ ST–tongue, cheeks, and lips–must be avoided cuz its a caustic substance mom ○ In form of: glove contamination–ST, handling of pellet, leakage from pellet Close bottle cuz volatile = evaporates Full-strength Buckley’s FC = 19% formaldehyde, 35%cresol in 15% glycerin + water After application mechanism ○ Coagulation necrosis occurs as pulp ↑Acidophilic + Fibrous within few min in areas adjacent to amputation surface Fixation progresses slowly thru tissue (60 days → 1 year) More distant areas are vital due to limited progression r sued ○ Ensures biological balance until tooth physiologically falls  Advantages ○ Formaldehyde gas released by formocresol penetrates organic pulp tissues in channels, dentin channels, and narrow side channels = fixes hard-to-reach bacteria ○ bactericidal Disadvantages Formaldehyde concentration Delays root resorption Riskof Ankylosis 19 diffusion ability might overflow from apex irritate periapical tissues root res irritation infl near germ Hypoplasia in Perment tooth causes calcification internal resorption in pulp Antibacterial effect overtime There are doubts that its toxic ○ This toxicity does NOT cause a single systemic case in literature ○ Acc. to WHO, amount of formaldehyde used is less than the amount naturally present in many foods (Milk, pears) No dentinal bridging, but Calcific changes occur Histologic zones in FC treated radicular pulp Acidophilic zone: Fixation = Coronal Pale-staining zone: Atrophy = Middle Broad zone of inflammatory cells = Apical  Pulpectomy = RCT Complete removal of all pulpal tissue For primary teeth w/ intact roots ○ If evidence of root resorption = Extraction ○ If severe infections ex. Acute facial cellulitis assoc. w/ primary teeth = Extraction Morpho diff of Primary roots from Permanent roots ○ Muti-rooted Primary teeth have ↑ Complex roots ○ They have Fins, Ramifications, and Inter-canal connections ○ = These factors inhibit chemo-mechanical debridement of RC ○ Anatomical apex may be up to 3 mm from radiographic apex Frequently on lateral surface of root = Difficult to determine true WL Electronic measurements used to help locate anatomical apex Over-instrumentation = Potential damage to underlying permanent tooth Obturation must NOT interfere w/ normal exfoliation of permanent successor ○ = Resorbable paste root filling ZOE, CaOH, Iodoform paste ○ Exception: where there's no permanent successor present = RCT to keep it in mouth = use Gutta percha + Pat or Calcium silicate cements (MTA, Biodentine, Bioaggregate) a b c Indications for Pulpectomy Q Irreversible pulpitis: Acute or Chronic Necrotic pulp: Partial or Total Carious exposure of Vital incisor (primary) Dark bleeding that doesn't stop after 5 min after coronal pulp removal Preoperative radiograph = Intact non-resorbed root ○ Or bone loss b/w roots does NOT exceed coronal ⅓ ○ Cuz Retention is needed If very little mobility Restorable tooth  Pulpectomy Indication Criteria: Clinical, Radiographic, and Operative Clinical indication criteria Persisting, Spontaneous, or Pulsating pain Presence of abscess or fistula Sensitivity in vertical percussion Radiographic indication criteria Deep dentin caries Widening of PDL space + Loss of lamina dura Lesion is limited to ⅓ coronal of interroot region When bone loss b/w roots does NOT exceed ⅓ — Retention is needed Operative indication criteria Bleeding outside physiological limits at Canal mouths QContradictions Presence of bone lesion exceeding coronal ⅓ of bifurcation Advance bone loss in tissues Uncontrolled bleeding even after removing Root pulp Int or Ext resorption Advanced physiological resorption Cystic or tumoral lesions Pulp chamber floor perforation Primary teeth differences in RCT Physiological root resorption + enlarged apical opening w/ time Tissues = Small in volume + Short crown length Presence of permanent teeth germs Narrow + curved RC Complex morphology, anatomical variations, lateral branching ○ Presence of Paramolar canals in furcation area = Pulp-periodontal canals Q  Behavior management Why are kids afraid? They're afraid of a new foreign environment w/ new people It's a new experience that might cause them pain What's our purpose in behavior management Reduce the child’s fear Provide quality dental service Emphasize good oral health Provide lasting behavioral change Receive positive feedback How do we do that? Coordinated team Child-friendly enviro Behavior management techniques + Experience Proper treatment plan General anesthesia or Conscious sedation Explain the concept of Pediatric behavior management in dentistry? It's about developing communication + cooperation w/ the child and parent to develop a more positive attitude and good oral health Guide the child’s behavior and receive positive responses The pediatric treatment triangle: Child -– Dentist — Family (all create society) Communication w/ child ○ From first moment, check gait and movement ○ Actively listening by Asking questions ○ Yes or No questions Q Verbal explanation tactile auditoryaspects visual ○ Descriptive assertiveness techniques demonstrate thru i aiiiiiiiiiiii Basic behavior guidance techniques: a maintain.in ○ Tell-show-do (most used) Q ○ Ask-tell-ask ○ Positive reinforcement by explaining and praising their bravery ○ Modeling = let them reenact the role of a doctor e ○ Showing positive images before appointment A infested a ○ Voice control = by using a diff tone, to ensure attention is drawn back to itself and the right physician-patient rs restored ○ Distracting = don't let them see blood gauzes Advanced behavior guidance techniques ○ Protective stabilization ○ Sedation ○ General anesthesia  of ppm affijide Primaryteeth extraction indications morpho resto diff of Primary remanent GIC usage restorative materials that release fluoride GIC RMGC Highviscosity GK Giomer Componer Nanoproperty GIC Pulpotomy materials glass larbomers composite resins stainless steel indications containing fluoride radio before IT in 1 teeth ask about Saf 8 about radio before Vit ask ask if we should just stateful info how many must we list liken II pictorial