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20 Cards in this Set
- Front
- Back
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when deciding whether extraction or pulp therapy we must assess? |
- quality of tooth and presence/ absence of successor, can cause non conicident centre line shift when older - age of patient and behaviour - presence of infection -medical history |
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why restore primary teeth |
- toothacche -abscess -early loss causing ortho problems - damade to permanent successor |
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when would we do a vital pulpotomy- indications |
- when asymptomatic or transient pain - carious /mechanical exposure of vital pulp tissue - No mobility, no sinus/abscess/ no history of swellling - no interradicular area - bleeding pulp - stops with pressure |
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medicaments used and preferred one |
Formocresol, - bactercidal, devitalising, toxocoty, cancer links ferric sulphate, - astrigdenet retraction cord, pulpal haemostasis promotion MTA- release cytokines from fibroblast, new and expensive |
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other methods use d |
calcium hydroxide , electrosurgery, laser treatment , ledermix.
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pulpotomy technique |
Pre op , LA, isolation, Caries, Access, - clear all remaining caries bfore removing aries adjacent to pulp - remove rood of pulp chamber using fissure bur remove coronal pulp with sharp excavator - control haemorrage with cotton wool, if uncontrolabe then pulpectomy considered - apply ferric sulphate on cotton wool, remove excess and apply to pulp chamvber - dont wash pulp chamber, just restore with Zno /eugenol cement and pack well apply stainless steel crown - fllow up, review clinically and radiographically. |
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indications for pulpectomy |
pulpectomy - history of swelling sinius presncefurcation pathology mobility and spontanous pain not resolving uncontrollable pulpal haemorrhage- necrotic pulpm |
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pulpectomy technique |
L.a, isolaiton, access and identify canals - instrument size 20-50- spin Zno into canals and zno cement to restore pulp chamber - apply ssc |
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why ssc |
- often little tooth tissue remaining- what is left is brittle - reduced miroleakage. |
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principles of dental care philosophy |
- gain trust and co operation of child and patient - make an accurate diagnosis and treatment plan according to childs needs - comprehensive preventive care - deliver care in a manner that child finds acceptable - use treatment and restorative techniques which produce a long lasting resultt |
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state all the different methods of behaviour management |
Tell show do childranses - we are going to polish your teeth with the buxxy brush, here it is it goes round and tickles your finger, now im going to do this on your teeth Behaviour shaping - developing appropriate behaviour by reinforcing successive approximations to the desired behaviour until it is achieved, praise the desired behaviour and ignore, discourage the undesired behaviour - only proceed when desired behaviour is exhibited, praisal and approval conditional continuation of desired behaviour. Reinforcement - praise, physical contact, stickers toys tokens to collection or exchange, activities,. anything deemed by the recipient to be gratifying. Distraction - drawing attention to a totally different sensation or action to divert attention from a potentially stress inducing procedure, breath through nose, leg lifting , lip pulling during la modelling - observed behaviour in model will be adopted as the new ode of behaviour in the observer , older sibling best modelas are someone the observer can relate to, live vs video models desensitisation - to deal with needle phobia (fear, anxiety, phobia ) -reciprocal inhibiition therapy, cannot be relaxed and anxious at the same time 2 mutually imcompatibly respones o teach the patient to relac, relaxation exercises, pharmacology, hyponosis o expose the patient to a hierarchy of anxiety provoking stimuli |
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3 strategies for managing behaviour |
hug em , drug em , slug em |
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indicaitons for SSC |
extensive caries, pulp therapy, developmental defects, rampant caries, bruxism, abutment for a space maintainer fractured teeth |
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ssc technique |
remove caries and reduce crown height reduce cusps and grooves using diamond bur check occlusal reduct is complete for lower primary molar 1-1.5mm, check occlusal clearance prepare mesial and distal slices, beware of adjacent teeth check for ridges and smooth angles ensure gingival extension of proximal slices size of crown is chozen and trial the fit when crown fits properly a click is heard. trim crown if necessary and crimpling pliers if need to crimple edge for a close fit |
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SSc cementation |
fill crown, place on tooth, clear excess, contact points with knotted floss, and then check occlusion assess any concerns about loss of space and concerns of exfoliation |
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safety problems |
swallowed crown inhaled crown lost crown. |
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when to put ssc in permanent teeth |
when molar incisor hypomineralisation or other congential malformation |
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studies on longevity o f ssc's |
roberts and sherrif - 468 ssc's over 4 years 10 failed 2.8% and failure rate of class 2 amalgams was 15,3% dawson et al 1981- retrospective study of 64ssc's, 216 amalgam, mean longevity of amalgams longer einwag 1996- ssc had significantly longer life span and lower replacement rat than amalgams papathanasiou et al - survival rate ssc>amalgam>composite>gic. |
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indications for strip crowns |
extensive caries in primary incisors congentially malformed or discoloured primary incisors discoloured following trauma jerry fracture primary incisors amelogeneis imperfecta |
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how to place strip crown stages |
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