Pedo 9

Front 1

Pulp exposure caused by caries occur more frequent in primary than permanent teeth?!

Back 1

because primary teeth have relatively

1.large pulp chambers ,

2.more prominent pulp horns and

3.thinner enamel and dentin

Front 2

In primary molars with proximal cavities , pulp involvement Occurs in about .... of those with .....

Back 2

Occurs in about 85 % of those with broken marginal ridges .

Front 3

definition of pain

type of pain

Back 3

unpleasant sensation

1.somatic pain

2.psychogenic pain

3.neurogenic pain

Front 4

pain in sound tooth

Back 4

odontolgya

D.M

Hypertension

sickle cell anemia

leukemia

Front 5

Provoked pain :

Unprovoked :

and the best prognosis

Back 5

Provoked pain :

Is precipitated by stimulus ( thermal , chemical , mechanical ) and disappears after removal of stimulus ...... associated with eating , cold or hot food or drinking ..... ( good prognosis )

Unprovoked ( spontaneous pain ) :

Is throbbing constant pain that may keep the patient awake at night ...... advanced pulp damage ( poor prognosis )

Front 6

2- Clinical signs and symptoms

Back 6

A- Abnormal tooth mobility indicates severely diseased pulp or involvement of periodontal ligament

B - Sensitivity to percussion indicates apical or periodontal inflammation or both

C- Presence of swelling , sinus , draining fistula or chronic abscess indicates anon vital pulp

D - Size of exposure and amount of pulpal bleeding are the most valuable observation in diagnosing the condition of the primary pulp :

1.Small pin - point exposure

surrounded by sound dentine indicates favorable condition for vital pulp therapy 2.Large exposure with watery exudate or pus indicated unfavorable condition for vital pulp therapy

3.Small controllable amount of bleeding during and or following pulp amputation is a favorable condition for pulp therapy 4.Excessive uncontrollable bleeding during and or following pulp amputation is an unfavorable condition for pulp therapy

Front 7

favorable condition for pulp therapy

Back 7

1.Small controllable amount of bleeding

2.Small pin - point exposure surrounded by sound dentine

Front 8

unfavorable condition for pulp therapy

Back 8

1.Excessive uncontrollable bleeding

2.Large exposure with watery exudate or pus

Front 9

Radiographic interpretation in children is more difficult than adult .... why ???

Back 9

a ) Periapical changes as widening PDL

b ) Rarefaction in supporting bone

c ) Calcified masses within pulp chamber and root cannal

4 ) Periapical and interradicular radiolucenies of bone

Front 10

pedia restoration

Back 10

stainless steel crown

Front 11

pulpotomy

definition

pulpoctomy

campers

Back 11

remove coronal portion of pulp tissue

vital teeth

reversible pulpitis

remove narcotic pulp tissue non vital teethirreversible pulpitis

Front 12

pulpotomy

indication 5

contraindications 5

Back 12

1. Deep caries , with vital pulp exposure of primary teeth

2. No history of spontaneous pain

3. Where extraction is contraindication

4. Slight amount of bleeding at exposure site

5. Normal clinical and radiographic signs

1.Radicular pulp involvement

2.Abnormal mobility

3.History of unprovoked pain

4.Presence of fistula or swelling

5.necrotic / irreversible damage pulp 6.Uncontrolled pulp hemorrhage

7.Pathological resorption of pulp

Front 13

Pulpotomy

Objectives

Back 13

1.Preserve vitality of radicular pulp 2.Amputate infected coronal pulp 3.Treatment remaining pulp with medicament

4.Avoid dystrophic pulpal change Avoid breakdown of periradicular area .

Front 14

Partial pulpotomy for carious exposures

Partial pulpotomy for traumatic exposures ( Cvek pulpotomy ) .

Back 14

It is indicated in young permanent teeth with incomplete root formation but with healthy pulp tissue in root canal ( vital pulp ) . Partial pulpotomy for carious exposures .

It is also indicated for permanent tooth with pulp exposure resulting from crown fracture when the trauma has also produced a root fracture of the same tooth Partial pulpotomy for traumatic exposures ( Cvek pulpotomy ) .

Front 15

Formocresol pulpotomy : It is recommended for

Back 15

primary teeth with carious exposure

Front 16

chemical composition Formocresol pulpotomy :

Back 16

19 % formalin ,

35 % cresol in a vehicle of

15 % glycerin and distilled water .

Front 17

Formocresol

Back 17

week tissue fixative

antimicrobial action

low toxicity

strong tissue fixative

bactericidal effect

high toxicity

root resorption

Front 18

There are two methods for formocresol pulpotomy :

Back 18

The one step technique ( one visit technique )

The tow steps technique ( 2 visit technique , Devitalization )

Front 19

Pulp capping agents have developed along three main lines

Back 19

1- Devitalization

Formocresol 19,35,15

Electro surgery

Laser :

2- Preservation

Glutaraldhyde 2-5%

Ferric sulphate15.5%

3- Regeneration

ca hydroxide 12

MTA 12.5

Front 20

Formocresol another type

Back 20

Glutaraldhyde

Ferric sulphate

Front 21

Failures following vital pulp therapy :

Back 21

1- Internal resorption :

2 - Alveolar abscess :

Front 22

General contraindications for pulp treatment of primary teeth :

Back 22

1 - A patient from family having un favorable attitude towards dental health and conservation of the teeth

2- Tooth , with gross breakdown that restoration would be impossible following pulp treatment

3 - A tooth with caries penetrating the floor of pulp chamber

4 - A tooth close to natural exfoliation

5 - A patient with poor general heath

Front 23

histological change of place ca hydroxide

Back 23

★first day -» necrotic zone.

★after week -» fibroblasts.

★after 14 -» odontoblast.

★28 day -» reprative dentine or secondary dentine

Front 24

why we don't Place calcium hydroxide primary teeth??

Back 24

high vascularity

Front 25

used for cutting cavity preparation

Back 25

rounded end

high speed carbide burs

no 329,330,256 245

Front 26

Treatment is judged successful if there is:

Back 26

1- No sensitivity to percussion2- No history of pain following treatment 3- No radiographic evidence of periapical pathosis or root resorption4- No clinical evidence of pulp exposure if the tooth was re-entered

Front 27

Direct pulp capping is not encourage in primary teeth because

Back 27

pulp tissue ages early and less active undifferentiated mesenchyme cells

less active umscs

Front 28

partial pulpotomy It is indicated in primary molars as it is impractical to perform complete pulpectomy in such teeth

Back 28

1.difficulty to obtain adequate access to the root canals in the small mouth of children and due to the

2.complexity in morphology of root canals having lateral branching and apical ramifications where removal of all radicular pulp content is impossible.