MD PEDIATRIC Flashcards by Hisham Abughoush

what are stages of tooth development and time?

initation stage ( 6 weeks )

bud stage ( 8 weeks)

Cap stage (9 weeks)

Bell stage ( 11 weeks)

Maturation ( 14+ week)

eruption

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all primary teeth and permanent molars arise from what tissue ?

DENTINAL LAMINA !!

BUD STAGE

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what stage does enamel begin to develop? how long does it take to get to this stage?

CAP STAGE ( after bud stage): enamel organ that makes enamel

dentinal papilla: rest of tooth bud creates dentin and pulp
Dental follicle: surrounding sac surrounds dentinal papilla and enamil organ

9 weeks

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what is the dental follicle?

Sac of cells surrounds both the enamel organ and the dental papilla (creates dentin and pulp)

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what stage follows cap stage and what is being created?

Inner cell layer (IEE) : ameloblasts

Dental Papilla: odontoblasts (dentin making)

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what are the stages of BELL stage?

Histodifferntiation: IEE -> ameloblasts ; Dental papilla -> odontoblasts

Morphodifferntiation: shape and size of crown determined during this process

Apposition: odontoblasts: deposit dentin matrix (collagen) ; ameloblasts: deposit enamel matrix; Cervical Loop: IEE and OEE join (HERS and epi rests of Malassez)

IEE + OEE = REE ( functional epithelium)

Maturation : depsit enamel and dentin; calcification begins at cusp tips and goes down

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what is the longestr stage of tooth development?

maturation ( bell stage)

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how long does it take to complete maturation of primary tooth crown?

2 years

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how long does it take to complete permanent tooth crown ?

4-5 years

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SUMMARY OF ERUPTED TOOTH

Enamel organ: emloblasts -> enamel

Dental Papilla: odontoblasts -> dentin; central cells-> pulp

Dental Follicle: cementoblsts -> cementum; osteoblasts -> alveolar bone ; fibroblasts -> PDL

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calcification order :

central incisors

lateral incisors

canines

first molars

second molars

central Incisors : 14 weeks

First molar: 15 weeks

Lateral incisors: 16 weeks

Canines: 17

second molars: 18 weeks

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development order

calcification order :

central incisors

lateral incisors

canines

first molars

second molars

central inciros ( mandibular first) : 6-7

lateral incisors ( max first) : 7-8

first molars: 9-11

canine: 10-12

second molars : 10-12

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primary tooth development?

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permanent tooth development

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most common supernumery teeth?

mesiodens ( middle ebtween 8 and 9)

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most common missing teeth order?

3rd molars

mandibular 2nd PM

maxillary Laterals

Maxillary second PM

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most common congenitally missing primary tooth?

Maxillary Lateral Incisor

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which one affects cap stage/ bell stage?

microdontia

fusion

gemination

macrodontia

Bell: Micro and Macro

Cap: FUsion and Gemination

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patient walks in count was one less than normal. what do they have?

FUSION

always anterior

2 buds merge into 1 tooth

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patient comes in with normal count of teeth. what is this called? what happens during it?

gemination !

2 crown 1 root

tooth count normal

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patient has tooth with extra cusp. what is this ?

dens invaginatus

dens evaginatus

tauradontism

dilaceration

dens Evaginatus :

talon cusp, has pulp, dentin , enamel ( dont extract)

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patient walks in and radiographs shows a tooth growing inside anotherl . what does this patient have? what causes this ? what tooth mostly found in?

dens invaginatus

dens evaginatus

tauradontism

dilaceration

dens invaginatus ( dens in dente)

caused by invagination of IEE

permanent maxillary lateral

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what does this radiograph show an image of ?

taurodotism

elongated pulp chamber and short roots

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what does this show an image of and what causes it ?

DILACERATION traumatic injury to primary tooth

patient walks in with this radiograph. what do they have? amelogenesis imperfects dentinogenesis imperfects regional odontodysplashia enamel hypoplasia

dentinogenesis imperfects ( no pulp)

a patient walks in with blue scelera in her eye. this is a feature of what? ## Footnote amelogenesis imperfects dentinogenesis imperfects regional odontodysplashia enamel hypoplasia

dentinogenesis imperfecta

what does this patient have? ## Footnote amelogenesis imperfects dentinogenesis imperfects regional odontodysplashia enamel hypoplasia

amelogenesis imperfecta : alteration of enamel

what does this patient have? amelogenesis imperfects dentinogenesis imperfects regional odontodysplashia dentin dysplasia concreasence enamel hypoplasia

dentin dysplasia !! chevron pup;s, short roots, messed up dentin short roots: type 1 Chevron pulps: type 2

what does this patient have? ## Footnote amelogenesis imperfects dentinogenesis imperfects regional odontodysplashia dentin dysplasia concreasence enamel hypoplasia

REGIONAL ODONTODYSPLASIA ghost teeth

after extraction. adjacent teeth look as though fused together by cementum. what is this concreascance fusion gemination

concreascene

difference between gemination fusion concreascence

fusion: 2 buds / 1 tooth ( one less) gemination (one root 2 crown ( normal) concr: adjacent fuse togehter

patient walks in with this. what is this condition? amelogenesis imperfects dentinogenesis imperfects regional odontodysplashia dentin dysplasia concreasence enamel hypoplasia

ENAMEL HYPOPLASIA turners hypoplasia

patient walks in with this. what is this condition? amelogenesis imperfects dentinogenesis imperfects regional odontodysplashia dentin dysplasia concreasence enamel hypoplasia

enamel hypoplasia congenital syphilis ( hutchinsons incisors and mulberry molars)

difference between primary and secondary mandibular first enamel in terms of - enamel - pulp - rootsa

primary: thinner enamel bigger pulp more divergent roots

this tooth is widest anterior tooth M-\>D direction and only ant tooth where width is bigger than height

primary maxillary central inciros

this tooth is widest anterior tooth FL direction

primary maxillary canine

what has longer and sharper cusps - primary maxillary canine - permanent maxillary canine - primary mandibular canine

PRIMARY MAX CANINE

this tooth resemebles oermanent maxillary 1st premolar

primary max 1st molar

this tooth has most prominent MF cervical ridge of max primary teeth

primary maxillary 1st molar ( resembles perm max 1st PM)

wides FL of ALL primary teeth and what does it resemble?

PRIMARY MAX 2ND MOLAR resembles perm max 1st molar last primary tooth to erupt onlyp rimary tooth with cusp of carabelli, oblique ridge, and DL groove

this is the only primary tooth with cusp of carabelli, Oblique Rirdge , and DL groove

primary max 2nd molar

this primary tooth has smallest FL

primary mandivular central incisor

this tooth is the most symmetrical tooth !

Primary Mand Central Incis.

this is the most unique tooth in dentition. has ML ice cream cone cusp which is highest and sharpest, 4 cusps and 4 pulp horns, CEJdips more on mesial half resulting in S shape cervical

Primary mand 1st molar \*\*\*

which cusp is the largest and highest on primary 1st mandibular molar ?

MB : LARGEST ML: HIGHEST AND SHARPEST

this tooth has widest MD in whole dentition

prim. mand. 2nd molar

how many cusps and roots of primary mandibular 2nd molar

2 roots and 2 canals prim mand 1st: 4 cusps 3 pulp horns

this tooth crown resembles perm mand 1st molar

primary mand second molar

primary tooth amalgam depth and isthmus width

depth: 1.5 mm isthmus width: 1/3

area of primary tooth where composite rstoration most common failure

gingival margin

stainless steel crown for teeth affected by caries that extend where? direction youre suppose to seat SSC?

past axial line angles lingual to buccal

patient walks in and has caries on primary incisors is worried about ESTHETICS. what rsetorative procedure should be done?

**strip crown** for primary incisors w/ proximal caries 1 mm incisal reduction !!

child walks in with R/L under tooth with pain, mobiity. what does this mean?

furcation r/l sign of necrosis for a primary pulp

what material should you use for Indirect pulp cap

CaOH or RMGI

when doing a procedure, accidentily have pinpoint pulp exposure on primary tooth. how shouls this be fixed and what is complication that could happen?

CaOH directly on pulp RMGI placed over as restoration INTERNAL ROOT RESORPTION

PULPOTOMY is for what type of pulp and what material should be used ?

VITAL and restorable primary tooth with exposure Formocresol: coagulation ZOE for BU SSC for coverage formecrosl -\> ZOE -\> SSC

PELPECTOMY PROCEDURE: what type of pulp? what tooth to not do on? material

NECROTIC and RESTORABLE teeth ( non resotrable= extraction) Primary first molars: acessory canals basically RCT but using ZOE

under what circumstance to EXT primary tooth

necrotic 1st molar nonresotrable root resorption ( except secondary primary molar so acts as space maintaner)

procedure for primary first molar with furcation ?

extraction

procedure for primary second molar with furcation ?

pulpectomy

procedure for tooth with no furcation involvement but endo sympms

pulpotomy

WHAT IS THE PRIMATE SPACE ON MAND AND MAX?? \*\*\* WHEN IS IT GONE?

Max: **M** to canine ( lat incisor and canine) Mand: **D** to canine ( 1st molar and canine)

WHAT IS LEEWAY SPACE

difference in size of the mesiodistal crown widths of the primary canines and molars compared with that of their permanent successors (canine, first and second premolars primary = more upper: 2.5 mm lower : 1.5 ,,

interdental space is caused by what? \*\*

growth of dental arches !!! ( Board ?)

what is the ugly duckling stage? age? \*\*

preceeds eruption of **_max canines_** ( 7-11 y/o)

match the terms: space management Space maintanence Space Regaining Reactive, Retroactive, Proactive

mange: proactive ( manage and hold leeway space) maint: reactive regaining: retro (want 3 mm max)

primary incisor loss causes what? and how to fix it?

localized space loss kiddie partial for speech and esthetics

primary canine loss? how to fix it?

cause lingual collapse of incisors and loss of arch ength LOWER LINGIAL ARCH or NANCE from perm first molars

when to use LLHA? and what teeth do they wrap around?

PRIMARY CANINE LOSS permanent first molars !

what to use for primary first molar loss ?

BAND AND LOOP LLHA or NANCE

what to use when primary second molar is lost?

**DISTAL SHOE** : from primary first molar to unerupted permanent 1st molar LLHA or NANCE: if permanent first molar is already erupted

when do we use : LLHA? NANCE? Distal Shoe? band and loop

LLHA or nance: if Perm first molar erupted BAND AND LOOP : primary fitst molar loss DISTAL SHOE : primary second molar loss

average tooth pierces bone with how much root formation?

2/3

average tooth pierces gingiva with how much root formation?

3/4

rule of 7 with primary molar lost?

lost before 7: eruption of PM delayyed Lost after 7: PM accelerated

space closure accours within ____ months after tooth loss

first 6 months

lingual eruption of teeth. how to treat?

double row of teeth: resolve on their own

(ectopic eruption) patient walks in with their teeth erupting laterally. what procedure should be done?

extract contralateral primary lateral teeth asap to avoid midline deviation

patient walks in. his molars are out of occlusion and have a hollow sound when tapped. what does patient have and treatment?

ANKYLOSED PRIMARY MOLARS no tmnt necessary

healthy gingiva in children vs adults color?

children: reddish due to thinner epithelium less keratinization, grater vascularity Adults: coral pink

children vs adults healthy gingiva features: contour

kids: rounded and rolled margins due to edema adults: knife edged

children vs adults healthy gingiva features: texture

kids: flabby adults: firm and resilient

children vs adults healthy gingiva features: sulcus

kids: deeper Adults: less deep

gingivits in children is induced by what?

**plaque**!!!!!

parents should participate in kids oral hygiene until what age

8 !!! b/c manual dexterity

what is ANUG? tmnt?

acute necrotizing ulverative gingivitis A; painful fever N: dying tissue U: pseudomembrane G: bleeding, inflammed gums, blunted papilla tx: Debridement, oxidizing mouth rinse, AB

what is RAG?

reduced **attached** gingiva atached gingiva: best gingiva

most common cause of inadequate attached gingiva?

labial eruption path

kid walks in with bump on crest of alveolar ridge. what is this and tx?

eruption cyst txx: nothing, simple surgical excision if symptomatic

tx for this high frenum?

CLOSE SPACE FIRST! THEN FRNECTOMY !

PREPUBERTAL PERIODONTITIS INVOLVES WHAT TEETH FIRST? tx?

PRIMARY MOLARS tx: debridement and AB

most common teeth for trauma in children? overjet in children?

maxillary anteriors \> 6 mm ( usually)

concussion or subluxation of teeth. what is it and what is tx?

mobility of tooth but no displacement ( luxators loosen teeth) no tmnt

child walks in tooth pushed in. what is this? tx? issue with this?

INTRUSION tx: none: spont erupt can damage permanent teeth - hypoplasia: during apposition - hypocalc: during calcification - dilaceration: during toot formation

child walks in and tooth pulling out. what does patient have? tx?

EXTRUSION of primary teeth TX: extruded more than 3mm = extraction if patient seen before PA blood clot then **REPOSITION** and **FLEXIBLE splint** 1-2 weeks

patient has avulsion of primary tooth. tx \> and \< than 30 minutes?

\<30: replant, flexible splint 1-2 weeks, soft diet, AB, endo tmnt \> 30: extract and space maint.

crown fracture of primary tooth. what to do if in enamel only? enamel and dentin? E and D and P ? \*\*\*\*\*\*

E: smooth D: restore EDP: pulpotomy: if vital Pulpectomy: non vital extract: if pathologic root resorption

a child walks in with root fracture. what to do if its in the apical half? coronal half?

apical: no tmnt coronal: rigid splint or ext

what is damaged in internal root resorption? External root resorption?

IRR: odontoblastic layer in pulp ERR: cementoblastic layer in PDL

age of most common child abuse and neglect?

0-3

dentist suspect child is being abused or neglected. he has no proof. what should the dentist do? \*\*

by law they have to report it !!!!

what is the frankl rating scale?

1: definitely negative 2= negative resistence 3= positive acceptance 4 = definitely positive

this is a no-tmnt dental visit to be introduced to dental setting

familiarization

the knee-toknee exam is for what patients? where is the childs head?

infants \<2 y/o Head: in DENTISTS lap

when should reinforcement be ?

immediate and specific to desirable behavior !

punish with the purpose of extinguishing or imporving negative behavior is caleld what? what patients does this not work on? defiant ucnontrolled timid tense cooperative whining

Aversive Conditioning not for **timid** and **tense-cooperative** palce hand over mouth to gain attention of **uncontrolled** patient

ADHD more common in M or F? age appears? most common meds?

M 3-6 methylphenidate ( ritalin) atomexetin (straterra) aphetamine (aderall)

patient with repetitive behavior and heightened sense of light and sound usually has what?

autism

MAX RECOMMENDED DOSE OF ANESTHETIC? \*\*

4.4 mg/kg

nitrous sedation in children steps

- fil bag w/ O2 and place on patients nose with flow rate 4-6 L/min - inc 10% increments to about **30**% for operative procedures - after stopping lungs fill with nitrous so give patients 100% O2 3-5 minutes

MOST COMMON COMPLICATION OF NITROUS SEDATION?

nausea

what is minimum alveolar concentration ( MAC) ? Mac of nitrous oxide?

conc required to render 50% of patients immobile 105%

is asthma a contraindication to nitrous ?

No !!! mild to moderate asthma is okay

3 contraindications to nitrous?

\<2 y/o uncooperative wheezing episode (asthma is okay tho)

4 stages of anesthesia?

1 paresthesia 2 vasomotor (warm) 3 Drift 4 Dream" eyes closed, jaw sagging

how is fluoirde in children given?

prescription only

fluroide for children \> 3 y/o?

fluoride tablets and lozenges !!! lozenges only above 3

fluoride in children \<3 y/o

fluroide drops !!! children cant swallow tabs

fluoride children \> 6

fluoride **mouth rinse**

thumbsucking very common in what age?

up to 3 !!

effects of thumbsucking? overjet, ant teeth. max, posterior?

increased overjet ant open bite maxillary constriction posterior crossbite

what age should appliance to intervene with thumbsucking be placed and what are 2 examples?

5 or 6 Crib BLuegrass : roller on ant plate crib: steel fixed appliance in anterior palate region

teeth present at birth called?

natal teeth !

teeth that erup within first 30 days called?

neonatal teeth

most common natal and neonatal teeth?

primary mandibular incisors

baby walks in and teeth causing ulceration on ventral tongue. what is this and what is tx?

riga-fede disease smooth or extract

EARLY CHILDHOOD CARIES also called what? patient what age? 2 things that cause it?

- baby bottle syndrome - younger than 6 years - constipation -\> fruit juice consumption - ear infection -\> AB with high sucrose

when should infants drink from a cup? age of first dental visit?

1 by age 1

age infant should use pea size of toothpaste?

2-5

age patient should use smear of toothpaste?

before age 2

MD PEDIATRIC Flashcards

(131 cards)