1
Q
Radiograph interval for trauma follow-up
A
4, 8, and 24 weeks
2
Q
Class 1 fracture
A
Enamel only
3
Q
Class 2 fracture
A
enamel and dentin
4
Q
Class 3 fracture
A
enamel, dentin, and pulp
5
Q
Class 4 fracture
A
Non-vital tooth (with or without crown fracture)
6
Q
Class 5 fracture
A
Avulsion (tooth loss from injury)
7
Q
Class 6 fracture
A
Root fracture (with or without crown fracture)
8
Q
Class 7 fracture
A
Displacement (of tooth without crown fracture)
9
Q
Concussion
A
10
Q
Subluxation
A
11
Q
Extrusive luxation (extrusion)
A
12
Q
Lateral Luxation
A
13
Q
Intrusive Luxation
A
14
Q
Avulsion
A
15
Q
What are considered minor injuries?
A
16
Q
What are considered moderate injuries?
A
17
Q
What are considered major injuries?
A
18
Q
Odontogenesis stages and their time-frames
A
19
Q
Dental lamina precursor
A
Primary epithelial band
Formed during the Initiation phase
20
Q
The ___ initiates the formation of individual tooth germs
A
Dental placode
During the Bell Stage
21
Q
2 common defects involved in the bud stage
A
Congenitally missing teeth
Supernumerary teeth
(this stage involves QUANTITY of teeth)
22
Q
What does the dental papilla become?
A
dentin and pulp
23
Q
Name the structures
A
A - Odontoblasts
B - Pulp
C - Predentin
D - Dentin
24
Q
The ____ is the connective tissue sac surrounding the dental papilla and enamel organ
A
Dental follicle
25
Defects associated with the cap stage
Gemination
Fusion
Dens in dente
26
2 stages of the Bell stage
Histodifferentiation (differentiation into distinct cell types)
Morphodifferentiation (size and shape of the crown)
27
2 defects associated with histodifferentiation
Amelogenesis imperfecta
Dentinogenesis imperfecta
28
3 defects associated with morphodifferentiation
Peg laterals
Macrodontia
Microdontia
29
During histodifferentiation, the inner enamel epithelium becomes _____, and the dental papilla becomes ____
Ameloblasts
Odontoblasts
30
During apposition, odontoblasts first deposit the dentin matrix of ___, which signals ameloblasts to deposit the enamel matrix of ____
Collagen
Amelogenin
31
During apposition, the cervical loop becomes ____, with remnants of that later becoming the ____
Hertwig's epithelial root sheath (HERS)
Epithelial rests of Malassez
32
Defects associated with apposition stage
Turner's hypoplasia
Enamel hypoplasia
Enamel pearls
Concrescence
33
Main goal of the apposition stage
The initial deposition (depositing) of tooth tissue matrices
34
What is the main goal of morpho- and histo- differentiation
Morpho - to determine the size and shape of crowns
Histo - when tissues differentiate into distinct cell types
----inner enamel epithelium --> ameloblasts
----dental papilla --> odontoblasts
35
Purpose of the maturation stage
calcification and mineralization of enamel and dentin
36
How long does it take primary and permanent tooth crowns to mature?
Primary: 2 years
Permanent: 3-5 years
37
Dental defects associated with the maturation stage
Enamel hypomineralization
Fluorosis
Tetracycline staining
38
Odontogenesis Summary
39
Tooth Germ Summary
40
From which cell is the pulp derived?
Central cell
41
The enamel organ gives rise to which cell type
Ameloblasts (--> enamel)
42
The Dental Papilla gives rise to which 2 cell types
Odontoblasts (--> dentin)
Central cells (-> pulp)
43
The dental follicle gives rise to which 3 cell types
Cementoblasts (--> cementum)
Osteoblasts (--> alveolar bone)
Fibroblasts (--> PDLs)
44
What time-frame does calcification of primary teeth occur in utero
weeks 14-18 in 1 week intervals
(in order: A(14) - B(15) - D(16) - C(17) - E(18)......same as tooth eruption sequence)
45
Calcification of permanent teeth begins at ___ and proceeds in ___ month intervals until ___ months of age
birth
6 month intervals
30 months of age
46
Calcification sequence of permanent teeth
6 > 1 > L2 > 3 > U2 > 4 > 5 > 7 > 8
(starts at birth and proceeds in 6 month intervals until 30 months of age)
47
Upper permanent eruption sequence
6 > 1 > 2 > 4 > 5 > 3 > 7 > 8
***3 and 6 out of place***
48
Lower permanent eruption sequence
6 > 1 > 2 > 3 > 4 > 5 > 7 > 8
***only the 6 is out of place
49
Primary eruption sequence
A > B > D > C > E
***C and D flip flop***
50
Who are fluoride drops prescribed to?
Children 3 and under
51
Who are fluoride tablets and lozenges prescribed to?
children 3-6 years old
52
Who are fluoride mouth rinses recommended for?
Everyone over 6 years old
53
What are the daily and weekly fluoride mouth rinse solutions?
Daily - 0.05% NaF
Weekly - 0.2% NaF
54
Community water and fluoride supplementation schedule
55
Where do supernumerary teeth most commonly appear?
Anterior maxilla
56
Hypodontia
congenitally missing 1-5 teeth
57
Oligodontia
Congenitally missing 6 or more teeth
58
Anodontia
Complete congenital absence of all teeth
59
Most commonly missing primary tooth
Maxillary lateral incisor
60
Top 4 most commonly missing permanent teeth
1. Third molars
2. Mandibular 2nd premolars
3. Maxillary lateral incisors
4. Maxillary 2nd premolars
61
3 conditions linked to congenitally missing teeth
Down syndrome
Cleft lip or palate
Ectodermal dysplasia
62
Fusion occurs in the ___ stage of odontogensis
Cap stage
63
Where does fusion most commonly occur
anterior region of primary teeth
64
Dens evaginatus is most likely to present on which tooth?
Mandibular premolars
65
What is a dens evaginatus called when it's on an anterior tooth?
talon cusp
66
How does dens invaginatus (AKA dens in dente) form?
This occurs when the inner enamel epithelium folds in (invaginates) into the papilla before calcification occurs
67
Are dens invaginatus and evaginatus typically bilateral or unilateral?
Evaginatus - bilateral
Invaginatus - unilateral
68
taurodontism
69
Taurodontism most commonly affects which teeth?
Mandibular molars
70
Dilacerations most commonly affects which teeth?
Permanent maxillary incisors
71
3 dental signs of congenital syphilis
Generalized enamel hypoplasia
Hutchinson's incisors (triangular notches on the incisal edges)
Mulberry molars
72
Amelogenesis imperfecta occurs at which stage of development?
Bell stage
73
Amelogenesis imperfecta type 1
Hypoplastic (most common)
Defect in quantity of enamel
Very thin but hard layer of enamel
74
Amelogenesis imperfecta type 2
Hypomaturation
Defect in maturation of enamel
Enamel is soft but normal thickness
75
Amelogenesis imperfecta type 3
Hypocalcified
Defect in mineralization of enamel
Enamel is soft but normal thickness
76
Dentinogensis Imperfecta may be associated with which other disorder? What is a major identifying factor in patients with it?
Osteogenesis imperfecta
Blue sclera
77
4 radiographic signs of Dentinogensis Imperfecta
Short roots
Obliterated pulps
Bell-shaped / bulbous crowns
Cervical constriction at the CEJ
78
Dentinogensis Imperfecta
79
2 types of dentin dysplasia
Type 1: Radicular
--- short roots and chevron pulps
Type 2: Coronal
--- thistle pulps, bulbous crown, thin roots
80
Characteristics of regional odontodysplasia
Ghost teeth
Short roots
Open Apices
Enlarged pulp chambers
81
Teeth most commonly affected by concrescence and enamel pearls
Maxillary 2nd and 3rd molars
82
Ectopic globules of enamel typically found on the root surface
enamel pearls
83
keratin filled cyst on the median palatal raphae of a newborn
Epstein pearls
no tx necessary
84
keratin filled cyst on the alveolar ridge of a child
Bohn nodule
no tx necessary
85
Congenital epulis
(tx = excision)
86
____ teeth are present at birth
___ teeth erupt within the first ___ weeks of birth
Natal teeth
Neonatal teeth - 4 weeks
***extract if excessively mobile and present risk of aspiration***
87
Traumatic ulcer that develops on the ventral surface of the tongue in infants, usually caused by rubbing against sharp edges of natal or neonatal teeth
Riga fede disease
88
Associated with tooth eruption
Eruption cyst
(typically no tx necessary)
89
2 types of down syndrome and their chromosomal difference
Translocation: an extra portion of chromosome 21 is present
Mosaic: only some of the cells have 3 copies of chromosome 21
90
Down Syndrome physical characteristics
Delayed tooth eruption
Malocclusion
Perio disease
Macroglossia
Flat nasal bridge
Eyes slanted up and outward
91
Distinctive features of fetal alcohol syndrome
Micrognathia
Smooth philtrum
Thin upper lip
92
Who needs antibiotic prophy?
Previous IE
Prosthetic heart valves
Congenital heart disease
Cardiac transplants with valvulopathy
93
Oral antibiotic prophy regimen for children not allergic to penicillin
Amoxicillin 50mg/kg
30-60 minutes before the procedure
94
Oral antibiotic prophy regimen for children that are allergic to penicillin
Azithromycin 15mg/kg
Clarithromycin 15mg/kg
Cephalexin 50mg/kg
Doxycycline 2.2mg/kg
***30-60 minutes before treatment***
***the "-mycins" have the smaller dosage (15mg/kg) because mice are small, and cephalexin (50mg/kg) be " flexin' " his big muscles***
95
When should a child's first dental visit be?
Within 6 months of the eruption of their first tooth, or by their 1st birthday
96
Which teeth (in order) are most susceptible to early childhood caries (ECC)?
1. Maxillary anteriors
2. Maxillary posteriors
3. Mandibular posteriors
4. Mandibular anteriors
97
What constitutes Severe early childhood caries in children under 3?
Any smooth surface caries
98
What constitutes Severe early childhood caries in children 3 - 5 years old?
- one or more cavitated teeth
or
- missing teeth due to caries
or
- smooth surface cavities on upper front teeth
also.....
Children aged 3: a dmfs >= 4
Children aged 4: a dmfs >= 5
Children aged 5: a dmfs >= 6
99
Early childhood caries definition
The presence of one or more decayed, missing (due to caries), or filled surfaces (DMFS) in children under the age of 6
100
What does DMFS stand for
Decayed, Missing (due to caries), Filled Surfaces
101
Toothpaste amount for children under 3
Rice-sized amount of fluoride toothpaste (2x per day)
102
Toothpaste amount for children 3-6 years old
Pea-sized amount of fluoride toothpaste (2x per day)
103
For amalgam restorations, what should the width of the isthmus be?
1/3 of the intercuspal distance
104
When are stainless steel crowns indicated?
For teeth with extensive caries that reach or extend beyond the axial line angles, where the remaining tooth structure cannot reliably support a filling.
105
Occlusal reduction for SSCs
1.0-1.5mm
106
What is the indication for strip crowns?
They are for primary incisors with interproximal or multi-surface caries, or caries involving the incisal edge when adequate tooth structure remains for bonding
107
How do you prepare a tooth for a strip crown?
Reduce the incisal edge 1.0mm
Break contact with adjacent teeth
108
Where do you place the vent hole on a strip crown?
Lingual surface
109
Indirect pulp capping indication and how is it performed?
When deep caries are close to the pulp
1. Leave a thin layer of affected dentin
2. Place CaOH or RMGI to promote the formation of tertiary dentin
3. Restore the tooth (Resin, RMGI, SSC, etc.)
110
Direct pulp capping indication and how is it performed?
For pinpoint pulp exposures from trauma within the past 24 hours, or from exposure by the dentist when it's 1mm or smaller.
1. Place CaOH or MTA over the exposed pulp
2. Place layer of RMGI
3. Restore the tooth (Resin, RMGI, SSC, etc.)
111
When is a pulpotomy indicated and how is it performed?
Pulp exposures in VITAL and RESTORABLE primary teeth.
1. Remove small section of exposed pulp
2. Use dry cotton pellets to stop bleeding
3. Apply MTA or formocresol for 5 minutes before restoring
4. Place ZOE or RMGI
5. Place a SSC
112
When is a pulpectomy indicated and how is it performed?
For necrotic primary teeth (except primary first molars)
1. Remove the pulp
2. Fill the canals with ZOE to seal and disinfect
3. Place a SSC
113
Indications for extracting a primary tooth
1. Non-restorable necrotic teeth
2. Root resorption or furcation involvement
3. Any tooth (restorable or non-restorable) approaching natural exfoliation
114
Typical Treatment Options for Less Severe Cases Flowchart
115
Typical Treatment Options for Severe Cases Flowchart
116
What is a behavior seen in kids with uncontrolled behavior?
Tantrum
Loud crying with or without tears (usually in children aged 3-6 years old)
117
A common characteristic of children exhibiting defiant behavior
Overindulgence
118
Clenched fists or white knuckles is something typically seen in a kid exhibiting which behavior type?
Tense-Cooperative
119
FRANKL Rating Scale
120
Explain Tell-Show-Do
The dentist explains the procedure verbally, demonstrates it, then performs it.
121
Explain minimal sedation with contraindications
Patients are capable of responding to verbal commands
Nitrous (less than 50%) OR oral medications (benzos)
Contraindications: Caution with children under 3, non-communicative patients, severe respiratory conditions
122
Explain moderate sedation with contraindications
Patients are capable of purposeful response to verbal and tactile stimuli
Nitrous (greater than 50%) AND/OR oral sedation meds (benzos)
Contraindications: ASA Class 3 or higher
123
Explain deep sedation with contraindications
Patients are capable of purposeful response to repeated or painful stimuli
Midazolam, propofol, ketamine, dexmedetomidine
Contraindications: Cooperative patients, ASA 3 or higher, liver problems
124
Explain general anesthesia (GA) with contraindications
Patient is unable to produce any response to stimuli
Contraindications: Cooperative patients, ASA 3 or higher, liver problems
125
What does NPO mean?
"Nil per os" (Latin for "nothing by mouth")
It means a patient should not eat or drink for a specified period before GA
126
What is the Minimum Alveolar Concentration (MAC) of nitrous?
105%
127
What percentage of nitrous concentration is effective for most kids?
30-40%
128
Indications and contraindications for nitrous
Indication: anxiety
Contraindication: Children under 2, uncooperative, wheezing (i.e. severe COPD), severe URI, vitamin B12 deficiency
129
What can result if you don't flush the lungs for 5 minutes with 100% oxygen after nitrous use?
Diffusion hypoxia
130
Maximum dose for lido in children? Septo?
Both: 7mg/kg
131
Where is the primate space in the upper and lower arch?
Upper: Between the lateral incisor and canine
Lower: Between the canine and primary 1st molar
132
Explain Leeway Space
It is the space difference between the sum of the mesiodistal crown widths of primary canines and molars and that of their permanent successors.
It is usually lost at 11-12 years of age when 2nd molars and permanent upper canines erupt
133
Are primary canines and molars wider or thinner than their successors?
Primary canines are thinner than permanent canines
Primary molars are wider than premolars
134
What is the Leeway space in the maxilla?
3.0mm for the arch
(0.9-1.5mm per side)
135
What is the Leeway space in the mandible?
5mm for the arch
(1.7-2.5mm per side)
136
What is interdental space?
The space between anterior permanent teeth during development
137
Name and indication
Band and Loop
Indicated for premature loss of primary 1st molars
138
Name and indication
Distal Shoe
Indicated for premature loss of primary 2nd molars before eruption of permanent 1st molars
139
Name and indication
Nance Appliance
Indicated for premature bilateral loss of maxillary primary 1st or 2nd molars or canines
140
Name and indication
Transpalatal Arch
Indicated for premature bilateral loss of maxillary primary 1st or 2nd molars or canines
141
Name and indication
Lower Lingual Holding Arch
Indicated for premature bilateral loss of mandibular primary 1st or 2nd molars or canines when permanent 1st molars have erupted
142
Stock mouth guard
143
Mouth-formed (boil and bite) mouth guard
144
Custom-fabricated mouth guards
145
Compression rate when performing CPR on a child
100-120 / minute
146
How deep should chest compressions be when performing CPR on a child
1/3 of the anteroposterior depth
147
Compression ventilation ratio for single rescuer when performing CPR
30:2
148
Compression ventilation ratio for two rescuers when performing CPR
How often should the 2 rescuers switch?
15:2
Every 2 minutes or sooner if fatigued
149
For pediatric resuscitation, 1 breath should be delivered every ___ seconds
2-3 seconds (20-30 breaths per minute)
150
Which age group most commonly experience abuse or neglect?
0-3 years old
151
Disadvantage of a crown and loop
Preparation of the abutment tooth
This is a variation of the band and loop except that the "loop" is part of a crown
152
4 abnormalities of Tetralogy of Fallot
1. Pulmonary stenosis
2. Ventricular septal defect
3. Right ventricular hypertrophy
5. Overriding aorta
153
Oral manifestations of celiac disease
Enamel hypoplasia (40-50% occurrence rate)
Delayed tooth eruption
Reduced salivary flow
Recurrent aphthous stomatitis
Angular cheilitis
154
What is the purpose of apexogenesis?
To preserve vital pulp tissue, facilitating continued root development of immature roots for normal lengthening, thickening of root walls, and apical closure.
(It helps young/immature permanent tooth roots to continue forming)
155
What is the purpose of apexification?
a method of inducing calcified tissue formation at the apex of non-vital permanent teeth with incomplete root formation.
156
Most common type of cancer and leukemia in young children
Acute lymphoblastic leukemia (ALL)
157
Which hormone plays a crucial role in tooth eruption
Parathyroid hormone-related protein (PTHrP)
Acting as a signaling molecule, PTHrP stimulates local bone resorption around the developing tooth. Without PTHrP, the bone surrounding the tooth follicle fails to resorb, resulting in the inability for the tooth to erupt.
158
most common seizure in children
febrile seizure
159
Which tooth is most likely to exhibit ankylosis?
Primary mandibular molar
160
What is the most appropriate duration of time for splinting an alveolar fracture in the primary dentition?
4 weeks
161
Traumatic dental injuries such as subluxation and extrusive luxation may typically be splinted for ___ weeks
2 weeks
162
Which cells are responsible for tooth eruption?
Osteoclasts
Osteoclasts resorb alveolar bone, creating a pathway for the erupting tooth to enter the oral cavity
163
Completion of root development and closure of the apex is typically within ___ years following tooth eruption
2-3 years
164
Herpangina is commonly associated with _____
Coxsackie virus (an enterovirus)
165
Hand, foot, and mouth disease (HFMD) is commonly associated with _____
Coxsackie virus (an enterovirus)
166
Primary herpetic gingivostomatitis is caused by ____
Herpes Simplex Virus type 1 (HSV-1)
167
Regional odontodysplasia inheritance pattern?
Sporadic (sometimes genetic, sometimes environmental, etc..)
168
An _____ deficiency is a contraindication for the use of nitrous in pediatric patients
untreated cobalamin (vitamin B12) deficiency
It can lead to potential neurological complications such as peripheral neuropathy and megaloblastic anemia.
INBDE - Booster Prep
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