INBDE bootcamp-pediatric amujral

enamel organ parts:

1. outer cell layer 2. inner cell layer 3. stellate reticulum: cells between those layers 4. enamel knots: cusp tips and signaling center

pulpotomy steps

1. removal of coronal pulp 2. dry with cotton pellets 3. apply formocrestol for fixation 3. zinc eugenol oxide buildup 4. SSC

bell stage begins in

11th week in utero

when does maturation begin in fetus

14 weeks

tooth calcification begins at (and the order of calcification)

14 weeks in utero -central incisors, then first molars, lateral incisors, canines, second molars -each are a week apart (14-18 weeks)

how much of root is developed when eruption occurs?

2/3 -takes 2-3 years to finish once erupted

when do roots of primary teeth complete development?

3-4 years of age

when do teeth start developing in the wound

6 weeks

leeway space in mandibular

about 1.5 mm per side

leeway space in the maxillary (numerical number)

about 2.5 mm per side

bacteria that causes perio in children

actinomyces

fluorosis affects which odontogenic tissue

affects enamel

parents should help with brushing until

age 8

what happens if the bell stage goes wrong?

amelogenesis or dentinogenesis imperfecta

fusion is most common in which area of the mouth

anterior teeth

enamel hypoplasia occurs during which stage of tooth development?

apposition

inheritance pattern of dentinogenesis imperfecta

autosomal dominant

if you have early primary first molar loss, which appliance

band and loop, LLHA, Nance

when do the crowns of permanent teeth begin calcification?

birth (0) -first molars, all anterior teeth except maxillary laterals, maxillary laterals, first premolars, second premolars, second molars -all progressively go up by 6 months

dentinogenesis imperfecta teeth/eye color

blue!!!

what happens if the upper canine is ahead of or alongside first premolar?

canine is forced labially and looks like a vampire fang

in which race is ankylosis more common in?

caucasian

what does the dental follicle give rise to?

cementoblasts, fibroblasts, osteoblasts

what provides retention for SSC

cervical bulge

enamel pearl

chunk of enamel in molars that blocks attachment of sharpey fiber (type I collagen that binds PDL to cementum) -creates perio pocket but this doesnt come off with scaling

if you have a high frenum how do you solve space gap?

close gap THEN do frenectomy -prevent scar tissue from building up and preventing ortho movement

if the tooth cap stage goes wrong:

cyst, odontoma, germination, fusion of crowns, dens in dente

sulcus in children

deeper because soft tissue more easily detachable

what signals for physiologic root resorption of primary tooth

dental follicle/stellate reticulum

what develops first: enamel or dentin

dentin-odontoblasts secreting dentin matrix makes enamel amelogenin deposition

which procedure is not typically done in primary teeth endo wise?

direct pulp cap

if you have early primary second molar loss, which appliances?

distal shoe if permanent molar unerupted LLHA or nance if permanent first molar already erupted

generalized microdontia is common with which conditions

down syndrome ectodermal dysplasia

what is the rest of the oral epithelium derived from

ectomesenchyme

what signals the oral epithelium to thicken into dental lamina to start tooth formation?

ectomesenchyme

mesiodens

extra tooth between 8/9

most space loss occurs within

first 6 months after tooth is lost

what material do we use as a liner in primary teeth pulpotomy?

formocresol -NOT CaOH: causes root resorption

regional odontodysplasia is also known as

ghost teeth -affects all tooth cells -usually only in one quadrants -short roots, open apices, enlarged pulps

interdental space is a result of

growth of dental arches

localized macrodontia is common in which condition

hemifacial hyperplasia

if you have an exposure, when can you do a direct pulp cap

if the exposure is less than 2mm

downside of direct pulp cap

internal root resorption

most common cause of reduced attached gingiva in children

labial eruption of tooth -ortho or free gingival graft/ct graft can help

how do you seat a SSC

lingual to buccal

which teeth erupt faster: upper/lower

lower

if you have early loss of canines AND all primary incisors have exfoliated/permanent incisors are in, which appliance do you use?

lower lingual holding arch or nance holding arch for maxillary

longest stage of tooth development?

maturation -2 years for primary tooth -4-5 years for permanent tooth

which primary tooth is most commonly missing?

maxillary lateral incisor

dens invaginatus is most common in which tooth?

maxillary lateral incisor -easier to get caries

what does the ectomesenchyme derive from?

neural crest

gingiva in children texture

not stippled: shorter and flatter papilla

what happens in morphodifferentiation goes wrong

pegged laterals, macrodontia, microdontia

turners hypoplasia

periapical infection or trauma to the primary tooth causes an inflammatory response that messes up ameloblasts of developing permanent tooth

which tooth is pulpectomy contraindicated in?

primary first molars

which primary tooth is most commonly ankylosed?

primary mandibular second molar

which primary tooth has a cusp of carabelli?

primary maxillary second molar

widest primary tooth FL

primary second molar

enamel rod orientation in primary vs. permanent teeth

primary: directed down toward apex permanent: directed up toward occlusal

when does gingivitis peak in children

puberty -thought to be due to hormones

gingiva in children color

red-adults is pink

gingiva in children contour

rolled/rounded margins-edema due to eruption and prominence of cervical ridges in adults: knife edge margins

dental follicle

sac surrounding enamel organ and dental papilla

widest primary tooth mesiodistally?

second primary mandibular molar

which primary tooth do we really try to not extract?

second primary molars

morphodifferentiation

shape and size of crown is determined -during bell stage

leeway space

space difference between primary canine/molars and permanent canines/premolars -lost at 12 years old with eruption of second molars

if the tooth bud stage goes wrong:

supernumerary/missing teeth

after the enamel organ collapses and the IEE and OEE join together, what does it form

the junctional epithelium

the primary second molars resemble:

the permanent first molars

What are succedaneous teeth derived from?

their primary tooth's bud

the primary first molars resemble:

their successors (premolars)

most commonly missing teeth order?

third molars mandibular second premolars maxillary laterals maxillary second premolars

when does interdental space last through

through eruption of maxillary canines (7-11 years old)

concrescence

union of two teeth by cementum only

difference between pulpectomy and RCT

use ZOE filling for primary tooth not gutta percha

taurodontism

vertically elongated pulp chamber and short roots -linked to type IV amelogenesis imperfecta

where does pulp come from?

what remains of the dental papilla?

when do you use a stainless steel crown?

when the caries has extended past the axial line angles

cervical loop

where IEE and OEE meet -forms HERS and eventually leaves behind epithelial rests of malassez in the tooth

what color do amelogensis imperfecta teeth have?

yellow/brown -can treat with crowns

SSC crown preparation

-1mm occlusal reduction -enough axial reduction to break contact

strip crown

-anterior crowns that have caries involving incisal edge -1mm incisal reduction and break contacts -vent hole on lingual to extrude excess composite

dentin dysplasia

-autosomal dominant -type 1: short roots -type 2: chevron pulps

cap stage (what happens and when)

-bud differentiates into different tissues: enamel organ and dental papilla -9 weeks in utero

what happens in the bell stage?

-cells differentiate -IEE cells become ameloblasts -dental papilla cells make odontoblasts -morphodifferentiation

bud stage

-dental placodes of the dental lamina bud off into the ectomesenchyme -condensing mesenchyme

when should you use a SSC

-extensive caries -after pulpotomy -fractured tooth

manifestations of congenital syphillis

-hutchinson's incisors: hypoplastic notch -mulberry molars: globular enamel

what happens to tooth count in germination?

-is still normal

what happens if the lower second molar erupts ahead of second premolar?

-loss of leeway space and may impact second premolar -use space maintainer

dental papilla

-mesenchyme -forms dentin and pulp

primate spaces are around which primary teeth

-mesial to upper canine -distal to lower canine -lost with eruption of permanent first molars at 6 years old

cervical bulge

-on facial of primary teeth especially first molars

radiographic appearance of dentinogenesis imperfecta teeth

-short roots -bell shaped crowns -obliterated pulps -constricted DEJ

tetracycline staining

-stains dentin -until 8 years gotta be careful

maturation stage of tooth development:

-when enamel and dentin are actually made (before it was just a matrix) -calcification begins at tip of tooth and goes down cervically

largest cusp on primary mandibular first molar

MB

sharpest/highest cusp on primary mandibular first molar

ML