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74 comments:
A couple interesting things:
1- An amalgam restoration on a primary 1st lower molar is most prone to fracture.
2- Primary teeth need more etching time.
3-Dental dame is not only for isolation of the tooth but a great pt management tool.
Sanaz Hamzehpour 132
1)Rubber dam: isolate from moisture, keep the tongue out of the way, assist NO2 administration, and prevent aspiration.
2)Kids with Spina Bifida and Myelomeningocele are considered latex allergic.
3)Lower 1st primary molar DO amalgams fail most frequently. Usually from sharp marginal angles.
Chris Claus 113
Pt caries experience is a good tool at the time of deciding the kind of retorative material we should use.
MOD restorations are contraindicated in primary teeth.
Slot prep. increase fracture.
Heidi Gonzalez # 526
ART is does not need local anesthetics. Only high speed and hand instruments are used.
Restore with GI that will slowly release F.
Xiang Li #146
1. Latex free Dental Dams are available.
2.Dental Dam in children mainly used for management purposes.
3. Stainless steel crowns are used instead of an MOD Composite/Amalgam restoration.
Dilshad Abtin 524
Due to the constant development of dentition and the jaws in children , sometimes an inadvertent 'high' restoration may not give the child patient much discomfort due to the continued growth and movement of teeth.Not a reason for sloppy dentistry but an interesting fact!
Eric Cheung 110
No sharp anything on pedo preps.
Since amalgam requires a certain thickness to prevent fracture, composite is a better choice.
Eric Cheung 110
One of the main principles for pediatric restorations is that all line angles should be rounded in order to avoid fracture. DO amalgams on lower primary molars fail the most.
Shelton Chow #111
-Dental abscess may cause brain damage and death in kids if not treated on time.
-Children with spina bifida and myelomeningocele should be considered as potential latex allergic.
-The outline for a preparation for a class I composite should be limited to caries removal, it is not necessary extension for prevention.
Claudia Rodriguez #531
Despite the advances in materials used in dentistry, some dentists continue to believe techniques previously taught to them still apply to the new materials available for today.
-Carol Kim (#138)
Composite resin material is not toxic to the pulp. All internal angles in deciduous preps should be rounded.
Ryan Plewe
#168
1) Rubber dams are great for moisture control and preventing the aspiration of dental materials.
2) Composite fillings may be indicated for surfaces with a less then ideal enamel thickness.
E. Lai #141
Out-of-date beliefs:
1. Composite resin restorations have a higher wear and fracture rate than do amalgam restorations.
2. Composite resin is inherently toxic to the pulp.
3. Zinc-Oxide and Eugenol soothes and kind to the pulp
4. Acid etching dentin injures the pulp.
5. and 4 other beliefs (too much to type here).
ALL OF THE ABOVE ARE NOT TRUE.
Oops, the above comment was written by
Naomi Nguyen
#158
Composite restorations are ideal for primary posterior teeth, and have better results than amalgam restorations in these same teeth. Additionally, there are many common misconceptions about composites which have been found to be incorrect.
Robert Busan #107
Very important things that I learned in this lecture:
-The less you use a high speed on a kid, the better- They hate the noise of a high speed. Use a slow speed handpiece or a spoon excavator whenever possible.
-Use a rubber dam to avoid losing clamps, tooth chips or cotton rolls. A child can die of a foreign body infection caused by an aspirated cotton roll. Ugh.
Raquel Ulma #188
Since kids' occlusion change a lot due to growth, we can expect kids to adapt to restorations better than adults. It is also recommended that we use a slow speed instead of the high speed to minimize the drill sound.
Tina Duong #125
Commposite has less leakage and more conservative than amalgam fillling. The most failure is amalgam filling on primary molar.
ART (Atraumatic Restorative Technique) last for 6 months to 2 years.
TIffany Hsu #529
Pediatric restorations are easy.
Austin Tung 187
I learned that:
1) Preps on primary teeth need to be rounded with no sharp angles.
2) Composite resin should be used on most restorations instead of amalgams, except on ones that require SSC's.
3) Don't do MOD preps, back-to-back composite restorations, slots, nor retention grooves.
Shelby Padua #166
Jonathan Do #121
Amalgam DO Restorations in primary mandibular 1st molars have the highest failure rate due to having sharp proximal line angles. Dental dams should be used whenever possible in pediatric dentistry. Slot preps can lead to fractures in primary teeth due to their anatomy.
All restoration on primary teeth should have round line angles; lower primary molar DO Ag has the highest failing rate.
Sonia Lee (145)
There is pretty much no reason to use amalgam in kids.
[Colby Smith #178]
It was a good reminder to hear that rubber dams are good not only for isolation but to keep patients' tongues out of the way, probably a good thing with kids. But, I was surprised to hear Dr. Troutman say there really is no use for amalgams ever in pedo patients -- interesting.
When treating children, you must consider the anatomical difference of their dentition compared to that of adults. The lecturer suggested the composite is the preferred restorative material for kids due to the conservation of tooth structure. MOD restoration are contraindicated in kids...do SCC instead (this will be the discussion for next week's lecture)
Jun Flores #130
primary mandibular molars have the highest failure rate on DO aspect restorations. rubber dams are good way to prevent aspiration of objects and to isolate the tx. area in a patient.
Neilesh Patel (Neil Patel)
# 165
Rubber dams have a variety of uses in pediatric dentistry including isolation, prevention of aspiration, and assist in NO2 administration. Also, MOD amalgams are contraindicated in primary teeth due to fracture.
Joshua Cardwell #108
There were many important points but, one which I previously did not know was:
Excavating lesions w/ hand instruments and restoring w/ GI, also know as the Atraumatic Restorative Technique (ART), does not require the use of local anesthesia.
- Sydon Arroyo #102
When doing pedo restorations, we don't really have to worry much regarding occlusion since most of the time, occlusion discrepancies will fix itself in the primary dentition.
Kim Pham #167
Amalgam has limitations in pediatric dentistry; composite preps are more conservative, have lower failure rates due to decreased marginal leakage, fracture and recurrent decay. Research also shows that contemporary composite resins have stronger marginal strength, similary wear rates to amalgam and pose little toxic hazard to pulp. Dr. Troutman definitely favors the use of composites over amalgam
-Jeanne Wong, #195
Composite restorations are ideal in pedo patients for several reasons:
-more conservative
-less likely to fracture
-Fl- release aids against caries
Farshid Siami
#177
failure of class II Restorations
Amalgams: Isthmus fractures, is the most common failure of molar amalgams.
#175
Mihir Shah
In primary teeth, DO amalgams on mandibular 1st molars are the most common amalgam fractures.
Stacy Yu #193
I learned that amalgam restorations on lower deciduous 1st molars are at the greatest risk for restoration fracture/failure.
Amy Dixon #120
New insights from Dr. Troutman.
1- The importance of having rounded internal line angles on restorations, not sharp angles.
2- ART or Scoop & Fill, is a great way to buy time w/ young pts.
Morris Poole #169
Although the "scoop and fill" technique is very simple, rapid, and requires no anesthesia, it is only suitable for severe gross decay and its success is less than that of a crown.
Sanam Soroudi #180
ART is very useful for non-compliant young children, especially to buy them a couple years before a definitive restoration can be placed. Composite is used much more frequently than amalgam on primary teeth.
Broc Mushet
#156
-It's really important to have no sharp angles in your preps
-Composite is a better material choice for children
-Children with spina bifida and myelomeningocele should be considered to have a potential latex allergy
stephanie morphis #154
Natalie Nguyen #159:
1. Avoid anything sharp (everything must be rounded) for composite restorations
2. Primary teeth differ from their permanent counterparts in that they have thinner enamel/dentin, larger pulp chambers, pulp horns are closer to surface, greater cervical constriction of crown, prominent cervical contour, broad/flat contacts, and enamel rods slope occlusally.
Don't put retention grooves in proximal box of primary molars because they increase the risk of fracture.
Hoang #135
For all restorations, one important concept when preparing a primary tooth is that the preparation should not have any sharp angles.
Joanne Kim, #140
The most common cause of failure in primary molar molar amalgam restorations is isthmus fracture.
Matthew Moadel #151
ART stands for Atruamatic restorative technique. In this technique caries is removed w/ a hand instrument and the tooth is restored w/ GI.
Orly Hendizadeh, #134.
No sharp anything on preparations so as to reduce risk of failure. Composite is non-toxic to the pulp and, on pedo patients, may be a superior restorative option.
Rick Shamo #176
I found it interesting that the past lecture seemed to contadict many things that we had been taught. It was nice to get a different point of view on restorative materials and sealants.
Marc Thomas 182
A couple of things I learned:
-Spina bifida and myelomeningocoele patients are considered to be latex allergic
-MOD preparations are contraindicated in primary teeth, use slot preparation instead or SS crown
-All preps need smooth angles
-Need to etch longer than adult teeth
Jonathan Miller #149
The most intersting things I learnt were:
1 DO amalgam restorations on primary 1 st molars fail most frequently.Usually from sharp line angles.
2 Stainless steel crowns are used instead of MOD composite or amalgam restorations on primary teeth.
Amandeep Iqbal
# 527
- Composite resin is not toxic to the pulp- which is in contradiction with other people's view.
- All the angles must be round in order not to get fractures
- It is better to use composite than amalgam in order to spare dental structure
Cornel Crasnean #525
Two points stands out:
1. kids sometimes get irritated by the sound of high speed. Therefore, for shallow caries or opening up grooves,use slow speed instead.
2. For a class II restoration, there should not be a sharp corner any where.
rc109
Amalgam and composite restorations in primary teeth should be limited to 2 contiguous surfaces only (No MOD's). Also, a rubber dam allows for better N2O management, as it requires the patient to breathe through his/her nose.
Kevin Omoto #163
1.composite fillings is superior than amalgam fillings in deciduous teeth and slot prep is not recommeded.
2.ART concept.
Lei Zeng, #535
Teeth are goig to be treated differently, this is going to depend on when the tooth is going to be exfoliated.
In the pediatric restoration all the angles should be rounded.
Anatomically, primary teeth differ from permanent teeth in that primary teeth have a thinner layer of enamel and dentin because primary teeth typically have larger pulp chambers. As a result, pulp horns of primary teeth are closer to the tooth surface.
Richard Duong #124
Both slot and MOD preparations increase the faliure rate of a restoration on a primary tooth. Also composite has similar wear to primary tooth enamel; amalgam does not wear so the long term outcome of composite restoration is higher than that of amalgam.
Niki Zarabian #194
Composite restorations are better for primary posterior teeth than amalgam restorations.
Jan Slapnicka #533
Composite restorations in primary dentition are more conservative, leess likely to fracture.
Poonam Rai
#530
For deciduous teeth composite restorations are a better choice than amalgam restorations.
Poonam rai
#530
after taking the longevity and size of primary teeth into consideration, we can conclude that composite restorations are more appropriate over amalgam restorations.
Pedram Sooferi
#179
Though we did practice some amalgam restorations in our 2nd year pedo lab course, apparently there is no use for them in children. And the DO restorations on primary 1st lower molars are most prone to fractures - even though amalgams are usually indicated for larger restorations in larger teeth. So if in the molars it's not good, then it shouldn't be used for other teeth. It all makes sense.
Azadeh Ahmadi-Ardakani
student 101
Primary teeth need special care while doing restorations specially primary molars.
Don't overextend the outline of restorations
composite restorations are better in primary restorations
For the "Scoop and Fill" method, it isn't used for severe caries but for small class V caries
David Tajima
#181
I have learned that rounded line angles to avoid fracture of restorations and composite is preferred since amalgam requires a specific thickness to avoid fracture.
Alina Tiraspolskaya #183
Amalgam restorations on lower deciduous 1st molars are at the greatest risk for restoration failure. Also avoiding 3 surface restoration (Amalgam/Composite) on deciduous teeth.
Soheil Yashari #191
I thought it was good to refresh our knowledge of the pulp size of primary teeth, and how we should be more conservative when making a prep to avoid impinging on the larger sized pulps. #160
Composite restorations are more conservative and a better option for primary teeth. Also, rubber dams play an important role in the management of pediatric pts.
When preparing for restorations in primary molars, it is very important to round off all angles and to not place retention grooves in interproximal boxes in order to avoid tooth fracture.
Jared Martin #147
The most important thing I learned from this lecture is that composite is the preferred material for restoring Class I cavities on primary teeth. Teeth restore w/ composite experience <15% fracture while Ag restored teeth experience fracture 35% of the time.
Also, MOD restorations shoud be avoided in primary teeth
Edvin, 100
DL cusp of primary 2nd max molar is prone to fracture
MOD amalgams should be avoided in primary teeth. Also, when working with children, rubber dam placement is important for moisture control and to prevent aspiration.
Brandon Seto, 173
-Only treat a primary tooth once in it's lifetime.
- when doing a class one on a maxillary primary molar, only cross the oblique ridge when undermined by caries.
-Lower first molar is the most failed restoration becaue of sharp proximal line angles when doing a class 2.
Regina Espinoza #126
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