Prosthetic Treatment

8/13/2019 Prosthetic Treatment

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Prosthetic treatment of

children and adolescents


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Prosthetic treatment of children and adolescents

Age

A. 0 - 6 years old

B. 6 - 12 years old

C. 12 - 18 years old


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Steal crown


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Indications for SSC

Primary and permament teeth with extesive carious lesions

Hypoplastic of primary or permament teeth

Primary teeth followin pulpotomy or pulpectomyprocedures

Teeth with herediatry anomalies

Disabled children in whom oral hygiene is poor

Abutment for space mainainersor prosthetic appliances Temporary restoration of a fractured tooth


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Space maintainers


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A space maintainer is an intra-oral appliance used to preserve

arch length following the premature loss of primary teeth/tooth.

This allows the permanent teeth to erupt unhindered into proper

alignment and occlusion.

A space maintainer is recommended after the untimely loss of a

primary tooth.


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1. Space closure occurs during the first 6 months after extraction.

It is best to insert the appliance as soon as possible following

the extraction.

2. Loss of space occurs primarily due to a tipping movement of

teeth (mesially or distally). In the maxillary molar region, spaceloss occurs due to rotation (mesial-in) in conjunction with

mesial tipping.

3. Erupting premolars usually require 4-5 months to move through

1mm of bone.


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Primary teeth can be lost

prematurely in several ways:

Traumatic injury

Caries

Some diseases or conditions, including hypophosphatasia,

diabetes and aggressive periodontitis, which is unusual in

children, can contribute to early tooth loss.


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Indications:

The premature loss of primary molars may require the placement of

a space maintainer to prevent the migration of the adjacent teeth,

depending upon the teeth present and the arch length.

When loss of a primary canine occurs, the dental arch midline may

be compromised and the arch length also may be reduced. The

premature loss of primary canines may therefore require the

placement of a space maintaining appliance to prevent midline

deviation and/or loss of arch length, perimeter and/or circumference. The premature loss of primary incisors does not usually require the

placement of a dental appliance for the maintenance of space because

mesial movement of the adjacent teeth is not generally expected.


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Contraindications:

A space maintainer is usually not necessary if there is a

sufficient amount of space present to allow for eruption of

permanent tooth/teeth.

A space maintainer may not be recommended if severe crowding

exists, such that space maintenance is of minimal effect and

subsequent orthodontic intervention is indicated.

A space maintainer may not be necessary if the succedaneous

tooth will be erupting soon.


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Benefits of this procedure:

May reduce or eliminate the need for braces.

Eat comfortably.

Save space for proper eruption of adult teeth.


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Types of space maintainers

Fixed appliances:

Band and loop / Crown and loop

Distal shoe

Lower lingual arch / transpalataarch

Nance appliance

Removable appliances:

Hawley appliance / Removable dentures


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Band and Loop Space Maintainer

Indications: Loss of first primary molar

Advantages: Ease of fabrication for the clinicianand ease of maintenance for the patient

Disadvantages: Opposing tooth may supererupt


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Crown and Loop Space Maintainer

Indications: Loss of first primary molar with significant loss

of tooth substance of the abutment tooth

Advantages: Same as above

Disadvantages: More difficult to fabricate than band and loop


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Distal shoe

Indications: Loss of second primary molar prior to

eruption of the first permanent molar

Advantages: Maintains the second primary molar

space

Disadvantages: Difficult to fabricate;

contraindicated in some medically compromised

patients, ie. pathological heart murmur


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Nance

Indications: Loss of second primary molar in the

maxilla-counterpart to LLHA

Advantages: Maintains the tooth space and the

leeway space

Disadvantages: Meticulous hygiene of the acrylic

button is required


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Hawley Appliance / Removable

Acrylic

Indications: When multiple teeth are lost and the

space maintenance and mastication are of concern

Advantages: Can maintain space as well as aid in

mastication

Disadvantages: Susceptible to fracture or loss


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Care of space maintainers

Avoid sticky sweets, popcorn, ice and or chewing gum.

Don't tug or push on the space maintainer with your fingers or tongue.

Keep it clean with brushing and flossing.

At night carefully clean around all wires, bands and other areas of the

appliance, as it tends to trap food.

After cleaning, please inspect the appliance carefully for damage.

Keep your 6 month check up appointments to monitor oral health andto evaluate the space maintainer to determine when it needs to be

removed.


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Prosthetic treatment of children aged 6 - 12

Prosthetic treatment of children aged 12 - 18


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Causes

First permanent molarscaries

Incisorscaries, traumatic injury


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VENEERS


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Dental veneers are wafer-thin, custom-made shells of tooth-

colored materials designed to cover the front surface of teeth to

improve your appearance. These shells are bonded to the front of the

teeth changing their color, shape, size or length.

Dental veneers can be made from porcelain or from resin

composite materials.


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discolorationeither because of root canal treatment; stains from

tetracycline or other drugs, excessive fluoride or

other causes; or the presence of large resin fillings that have

discolored the tooth

after traumatic injury

teeth that are misaligned, uneven, or irregularly shaped (forexample, have craters or bulges in them)

teeth with gaps between them (to close the space between these

teeth)

Indications

Prosthetic Treatment

Documents

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