Pedo Competency.pdf

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1 Class II Amalgams in the Primary Dentition • By: Yacoub Al-‐Abwah • Class of 2007 2 Class II amalgam restorations • Amalgam restorations are useful in children. • The technique is not as critical as when placing composites restorations . • It has been shown that the success rate is 70-‐80% when treating early to moderate interproximal lesions. 3 Obtain adequate anesthesia and field isolation • This can be challenging in children when cooperation is an issue. • Rubber dam isolation helps in securing a better field of vision, as well as keeping the tongue out the way. • Do not start until the patient is profoundly anesthetized! 4 Proceed with preparation • Prepare the occlusal surface using a 330, round diamond, or small pear shaped burs. • Do not extend to include all fissures but be sure to include all susceptible fissures and pit. • The depth should be 0.5 into dentin and make sure to include isthmus and dovetail for retention. • Gingival and buccolingual contacts should be just slightly open so the T-‐band can go through and can be placed firmly around the tooth. • Do not make the gingival wall too deep or you will have a narrow gingival seat because of the cervical constriction of the primary teeth. 5 Preparation • Occlusal View 6 Preparation 7 Finishing the preparation
• Deep caries should be remove using a spoon excavator or slow speed handpiece with a round bur. • Be sure to bevel the axio-‐pulpal line angle and smooth the enamel walls. • Be sure the isthmus width is adequate as it is the most common site of amalgam failure. • If the preparation is moderately deep use of light-‐cured GI liner is indicated. • If preparation is close to the pulp chamber a liner should be used. 8 Preparation consideration • The proximal box should be broader at the cervical than at the occlusal surface. • The axial wall of the proximal box should be 0.5mm into dentin(1mm mesiodistal width of the gingival seat) and should follow the same contour as the outer proximal contour. • No buccal or lingual retentive grooves are necessary in the proximal box. 9 Proceed to Amalgam placement • The T-‐band should be adapted around the tooth. • Place wooden wedge beneath the gingival seat from the lingual embrasure. However, sometimes it is fine to place it from the facial to obtain solid contact. • Insert the amalgam incrementally, be sure to condense it well! • Use of a small condenser may help with condensation. 10 Amalgam placement • T-‐Band and wedge 11 Restoration adjustment • A slight overfill of the restoration may be helpful. • The occlusal should be carved using a small ball burnisher and cleoid-‐discoid carver. • An explorer may be used to obtain good form of the marginal ridge. • Remove the T-‐band and remove excess amalgam at the margins.
Page 1 and 2: 1 KNEE TO KNEE LAP EXAM 2 ON
Page 3 and 4: 8 Oral Hygiene Instruction o Av
Page 5: o give appropriate referral
Page 9 and 10: 1 Pulpotomy on Primary Teeth 2
Page 11 and 12: 8 Technique • Profound anesthe
Page 13 and 14: 21 Before & After Treatment Ra
Page 15 and 16: interim restorations for adult
Page 17 and 18: • When seating crown, if blan
Page 19 and 20: • To maintain space… • Whe
Page 21 and 22: Birdbeak plier 13 Band and Loo
Page 23: • http://www.thejcdp.com/issue026

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