943103
Description
Mind Map by pengiran92, updated more than 1 year ago
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Created by pengiran92
almost 11 years ago
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|
Oral Surgery
in Children
- Special
consideration before
surgical procedures
- I. Preoperative evaluation
- II. Behavioral
consideration
- III. Growth & dev
- IV. Developing dentition
- I. Preoperative evaluation
- Indication of
exodontia
- 1. Non restorable tooth -> carious/fractured
2. Severely broken tooth w periapical lesion/cellulitis
3. Over retain primary teeth
4. Infected remaining root
5. Supernumery tooth
6. Ankylosed tooth which its successor present
7. Impacted / malformed tooth
8. Traumatized primary tooth that disturb the permanent one
9. Natal / neonatal tooth
- 1. Non restorable tooth -> carious/fractured
2. Severely broken tooth w periapical lesion/cellulitis
3. Over retain primary teeth
4. Infected remaining root
5. Supernumery tooth
6. Ankylosed tooth which its successor present
7. Impacted / malformed tooth
8. Traumatized primary tooth that disturb the permanent one
9. Natal / neonatal tooth
- Relative
contraindication
- 1. Acute oral infection
2. Congenital heart ds.
3. Bleeding disorder
4. Uncontrolled DM
5. Acute renal inflammation
6. Teeth remained in irradiated bone
- 1. Acute oral infection
2. Congenital heart ds.
3. Bleeding disorder
4. Uncontrolled DM
5. Acute renal inflammation
6. Teeth remained in irradiated bone
- Difference between
primary & permanent
teeth that modify
extraction procedures
- I. Size
- Smaller in all dimension
- Small mouth
- Smaller in all dimension
- II. Shape
- Crown = bulbous
- Root = divergent/splayed
- furcation = more cervically
- Crown = bulbous
- III. Supporting St.
- alveolar bone = more elestic
- jaw = continuos growing
- alveolar bone = more elestic
- I. Size
- Preoperative
preparation
- Parent prep
- 1. Tell them why extraction
- 2. Describe the
procedure &
pre/post operative
instruction
- 3. Consent must
taken from parent
- 1. Tell them why extraction
- Child prep
- 1. Min anxiety & fear
- 2. Describe the procedure
- 3. Tell what he will feel
- 1. Min anxiety & fear
- Parent prep
- Extraction
techniques for
primary teeth
- Patient &
operator position
- Non-working hand
- 1. Retract soft ts & allow visibility
2. Protect ts. from ins slip
3. Hold mandible (resistance to force)
4. provide 'feel' to operator
- 1. Retract soft ts & allow visibility
2. Protect ts. from ins slip
3. Hold mandible (resistance to force)
4. provide 'feel' to operator
- Extraction of
ANTERIOR
primary teeth
- Maxi
- Root -> single & conical shape
- Just rotational movement
- Root -> single & conical shape
- Mandi
- Root -> single & conical shape
- Rotational movement -->
alternate labial & lingual
movement
- Root -> single & conical shape
- Maxi
- Extraction of
1st primary
molar
- Maxi
- Root --> widely splared
- Thus need socket expension
(to avoid fracture)
- Initial luxation bucally -->
alternating buccel-palatel
motion
- Root --> widely splared
- Mandi
- motion => same with maxi above
- need support from non-working
hand to protect TMJ against injury
- motion => same with maxi above
- Maxi
- Management
of fractured
primary
molar root
- If clearly visible
- remove by elevator/
root tip pick
- remove by elevator/
root tip pick
- If small &
deep position
- Left to be resorbed
- Left to be resorbed
- DON'T blind
investigation the socket
- avoid damage to
permanent successor
- avoid damage to
permanent successor
- If clearly visible
- Ankylosed teeth
- some easy
- some need
section of
tooth / flap
- Divide tooth half bucco-lingually, till depth
of floor of chamber. Then remove bone at
buccal aspect. Then split using elevator.
Then remove each part by forcep
- Divide tooth half bucco-lingually, till depth
of floor of chamber. Then remove bone at
buccal aspect. Then split using elevator.
Then remove each part by forcep
- some easy
- Patient &
operator position
- Post-operative
care
- Child instruction:
1. Bite gauze for 30 min (avoid lip biting)
2. Tell him that he will get a new tooth
3. Light meat with no hard food on the day of extraction
.............................
Parents instruction:
1. Explain why cotton roll is used & slight oozing blood from socket is no prob.
2. Not ask the child about how painful the area is
3. Dentist prescribe analgesic & antibiotic if extensive surgery is done
- Child instruction:
1. Bite gauze for 30 min (avoid lip biting)
2. Tell him that he will get a new tooth
3. Light meat with no hard food on the day of extraction
.............................
Parents instruction:
1. Explain why cotton roll is used & slight oozing blood from socket is no prob.
2. Not ask the child about how painful the area is
3. Dentist prescribe analgesic & antibiotic if extensive surgery is done
- Principle of
exodontia in
pediatric
- 1. Pre-extraction radiograph
2. Avoid soft ts. injury
3. Adequate TA & profound LA
4. Explain to the children (Tell-Show-Do tech)
5. Use pead forcep
6. Place palatal/lingual beak first then labially
7. Keep apical firm pressure on tooth
8. Alert --> prevent tooth swallow
9. Avoid injury to permanent bud
10. Separated epi. attachment firstly using currette
11. Extend the gauze pack extraorally
- 1. Pre-extraction radiograph
2. Avoid soft ts. injury
3. Adequate TA & profound LA
4. Explain to the children (Tell-Show-Do tech)
5. Use pead forcep
6. Place palatal/lingual beak first then labially
7. Keep apical firm pressure on tooth
8. Alert --> prevent tooth swallow
9. Avoid injury to permanent bud
10. Separated epi. attachment firstly using currette
11. Extend the gauze pack extraorally
- Post-Extraction
complication
- 1.Aspiration / swallow of tooth/root
2. Post-O hemorrhage
3. Tooth fractured
4. Dry socket (rare)
5. Damage permanent successor
6. Lip bitting
- 1.Aspiration / swallow of tooth/root
2. Post-O hemorrhage
3. Tooth fractured
4. Dry socket (rare)
5. Damage permanent successor
6. Lip bitting
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