Paediatric presentation Stacey Cooper Patient/medical history 8 - - PowerPoint PPT Presentation

Paediatric presentation

Stacey Cooper

Patient/medical history

• 8 year old female
• Irregular attendee, referred into community due to dental

anxiety

• No previous dental treatment
• Family history of dental caries/periodontal disease and

premature extractions

• P.C.O- Nil
• P.M.H- clear

Referral

• OHI, diet advice
• Fluoride application and fissure seal all posterior

teeth.

• Restorations and stainless steel crowns (SSC)

as charted

• Extract grossly carious LLE

Initial examination

• E.O-nad
• I.O- OH: poor
• Caries present in 55,54,65,64,75,74,85,84
• -74 grossly carious and causing dental pain.
• HIGH caries risk

Initial treatment

• Extract 75 to eliminate infection and relieve

dental pain.

• Extensive OHI and diet advice to child and

mother.

• Preventative measures such as fissure sealants

and fluoride application.

• Restorations as charted.

PICO question

• Amalgam Vs stainless steel crowns
• Person: paediatric patients with amalgam

restorations and SScs

• Intervention: what are the benefits of SSCs
• Comparison: success rates of SSCs vs

amalgams

• Outcome: What are the most effective?

Indications for SSCs

• Grossly carious teeth
• Multiple carious teeth
• Following pulpotomies
• High caries rate children

Evidence for SScs

• Innes et al (2007) concludes that SSCs using

the Hall technique are the preferred restorative method by the majority of children and GDPs.

• Later within the same paper it also states the

SSCs produced more favourable outcomes for pulpal health and restorative longitivity than that

• f class II amalgam restorations.

Evidence continued

• Roberts et al: SSCs continue to prove very

successful for the restoration of larger cavities and for pulp-treated primary molar teeth. For the smaller cavities RMGIC were also very successful.

Amalgam Vs SSCs

• Amalgams show high success rates in class I

cavities

• SScs produce higher success rates in class II

cavities

• SSCs lasted roughly 33 months or until

exfoliation.

Clinical message

• Although amalgam and RMGICs have their

place in paediatric dentistry I think it is important when and where possible to place SSCs using the Hall technique.

• The high success rates and the patient and

parent feedback all conclude that this is the preferred method of treatment

References

• Innes. N., Evans. D., Stirrups. D,. (2007)`The hall

technique: randomised controlled clinical trial of a novel method of managing carious primary molars in general practice`BMC Oral Health (7):18

• Roberts. J.F., Attari, N., Sherriff. M., (2005)`The survival
• f resin modified glass ionomer and stainless steel crown

restorations in primary molars, placed in a specialist paediatric dental practice`British dental journal (198) 427-431