Orthodontics and Pediatric Dentistry
Orthodontics and Pediatric Dentistry tests growth and development, diagnosis, appliance mechanics, retention, child behavior, caries prevention, pulp therapy, trauma and space management.
Core concepts
- Angle classification: Class I normal molar relation; Class II distal mandible; Class III mesial mandible. Class II division 1 has proclined incisors; division 2 has retroclined central incisors.
- Cephalometric norms vary; SNA about 82 degrees, SNB about 80 degrees and ANB about 2 degrees are teaching values, not a diagnosis on their own.
- Anchorage controls unwanted tooth movement; temporary anchorage devices provide absolute anchorage.
- Pediatric caries: fluoride varnish, sealants, dietary control and risk-based recall. Silver diamine fluoride arrests caries.
- Pulpotomy preserves the radicular pulp; pulpectomy removes all pulp. Stainless steel crowns are durable for primary molars.
- Avulsion: replant immediately if possible; if dry, store in milk or saline; splint for 2 weeks; mature teeth often need endodontic treatment within 7–10 days.
Worked example
A 7-year-old avulses a permanent central incisor and arrives with the tooth dry. Reasoning: do not scrub it; rinse briefly, replant if the window and bone allow, then splint and refer. Dry time and storage medium determine prognosis.
Traps
Do not replant a primary tooth. Do not ignore growth in orthodontic planning. Do not apply adult trauma timelines to primary teeth. Do not promise a simple fixed appliance result without assessing skeletal pattern and compliance.