5yr old child had early childhood caries...her mother worry about anterior esthetics..what procedure can b done for this case???
as a pedidontist i would lk to suggest tht as the child is nly 5 yr old so v hv to preserve the the deciduous teeth for its sucessor so u shuld go for pulpectomy n followed by strip crowns so tht esthetics will not be compromised too .
nothing... ask the patient if there is any pain.. if there is pain.. do pulpectomy.. otherwise just leave it like that.. early extraction will affect the the normal eruption of the permanents..
I beg to differ from Dr. Pallavi here. This is a straight forward case indicated for extraction. They are root stumps and the child is 5 yrs old. One of the contraindications for pulpectomy of anterior teeth is Age >4 yrs. The books suggest extraction. If the patient is concerned about esthetics, you can either give a fixed aesthetic space maintainer or a removable denture. Usually space maintenance is not required for early loss of primary anterior teeth as there is minimal space loss.
hello everyone strip criwns are nothing but made up of celluloid material are used in extensive caries in ant .teeth as v Hve seen in ths case. they are custom made crowns they are easy to fit and trim acc to anatomy anf these crowns filled with composite and bonded on the tooth so v Hve Bettr shade control with composite these r the advantages n less tm consuming also.
premature extraction of anterior teeth, one doesn't worry about space loss. rather a doc should worry about pre maxilla growth and narrow arch ! so it is imperative to retain anteriors, although root stumps. now when retaining the rule is do not leave source or chance of infection, so pulpectomy! then comes question of restoration. post of minimal length not going beyond cervical third shall be favourable for exfoliation later. but then it conflicts with the basic principles of length of post. but to remind here, those principles are for adults and fully funtional teeth. here deciduous teeth anyways loose on root size and still the crown sustains and funtions well. also the new artificial crown could be kept dysfuntional and also could expect somewhat compliance from child for not using these crowns at all. also fibre reinforced flexi posts can be used which are much tougher even with smaller lengths. in fact even in adult cases such posts are to be inserted only till half of root length and not 2/3rd. then once the post is in place one can do a composite build up or a strip crown or a polycarboxylate crown. of course with all this parent should be clearly explained that durability is subjective to oral hygiene maintenance and child compliance. yes IOPA is imperative first. if the permanent is developed enough and can predict it's eruption to be within 6 months then extract deciduous, it'll hasten permanent eruption. but if it's gonna take more than 6 months then it'll delay the eruption of deciduous extracted prematurely. also there is risk of gingiva getting fibrosed preventing eruption of permanents on time
Kindly post the radiograph of anteriors too to check the status of permanents n root resorption of decidous.. Rg will gv a clearer scenario.. N even if v try to save laterals , posts are necessary
I beg to differ from Dr pallavi. this is not a case for strip crowns. there is poor supporting tooth structure. strip crowns if done will not stay even if done with post.
if pts really feel for the esthetic look, then fibre post with composite esthetic crown can be fabricated till the pts reach the age of seven .
A lot depend upon how much root structure is left. Loss of Anterior teeth delays speaking and hampers psychological development of child.
nothing we can do except what Dr. shalini just said...... let her mother worry about esthetics after the permanent erupts
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