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CHAPTER 9

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exist as to what hemoglobin levels dictate the need for transfusion. The hematologist will base the decision on the patient’s history and current treatment needs

• Note that, in addition to the sickle cell anemia, this patient’s prognosis is complicated by his intellectual disability and behavior

• The prognosis for continued maintenance of this patient’s dentition is poor, unless the parents make a concerted effort to improve their son’s daily oral hygiene and diet. There are already numerous teeth with very questionable prognosis

• If extraction of teeth is required, the patient is not a good candidate for replacement with fixed prosthesis at this time (due to poor hygiene, soft tissue inflammation). Given the patient’s resistance to intraoral manipulations, his ability to tolerate a removable prosthesis is also questionable

• The patient is not a candidate for orthodontic or orthognathic treatment at this time due to:

Poor oral hygiene Resistant behavior requiring sedation or general anesthesia for any procedures other than cursory examinations and cleanings

N. Complications andAlternative TreatmentPlan

• If the patient’s behavior was cooperative, would he be a good candidate for orthodontic treatment?

• How does the increased probability of osteomyelitis affect the decision to extract or restore teeth with a questionable prognosis?

• What would be the primary postoperative concern in patients requiring extractions?

386 Clinical Cases inPediatric Dentistry

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Self‐Study Questions

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PATiEnTs wiTHDisAbiliTiEs

1. Genetically, how does the full sickle cell genotype differ from the genotype for sickle cell trait?

2. Is there an ethnic predilection for sickle cell anemia?

3. What are possible sequelae of a vaso‐occlusive sickle cell crisis?

4. What is the underlying cause for the maxillary enlargement that is present in many individuals with sickle cell anemia?

Name possible precipitating factors for a

vaso‐occlusive crisis

What are some considerations for treating a

patient with sickle cell anemia?

7. What is the hematologic process that results

inavaso‐occlusive sickle cell crisis?

8. What are some intraoral ndings associated

withsickle cell anemia?

Answers are located at the end of the case

Clinical Cases inPediatric Dentistry 387

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CHAPTER 9

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Self‐Study Answers

1. In the most common type of sickle cell anemia in the USA, the patients are homozygous for the HbS gene. Individuals with the sickle cell trait are heterozygous for HbS, and are asymptomatic

2. In the USA, sickle cell anemia is seen most frequently in African‐Americans. It may also be present in individuals of Mediterranean, Middle Eastern, African, Indian, Caribbean, and Central and South American decent

Sequelae of a vaso‐occlusive crisis can include

tissue anoxia, tissue necrosis, infarct, and pain. These can occur in any organ system in the body

4. The maxillary enlargement is secondary to heightened bone marrow activity and an increase in the marrow space in the maxilla

5. Factors that may precipitate a vaso‐occlusive crisis in a patient with sickle cell anemia include

hypoxia, infection, stress (such as a dental visit), dehydration, and menstruation

A careful medical history must be elicited,

including a history of vaso‐occlusive crises, transfusions, medications, infections, psychosocial issues, and subsequent damage to organ systems. Treatment recommendations should be discussed, such as the need for antibiotic prophylaxis

7. Sickled red blood cells adhere to vascular

endothelium. This aggregation of cells results in vasoconstriction and inflammation of microvasculature, resulting in a vaso‐occlusive crisis

Some intraoral findings associated with sickle cell

anemia include maxillary enlargement, maxillary incisor proclination, pallor of soft tissues, gingival enlargement, and glossitis

Bibliography

Alves PVM, Alves DKM, de Souza MMG, Torres SR. 2006.

Orthodontic treatment of patients with sickle‐cell anemia. Angle Orthod 76(2):269–73.

American Academy of Pediatrics. 2002. Hematology/Oncology

Committee on Genetics; health supervision for children with sickle cell disease. Pediatrics 109(3):526–35. Reaffirmed February 2016.

da Fonseca MA, Oueis HS, Casamassimo PS. 2007. Sickle

cell anemia: a review for the pediatric dentist. Ped Dent 29(2):159–69.

Licciardello V, Bertuna G, Samperi P. 2007. Craniofacial morphol-

ogy in patients with sickle sell disease: a cephalometric analysis. Eur J Orthodont 29(3):238–42.

Lockhart PB. 2013. Sickle cell anemia. In: Oral Medicine

and Medically Complex Patients, 6th Edition. Oxford: Wiley‐Blackwell. pp. 98–100.

388 Clinical Cases inPediatric Dentistry

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INDEX

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21‐mm K‐type endotic files 99 330 bur

39, 44, 51

AAPD see American Academy of Pediatric Dentistry

322

191

367

277

200–205, 207

319–326

319

324

329–330

209–214

301

251

256–257

228

234

Ace bandages acute herpetic gingivostomatitis acute lymphoblastic leukemia (ALL)

background information chemotherapy effects dental treatment

oral care acute odontogenic infections acyanotic lesions Acyclovir ADA see American Dental Association adalimumab 350 Adderall ADHD see attention deficit hyperactivity disorder administration

diphenhydramine

epinephrine

general anesthetics

local anesthetics

nitrous oxide/oxygen

preanesthetics 257

sedatives 240 adontogenic infections, acute 209–214 AI see amelogenesis imperfecta airway assessment 238, 244 airway management 244–248

allergic reactions 251

assessment 238, 244

bag‐valve‐masks 246

complications 245

oxygen therapy 246 airway structure 245 ALL see acute lymphoblastic leukemia

allergies

alpha alveolar bone grafts alveolar fractures amalgam restorations amelogenesis imperfecta

11–14 and asthma celiac disease reactions

adrenergic agonists 367

339, 341

206–208

249–254

288, 296–297

151

215–217

American Academy of Pediatric Dentistry (AAPD) guidelines

caries risk assessment cerebral palsy

361 class II resin restorations dental history first visits

7 Frankl Behavioral Rating Scale maximum local anesthetic doses nitrous oxide

232 pharmacological behavior guidance preanesthetics

257 protective base formation radiography

25, 31, 38

transitional dentition

8, 12

45–46

223

228

239

31, 38–39, 43

American College of Chest Physicians guidelines, congenital

heart disease 305

American Dental Association (ADA) guidelines

congenital heart disease 305 mouth guards 150

American Society of Anesthesiologists (ASA) classifica-

tions 238, 356

aminocaproic acid (Amicar

) 314 aminosalicylates (ASA) 350 amoxicillin 211 amphetamines 367 analgesics

asthmatic patients 344 hemophiliac patients 315 liver transplant patients 329

Clinical Cases in Pediatric Dentistry, Second Edition. Edited by Amr M. Moursi. © 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc. Companion website: www.wiley.com/go/moursi/pediatrics

389

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Index

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anaphylaxis 250–251 ANB angle

281 anesthesia see general anesthesia; local anesthesia angular cheilitis ankylosis anterior crossbite anterior zirconia crowns

200

168–170

279–284

71–76

antibiotics

avulsed teeth Crohn’s disease cystic fibrosis

facial infections anticoagulant therapy antifungal medications

169

350

309

211, 212

305

201

anxious patients see also behavior guidance

asthmatics

behavioral rating

communication techniques

desensitization

medications

343

223

224

380

231–236, 241

apexifications

risks and complications 119

root end closures

technique aphthous stomatitis

115–120

118

206–207

apical periodontitis

definition 128

necrotic tooth revascularization

Arestin aripiprazole articaine

170

379

228

127–132

ASA see American Society of Anesthesiologists;

aminosalicylates ASD see atrial septal defect; autism spectrum disorder assessment see also diagnosis; differential diagnosis

asthma

341

orthodontic

asthma

assessment atopy attack management background information classifications

260–261

30, 233, 339–346

341

342

344

340

340 general anesthesia 343 management and treatment

340, 342, 343 oral implications 342 sedation 343

asymptomatic apical periodontitis 128 atomoxetine (Strattera) 367 atopy and asthma 342 atrial septal defect (ASD) 301 atrophic candidiasis 200 attention deficit hyperactivity disorder (ADHD)

365–370 background information 366 comorbidities 366 management 367

autism spectrum disorder (ASD) 377–382

background information 378 behavior guidance 380

diagnosis oral considerations

378

379

avulsions

flowchart management outcomes permanent teeth transport treatment

azathioprine

177

168

170

167–172

169

168

330, 350

bag‐valve‐masks 246 band and loop spacers beginning brushing

270

behavioral disorders

attention deficit hyperactivity disorder autism spectrum disorder

behavioral rating

223

behavior guidance/management

airway management asthma

343 autism spectrum disorder desensitization

380 functional inquiries general anesthesia

377–382

221–258

243–248

380

222 255–258

intraoperative pain management

224

231–236

221–226

237–242

224

337

277

241

281 269–274

350

30–31

31, 38, 43

modeling nitrous oxide/oxygen sedation nonpharmacological pharmacological positive reinforcement type 1 diabetes

behavior modification benzodiazepines beta agonists bilateral crossbite correction bilateral space management BioCem biopsy, Crohn’s disease bitewing radiographs

incipient decay transitional dentition

365–370

227–230

blood disorders

acute lymphoblastic leukemia 319–326 hemophilia A 313–318 sickle cell disease 233, 383–388

blood sugar levels, diabetes 334, 335 bluegrass habit appliance 276 bone grafting, cleft lip and palate 288, 295 BPD see bronchopulmonary dysplasia Brodsky Scale 238, 243 bronchopulmonary dysplasia (BPD) 359–364 brushing, start of 7 budesonide 350 bupivacaine, maximum doses 228

calcium hydroxide

methodology 112

390 Clinical Cases inPediatric Dentistry

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Index

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root end closure–apexifications 115–120 vs. mineral trioxide aggregate

candidiasis

types carbamazepine carbide burs

199–204, 342

200

373

45, 50

124

cardiovascular abnormalities, 23, 62 see also blood disorders

anticoagulant therapy

atrial septal defect

congenital heart disease

Ebstein’s anomaly

infective endocarditis

tetralogy of Fallot

305

301

300–306

354

303

23, 301

caries

cervical pulpotomies

class II glass ionomer restorations

class II resin restorations

class IV resin restorations

class V glass ionomer restorations

class V resin restorations

deep lesion removal

general anesthesia

incipient decay resin restoration

interim restorations

partial pulpotomies

risk assessment

selective removal

silver diamine fluoride Caries‐Risk Assessment Tool (CAT)

91–92

37–42

43–48

61–66

49–54

55–60

23–28

29–36

19–22, 51

103–108

8, 12, 303

78–84

15–18

303 CAT, see also Caries‐Risk Assessment Tool Catapres

367

cavity preparation

class II glass ionomer 39 class II resin restorations class V glass ionomer class V resin restorations resin restoration

32, 39

CD see Crohn’s disease celiac disease 205–208 cell‐mediated hypersensitivity reactions cementation, zirconia crowns central papillary atrophy cerebral palsy

359–364

200

250

background information 360 oral medicine 361 sedation 361 ventilation

359–360

cervical pulpotomy in cariously exposed primary

molars 91–96 CF see cystic fibrosis CHD see congenital heart disease chemotherapy see also acute lymphoblastic leukemia

acute and long‐term effects 324

mucositis 324 chicken pox 207 chlorhexidine 116, 117, 123 chronic atrophic candidiasis 200 chronic disease management 16 ciprofloxacin 129, 350 classifications

American Society of Anesthesiologists asthma seizure disorders

339

372 class II glass ionomer restorations class II resin restorations class IV resin restorations

43–48

61–66 class V glass ionomer restorations class V resin restorations cleft lip and palate

bone grafting complications diagnosis embryology etiology evaluation incidence management oral health

288, 296–297

290, 296–297

287–288, 295

286

285–292

286

286–288, 295–296

294 oral manifestations orthodontics

293–298 prenatal diagnosis presurgical treatment sequential treatment method

clonidine (Catapres clotting disorders, hemophilia A

55–60

285–298

295

286

287

) 367

288

313–318

237, 362

37–41

49–54

combined presentation attention deficit hyperactivity disorder

(ADHD‐C) 366

communication techniques, anxious patients

223

comorbidities

attention deficit hyperactivity disorder 366 natal teeth

complex pulp therapy

cervical pulpotomies indirect partial pulpotomies revascularization root canal treatments root end closure–apexification with calcium hydroxide root end closure with mineral trioxide aggregate selective caries removal

complicated crown fractures

77–132

91–96

77–84

85–90, 103–108

127–132

97–102

115–120

121–126

77–84

87, 143–148, 177

complications

airways 245 asthma 343 attention deficit hyperactivity disorder medications 367 cerebral palsy 361 of chemotherapy 324 cleft lip and palate 289 congenital heart disease 301 crossbite corrections 282 cystic fibrosis 308–310 Down syndrome 355 general anesthesia 256 head and neck infections

211 hemophilia 315 intrusion injuries 163 liver transplants 329, 330 local anesthesia 229 nitrous oxide 233 seizure disorders 373, 374

Clinical Cases inPediatric Dentistry 391

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Index

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complications (cont’d)

of trauma 136, 140–141 type 1 diabetes

Concerta

337, 355

367

cone beam computed tomography (CBCT)

cleft lip and palate orthodontic evaluation

295

261, 295

congenital conditions

amelogenesis imperfecta bronchopulmonary dysplasia cerebral palsy

359–364 cleft lip and palate Down syndrome

354–358

sickle cell disease

congenital heart disease (CHD)

anticoagulant therapy background information caries risk

301–302 infective endocarditis medical consultation

conscious sedation

51, 231–236, 240, 343 see also nitrous

215–220

359–364

285–298

233, 383–388

299–306

305

301

303

299, 301

oxide/oxygen sedation conservation, of tooth structure 34 contraindications

class II glass ionomer restorations 37 class II resin restorations class V glass ionomer cement general anesthesia nitrous oxide

232, 309 nonsteroidal anti‐inflammatory drugs partial pulpotomies pharmacological behavior guidance primary teeth pulpotomies resin restorations zirconia crowns

74 corticosteroids, asthma Coumadin

305

256, 309

315, 329

238

92, 98–99

342

craniofacial anomalies

chemotherapy effects 324 cleft lip and palate

245

cricoid Crohn’s disease (CD)

285–298

347–352 background information 347–338 diagnosis 349 management 350 oral manifestations 349 presentation

349

treatment 349, 350

crossbite, interceptive orthodontics 279–284 crowding see also space management

space analysis 270–271 space management 271

crown fractures

complicated 87, 143–148, 177 flowchart 177 treatment methods 145, 177

crowns

amelogenesis imperfecta 217 strip‐type 67–70 zirconia 71–76

Cvek pulpotomy see partial pulpotomies cyanotic conditions, congenital heart disease cyclosporine Cyklokapron cystic fibrosis (CF)

background information medical history oral manifestations treatment considerations

330

314

307–312

308

307

309

cysts

eruption mucocele

cytotoxic hypersensitivity reactions

183–188

195–198

250

DDAVP® see desmopressin decoronation, avulsions deep lesions, caries removal delayed hypersensitivity reactions dental history see also medical history;

patient history

avulsions

167–168

functional inquiries

8, 12

infants

pain space management

134, 139–140, 143, 155

trauma

dentin

80 dentinal bonding agents dentoalveolar luxation injuries desensitization

380 desmopressin (DDAVP development see growth and development developmental abnormalities

amelogenesis imperfecta

natal/neonatal teeth diabetes, type 1 diagnosis

autism spectrum disorder 377

candidiasis

201 celiac disease cleft lip and palate Crohn’s disease 350 crossbites 280–281 eruption cysts 185

diamond burs 51, 73 diazepam 241 differential diagnosis

acute odontogenic infections amelogenesis imperfecta 216 candidiasis 199 celiac disease 205, 207 Crohn’s disease 350 eruption cysts 184, 185 lower lip masses 195 primary herpetic gingivostomatitis 190, 206

Dilantin

373 diphenhydramine 251 disabilities 353–388

attention deficit hyperactivity disorder 365–366

169–170

222

265

149–154, 177

) 314

215–217

1–5, 183–188

333–338

205

286–287, 295–296

250

211

301

392 Clinical Cases inPediatric Dentistry

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Index

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autism spectrum disorder 377–382 bronchopulmonary dysplasia cerebral palsy Down syndrome intellectual seizure disorder

sickle cell disease discharge criteria, pharmacological behavior guidance discoloration disinfection of root canals distal shoes distraction techniques documentation, orthodontic Down syndrome

background information

complications

medical history

orofacial pathology

sedation doxycycline drooling DynaCleft

361

359–364

353–358

371–376, 383–388

371–376

383–388

135, 141, 329

267

224

23–25, 301, 353–358

356

354

355

356

169, 170

287, 288

359–364

240

117

259–264

354

EAPD, see also European Academy of Pediatric Dentistry early oral health

dental history

first visits

fluoride assessment

general anesthesia

healthy children

intraoral exams

medically compromised

perinatal

radiographs

silver diamine fluoride Ebstein’s anomaly embryology, cleft lip and palate endocarditis, infective enoxaparin sodium epilepsy, 371 see also seizure disorders epinephrine

administration 251

with lidocaine 32, 57

with xylocaine 44 eruption cysts 183–188 erythematous candidiasis 200 European Academy of Pediatric Dentistry (EAPD) guidelines,

radiography 31 evaluation, orthodontic 56, 259–261 executive function 366 see also attention deficit

hyperactivity disorder extremely low birth weight 359 extrusive luxation injuries 155–160, 177, 179

1–28 7

7–14

11–12

23–28

7–10

11–14

1–5

15–18

354

286

303

305

facial infections 209–214 FC see formocresol ferric sulfate (FS) pulpotomies 93 fibrin sealants 305

first generation cephalosporins first visits

caries risk assessment eruption cysts functional inquiries healthy children medically compromised perinatal

timing fluconazole fluoride assessment fluoride varnish food allergies

celiac disease

and GERD formocresol (FC) pulpotomies formoterol fostered children Frankl Behavioral Rating Scale FS see ferric sulfate full coronal restoration functional enquiries fungal infections

candidiasis 199–204

medications

1–14

183–185

222

7–10

1–5, 183–188

201

11–13

11–14

205–208

342

162

222

201

212

8, 11–14

11–14

102

223

gastroesophageal reflux disease (GERD) 11–14

and food allergies gastrointestinal disorders

celiac disease 205–208

Crohn’s disease

cystic fibrosis

liver transplants G‐CSF see granulocyte colony stimulating factor general anesthesia

administration

asthma

behavior guidance

complications

indications/contraindications

infant caries

liver transplant patients 329

preanesthetics

type 1 diabetes 337

zirconia crowns 72 GERD see gastroesophageal reflux disease GIC see glass ionomer cement gingivostomatitis, primary herpetic 189–194 glass ionomer cement (GIC)

class II 37–40, 46

class V 49–54

properties 50

selection rationale 38, 46 glucocorticoids 330, 350 gluten sensitivity 205–208 granulocyte colony stimulating factor (G‐CSF) 324 growth and development 260–298

chemotherapy effects 324

cleft lip and palate 285–298

343–344

347–352

308

327–332

256–257

255–258

256

256, 309

23–28

257

Clinical Cases inPediatric Dentistry 393

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Index

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growth and development (cont’d)

evaluation 285–292 orthodontics early primary second molar loss habit appliances leeway space mixed dentition anterior crossbite bilateral space management orthodontic documentation, evaluation and

assessment primary dentition loss, early space analysis space management bilateral, mixed dentition early primary second molar loss

guanfacine (Tenex/Intuniv)

293–297

265–268

275–278

270

279–284

269–274

260–264

265–268

270–271

265–274

269–274

265–268

367

habit appliances 275–278 Hank’s Balanced Salt Solution (HBSS) harmatomas HBSS see Hank’s Balanced Salt Solution healing, root fractures healthy children, first visits heart disease, congenital heart murmurs hemophilia

dental treatment management surgical treatment

heparin sodium herpetic gingivostomatitis high body mass index patients hospital admission, facial infections hyperactivity

disorder

hyperglycemia 335 hyperplastic candidiasis hypoglycemia hypotonia of tongue and perioral musculature

184

141, 157

7–10

299–306

61–62

313–318

315

313–314

315

305

189–194

365 see also attention deficit hyperactivity

200

55, 335

168

31, 244

211

361

IBD see inflammatory bowel disease ICS see inhaled corticosteroids IE see infective endocarditis imidazoles 201 immature permanent incisors, revascularization 127–132 immature permanent molars

partial pulpotomies 103–108 pulpotomy with mineral trioxide aggregate 109–114

immediate hypersensitivity reactions 250 immune complex hypersensitivity reactions 250 immunocompromised patients

acute lymphoblastic leukemia 322–323 liver transplants 330

immunological causes

allergic reactions 250 gingivostomatitis 190 swelling 210

immunosuppressants impulsivity

inattention

incidence

amelogenesis imperfecta asthma

Candida albicans

celiac disease cleft lip and palate comorbid attention deficit hyperactivity disorders congenital heart disease Crohn’s disease cystic fibrosis hemophilia latex anaphylaxis natal teeth recurrent herpes simplex virus salivary gland tumors sickle cell disease

type 1 diabetes incipient decay, resin restoration incisors

avulsions 167–172, 177

complicated crown fractures

dentoalveolar luxation injuries

and extrusive luxation

intrusion injuries

necrotic, revascularization

partial pulpotomies

in primary dentition

root end closure–apexification with calcium

root end closures with mineral trioxide aggregate

root fractures indications

class II glass ionomer restorations

class II resin restorations

class V glass ionomer restorations

early orthodontics

general anesthesia

interim therapeutic restorations 50

liver transplants 328

nitrous oxide 232

partial pulpotomies 87, 104

primary teeth pulpotomies 92, 98–99

revascularization 128 indirect pulp treatment (IPT) infants 7–28 see also neonatal teeth

caries risk assessment 8, 11–14

dental history 7

fluoride assessment 11–13

general anesthesia 23–28

healthy 7–9

interim restorations 19–22

intraoral exams 12

medically compromised 11–14

radiographs 25

silver diamine fluoride 15–18

366 see also attention deficit hyperactivity

disorder

366 see also attention deficit hyperactivity

disorder

339

313

185

hydroxide 115–120

330, 350

216

201

206

285–286

301

347

308

250

191

195

383–388

333

30–36

143–148, 177

149–154, 177

155–158, 177, 179

133–138, 161–166, 177

127–132

85–90

139–142

282

256

77–84

365–361

121–126

394 Clinical Cases inPediatric Dentistry

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Index

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infections

acute odontogenic candidiasis oral ulcers

199–204

207

primary herpetic gingivostomatitis

infective endocarditis (IE)

209–214

189–194

303

inflammation see also swelling

gingivostomatitis primary herpetic gingivostomatitis as swelling

inflammatory bowel disease (IBD)

190

189–194, 207

210

348 see also Crohn’s

disease inflammatory hyperplasias inflammatory root resorption infliximab

350 informed consent, orthodontics inhaled corticosteroids (ICS) initial management, cleft lip and palate innocent heart murmurs insulin‐dependent diabetes mellitus

184

170

262

342

286, 287

333–338 see also type 1

diabetes intellectual disability 371–376, 383–388 interceptive orthodontics

anterior crossbites 279–284

habit appliances interdisciplinary teams, cleft lip and palate interim therapeutic restorations (ITR) intraoperative pain management

275–278

286

19–22, 50

227–230

intraoral exams

crown fractures 143, 177

infants

trauma

140, 150

intrusion injuries

complications 163

367

177

161–166

133–138

flowchart

permanent incisors

primary incisors Intuniv IPT see indirect pulp treatment ITR see interim therapeutic restorations

ketoacidosis 335 K‐type endodontic files 99

LABA see long‐acting beta2‐agonists LAMA see long‐acting muscarinic antagonists latex allergy leeway space 270 leukotriene receptor agonists (LTRA) 342 lidocaine

class V resin restorations 32

incipient decay restoration 32

liver transplant patients 329, 330

maximum doses 228 lip taping 287, 288 liver transplants 327–332

background information 328

dental management 330

250

indications medical history treatment considerations

328

327–328

330

local anesthesia

class II resin restorations class V resin restorations complications

229 incipient decay restoration intraoperative pain management liver transplant patients maximum doses

long‐acting beta

229

‐agonists (LABA) 342

44 32

227–230

329

long‐acting muscarinic antagonists (LAMA) low birth weight lower anterior crowding

359

271 LTRA see leukotriene receptor agonists luxation injuries

dentoalveolar and root fractures splinting

lymphoblastic leukemia, acute

149–154, 180

155–160, 178, 180

150–151

319–326

Mallampati scores 244 management

asthma 339, 340, 342 attention deficit hyperactivity disorder avulsions cleft lip and palate Crohn’s disease facial infections hemophilia A herpetic lesions liver transplant patients seizures

168–169, 181

286–287, 295

348

211–212

313–314

190

330

374 mandibular shifts, crossbite corrections material selection

class II resin restorations 46 class V resin restorations glass ionomer cements

maxillary orthopedics

287

medical emergencies

anaphylaxis 251 asthma 344 bag‐valve‐masks 246 oxygen therapy 246 seizures 374

medical history 11

acute lymphoblastic leukemia 319–320 allergies 251 asthma 30, 339 avulsions 167 cleft lip and palate 286 congenital heart disease

301 cystic fibrosis 307–308 Down syndrome 24, 354 heart murmurs 62 hemophilia A 313 hypoglycemia 55 liver transplants 327

367

281

342

Clinical Cases inPediatric Dentistry 395

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