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1. Case Presentation “ Pediatric “
By : Osama Ahmad Al masry
+ Ahmad M. Ameen
Level
IX
Course Director :
Dr . Shokry
Head of Department :
Dr.Kusai Barodi

3. Abdullah Azim Jameel
File Number : 25735
Patient father’s Mobile : 0506072568

4. The Consent

5. • Patient’s Personal Data
•
•
•
•
•
Age : 9 years old
Gender : Male
Nationality : Palestinian
Teaching Grade : Elementary
Patient Attitude : Cooperative

6. Chief Complaint
I want to fix my faulty teeth !

7. Past Medical H
Respiratory system : 0
GIT : 0
Urinary tract : 0
Nervous system : 0
Endocrine system : 0
Cardiopulmonary : 0
Blood disease :0
Hospitalization : 0

8. Medical history
NAD
Nothing abnormalities detected
Patient and his family stated
that the patient is free from
any medical condition
Family history
NO SIGNIFICANT
Hypertension : no
D.M : no
Bad habits : no

9. Dental history
Last dental visit ?
Before 3 weeks , Make
PRR
With My colleague
Dr . Ibrahim
With no complications

10. Oral hygiene Activities
# Fair Oral Hygiene
# Patient very rare brushes his teeth.
# Technique of brushing: Horizontal Scrub.
# Uses a “ soft ” brush.
# Doesn’t change his toothbrush very often.
# Doesn’t visit the dentist periodically

11. Management of The Child
No abnormality in his body Function
Positive in Mood
No need for Sedation

14. Extra-oral
Examination
Transverse “non - smile”
# | Symmetrical face | .

15. Extra-oral
Examination
Antro- posterior, Vertical
# Slightly convex profile
# Competent Lips
# Normal NLA Nasiolabial
Angle“90⁰”
# normal lower
facial height.

16. Intra Oral
Examination
The Gingiva is
# pink
# Tongue, floor of the mouth
,Palate and Mucosa are
all with in the normal limit
(WNL).

17. Class II Occlusion

22. Clinical Ex.

23. Intra Oral
Examination
Loss of teeth structure in # 54 , # 55

24. Intra Oral
Examination
Loss of teeth structure in # 75 , # 85

25. Intra Oral
Examination
Occlusal Caries in # 64 , # 65

26. Diagnostic Aids

27. Radiograph

28. Panoramic Radiograph

29. Bitewings and periapical

31. Treatment plan
Treatment Objectives :
• Chief Complaint
• Oral Hygiene Motivation
To Restore:
Function.
Structure.
Esthetics.

32. Treatment plan Schedule
Site
Occlusal caries
Tooth
# 65
Procedure
Pulpotomy
Restoration
Glass ionomer then
S.S.C
Treatment Objectives of this case :
• To remove entire pulp content of coronal portion of the vital tooth
• followed by medicament to stimulate repair , Fixation of the
remaining radicular pulp .

33. Instrumentation :
1
2
3
4
5
6
7
Supplies :
1 Sterile cotton pellets
2 Formocresol (1/5 strength )
3 Zinc oxide eugenol
mirror
Explorer
Spoon Excavator
Tweezer
Plastic instrument
No. 330 curbide bur
Low , high speed piece

34. The procedure :
1 L.A and Rubber Dam
2 Remove all carioous dentin by large
Sterile spoon excavator or round bur
3 De roofing “ move the bur mesially and distally “
4 excavate the pulp tissue
5 after complete removal of coronal pulp
The hemorrhage should minimal by pressing
Cotton pellets 3 – 5 min . Over the orifices
6 Following homeostasis , replace dry pellets
With other moisted with formocresol
and squeeze out excess Before putting “ 5 min. “
7 Remove the pellets , the pulp should
appear blakcish brown .
8 Fill the chamber with IRM “ Z O E “
9 Glass ionomer

36. We hide the needle and
not to make the child sees the needle
Tell him that we will put
hot water over your teeth
And you will feel the little sting
Then We put light on his eyes
Let the assistant to hold his lips from
behind , thus hands helping
to hide eyes of the patient
Then we put the needle and injected!
When finish , we hide the needle
And the assistant raises his hand
We massage the child
to the other cheek
that not been injected
Distracting has been successfully
!!

43. Round bur
To gain access
Triangular shape
2 canals “Buccal “
One “ palatal “
330 bur
Spreading
And cutting
Endo Z bur
To De roof
of the cavity
we check with
excavator if there
Is soft caries
And for remove pulp tissue

44. To make the hemorrhage minimal

45. As medicament To fix of the pulp until
blackish brown appear

49. Post
operative
Radiograph

50. Post
operative
Photograph

51. Next Term inshallah ..

52. Management in dental office
No need a lot of praise
Not withdrawing in new situation
Time and length of appointment
No change in his behavior during and after
the procedure
Cooperative patient (easy temperament)
No Complications
Thanks for my colleague
Dr.A.Aloufi For the gift

54. Presented by :
Osama Ahmad
Course Director :
Head of Department :