Cover
Contributors
Preface
Invited Preface
Acknowledgements
About the Companion Website
Unit 1: General Considerations for Emergency Management in Children and Adolescents
1. 1.1 Developmental and Histological Aspects of Deciduous and Young Permanent Teeth
  1. Differences between Deciduous and Permanent Teeth
  2. Tooth Development and Structural Characteristics of Dental Hard Tissue
  3. Acknowledgements
  4. References
2. 1.2 Pulp Biology of Deciduous and Permanent Teeth
  1. Introduction
  2. Architecture of the Dental Pulp
  3. Dental Pulp Cells and Extracellular Matrix
  4. Blood Vessels
  5. Lymphatic Vessels
  6. Pulp Nerves
  7. Pulp Regeneration
  8. Pulp Resorption
  9. References
3. 1.3 Management of Odontogenic Infections: Indications for Antibiotics
  1. Introduction
  2. Antibiotic Resistance, Misuse and Adverse Drug Events
  3. Indications for Antibiotic Therapy
  4. Time Point, Time Period, Dosage and Drug Interval of Antibiotic Therapy
  5. Antibiotic Prophylaxis
  6. Conclusion
  7. References
4. 1.4 Management of Pain and Fear: Behavioural Management, Anaesthesia and Sedation
  1. Introduction
  2. Behavioural Management
  3. Diagnosis
  4. Fear Management/Anxiolysis
  5. Local Anaesthesia
  6. Referring the Patient
  7. References
5. 1.5 Management of Radiographic Needs
  1. Imaging Procedures in Dentomaxillofacial Radiology
  2. Imaging Procedures in Children and Adolescents
  3. Biological Risk in Children and Adolescents
  4. Dental Emergencies in Children and Adolescents
  5. Case Studies
  6. Conclusion
  7. References
Unit 2: Management of Tooth Substance Loss
1. 2.1 Deep Carious Lesions and the Dental Pulp
  1. Introduction
  2. Origin of Pulpitis, Pain and Necrosis
  3. Pulpitis and Periradicular/Periapical Periodontitis in the Primary and Permanent Dentitions
  4. The Spectrum of Pain
  5. Managing Deep Lesions: Treat the Carious Lesion or Treat the Pulp?
  6. Strategies for Dealing with Carious Lesions
  7. Conclusion
  8. References
2. 2.2 Management of Crown Fractures and Crown‐Root Fractures
  1. Epidemiological Data
  2. Enamel Infractions
  3. Crown Fractures
  4. Crown‐Root Fractures
  5. Management of Crown and Crown‐Root Fractures of Deciduous Teeth
  6. References
3. 2.3 Management of Root Fractures
  1. Introduction
  2. Biological Considerations
  3. Diagnostics of Root Fractures
  4. Treatment and Prognosis of Root Fractures
  5. Recall
  6. References
Unit 3: Management of Open Pulp in Permanent Teeth
1. 3.1 Pulpotomy after Trauma
  1. Introduction
  2. Dental Trauma
  3. Pulp Histology
  4. Pulp Vascularisation
  5. Pulpotomy
  6. Conclusion
  7. References
2. 3.2 Pulpectomy with Open Apex
  1. Introduction
  2. Choice of Treatment
  3. Clinical Procedure
  4. MTA and Bioceramic
  5. References
3. 3.3 Regenerative Endodontic Procedures
  1. Introduction
  2. Patient Selection
  3. Treatment Protocol
  4. Success and Future of REPs
  5. References
Unit 4: Management of Open Pulp in Deciduous Teeth
1. 4.1 Pulpotomy
  1. Introduction
  2. Indications and Contraindications
  3. Pulpotomy Techniques
  4. Other Techniques and Materials
  5. Conclusion
  6. References
2. 4.2 Pulpectomy of Deciduous Teeth
  1. Introduction
  2. Indication of Pulpectomy
  3. Clinical Procedure
  4. Conclusion
  5. References
3. 4.3 Tooth Extraction
  1. Introduction
  2. Extraction of Incisors
  3. Extraction of Molars
  4. Extractions in Emergency Situations
  5. References
Unit 5: Management of Missing Teeth
1. 5.1 Reconstructive Considerations
  1. Introduction
  2. Treatment Plan for Managing Anterior Tooth Loss during Growth
  3. Reconstructive Treatment Options
  4. Design and Material Selection of Resin‐Bonded Restorations
  5. Adhesive Cementation of Resin‐Bonded FDPs
  6. Conclusion
  7. Acknowledgements
  8. References
2. 5.2 Management of Avulsed Teeth
  1. Introduction
  2. Terminology
  3. Behavior at the Scene of the Accident
  4. Procedure in the Dental Practice
  5. Prognosis
  6. References
3. 5.3 Autotransplantation
  1. Introduction
  2. Trauma and the PDL
  3. Autotransplantation
  4. Traumatic Injuries in Later Life
  5. Conclusion
  6. References
4. 5.4 Orthodontic Aspects of Missing Teeth at Various Ages
  1. Introduction
  2. Early Tooth Loss
  3. Congenitally Missing Teeth
  4. References
Unit 6: Management of Oral Health Conditions
1. 6.1 Viral Causes Affecting the Oral Mucosa
  1. Introduction
  2. Common Viral Infections in Children that Affect the Oral Mucosa
  3. Viral Infections in Children that Less Frequently or Only Indirectly Affect the Oral Mucosa
  4. Conclusion
  5. References
2. 6.2 Non‐infective Swellings
  1. Introduction
  2. Tumours, Cysts and Extravasation or Retention Phenomena in the Soft Tissues
  3. Jaw Cysts, Odontogenic Tumours and Treatment in Children
  4. References
3. 6.3 Oral Problems in Patients Undergoing Haematology or Oncology Treatment
  1. Introduction
  2. Haemostasis
  3. Disorders of the Immune System/Granulocytes
  4. Anaemia
  5. Mucositis
  6. Graft‐versus‐Host Disease
  7. Management
  8. References
Unit 7: Management of Non‐infective Dental Conditions
1. 7.1 Molar–Incisor Hypomineralisation
  1. Introduction
  2. Diagnosis of MIH
  3. Aetiology of MIH
  4. Prevention of MIH
  5. Noninvasive Dental Care of MIH‐Affected Teeth
  6. Restorative Dental Care
  7. Cavity Preparation
  8. Treatment of the Dentin–Pulp Complex
  9. Extraction and Orthodontic Space Closure
  10. Interim Management until Adolescence or Adulthood
  11. Implications for Dental Practice
  12. References
2. 7.2 Dentine Hypersensitivity
  1. What is Dentine Hypersensitivity?
  2. How Does DH Occur?
  3. Prevalence of DH in Children and Adolescents
  4. Clinical Aspects of DH in Children and Adolescents
  5. Clinical Management of DH
  6. Conclusion
  7. References
3. 7.3 Cracked Tooth Syndrome
  1. What is Cracked Tooth Syndrome?
  2. Epidemiology
  3. Aetiology
  4. Clinical Picture
  5. Diagnosis
  6. Clinical Management
  7. Conclusion
  8. Acknowledgements
  9. References
Index
End User License Agreement

List of Tables

Chapter 1.3
1. Table 1.3.1 The main antibiotics used in paediatric dental patients (according t...
2. Table 1.3.2 American Heart Association (AHA) antibiotic prophylaxis (AP) regimen...
Chapter 2.2
1. Table 2.2.1 Treatment options for crown‐root fractures (modified after Weiger et...
Chapter 2.3
1. Table 2.3.1 Factors related to favourable pulpal (PU) and periodontal (PE) heali...
Chapter 3.2
1. Table 3.2.1 Clinical protocol summary.
Chapter 4.1
1. Table 4.1.1 Indications and contraindications for pulpotomy in primary molars.
2. Table 4.1.2 Different pulpotomy materials and their action on the pulp.
Chapter 5.1
1. Table 5.1.1 Factors evaluated during clinical examination and via panoramic radi...
2. Table 5.1.2 Options and indications for one‐ and two‐wing metal or full ceramic ...
3. Table. 5.1.3 Cementation of metal and full‐ceramic resin‐bonded FDPs.
Chapter 6.3
1. Table 6.3.1 Causes of thrombocytopaenia (Hoffbrand and Moss, 2016).
2. Table 6.3.2 World Health Organization (WHO) Classification of Hematologic Malign...
Chapter 7.2
1. Table 7.2.1 Studies reporting the prevalence of DH in children and adolescents.

List of Illustrations

Chapter 1.1
1. Figure 1.1.1 (a) Deciduous teeth have a significantly thinner enamel layer tha...
2. Figure 1.1.2 The prisms in deciduous teeth are more curved than those in perma...
3. Figure 1.1.3 (a–d) Stages in the development of deciduous and permanent teeth:...
4. Figure 1.1.4 Tooth germ at the cap stage.
5. Figure 1.1.5 Tooth germ at the early bell stage.
6. Figure 1.1.6 Tooth germ at the bell stage.
7. Figure 1.1.7 Hertwig epithelial root sheath with outer and inner enamel epithe...
8. Figure 1.1.8 Apical view (left) and view from the side (right) of the developi...
9. Figure 1.1.9 Vertical section through the crown of a permanent tooth. The cycl...
10. Figure 1.1.10 Enlargement of the tooth surface, clearly showing the perikymata...
11. Figure 1.1.11 Columnar and piston‐like enamel spindles extending from the dent...
12. Figure 1.1.12 (a,b) Enamel buds unfold like grass tufts from the dentinoenamel...
13. Figure 1.1.13 A real enamel pearl lies on the dentin in the root area. It is s...
14. Figure 1.1.14 On the root surface of a permanent tooth, a composite enamel pea...
15. Figure 1.1.15 Scanning electron micrograph (SEM) image of cross‐sectioned dent...
16. Figure 1.1.16 Light microscope image of dentin with incremental lines of von E...
17. Figure 1.1.17 After removal of the predentin, the calcospherites facing the pu...
18. Figure 1.1.18 Light microscope image of the dentinoenamel boundary (upper righ...
19. Figure 1.1.19 Sharpey fibre bundles anchored in a thin layer of acellular extr...
20. Figure 1.1.20 Repair of superficial root resorption by intrinsic cellular ceme...
21. Figure 1.1.21 During the development of cementum, cementoblasts are enclosed w...
22. Figure 1.1.22 Cellular mixed‐fibre cementum consisting of superposed layers of...
23. Figure 1.1.23 Horizontal section through the middle of a tooth root. The root ...
Chapter 1.2
1. Figure 1.2.1 Histologic overview (Gomori staining) of the pulp chamber of (a) ...
2. Figure 1.2.2 Histologic section (HE staining) of the pulp periphery, showing (...
3. Figure 1.2.3 Histologic section (HE staining) of the cell‐rich zone of the odo...
4. Figure 1.2.4 Histologic section (Azan staining) of the root pulp. (a) The cent...
5. Figure 1.2.5 Histologic view of pulp connective tissue (a) with reticular cell...
6. Figure 1.2.6 Higher‐magnification images of immunocompetent cells within the p...
7. Figure 1.2.7 Histologic sections (HE staining) demonstrating various intrapulp...
8. Figure 1.2.8 Histologic section (HE staining) of a deciduous root canal pulp w...
9. Figure 1.2.9 (a) Scanning electron micrograph of an odontoclast (1) surrounded...
10. Figure 1.2.10 Histologic section (HE staining) of the pulp resorption area of ...
11. Figure 1.2.11 Histologic (Azan staining) overview of an internal granuloma fol...
12. Figure 1.2.12 Higher‐magnification image of odontoclasts (arrows) resorbing de...
Chapter 1.3
1. Figure 1.3.1 Clinical situations in which antibiotic therapy is and is not ind...
Chapter 1.4
1. Figure 1.4.1 Sometimes, patients seek emergency treatment over trivial matters...
2. Figure 1.4.2 (a) A 5‐year‐old patient with disabilities was referred by a neur...
3. Figure 1.4.3 A safe position for inspection of toddlers and infants can be ach...
4. Figure 1.4.4 (a) Totally neglected oral health in a 4‐year‐old patient. Dentin...
5. Figure 1.4.5 (a) Serious lip injury 1 day after dental treatment in the lower ...
6. Figure 1.4.6 Conscious sedation with oxygen/nitrous oxide allows perfect treat...
7. Figure 1.4.7 (a) The facial swelling and the reduced general condition indicat...
Chapter 1.5
1. Figure 1.5.1 Number of excess cancer deaths caused by a single radiation expos...
2. Figure 1.5.2 (a,b) Bitewings for caries detection in children.
3. Figure 1.5.3 (a,b) Bitewings for caries detection in adolescents.
4. Figure 1.5.4 Complicated wisdom tooth eruption with retromolar swelling. (a) C...
5. Figure 1.5.5 (a) Initial bitewing radiograph showing a conic tooth 18. (b) The...
6. Figure 1.5.6 (a) Extraoral and (b) intraoral swelling in an 8‐year‐old patient...
7. Figure 1.5.7 (a,b) Clinical view of the malformation of tooth 32 in an 8‐year‐...
8. Figure 1.5.8 (a) Clinical view showing incomplete eruption of tooth 11. This s...
9. Figure 1.5.9 (a) Swelling, pain and redness in the area of the incisive papill...
10. Figure 1.5.10 (a) Panoramic radiograph showing a round opaque structure in the...
11. Figure 1.5.11 (a) Clinical view of an incompletely retained tooth 36 in a 7‐ye...
12. Figure 1.5.12 (a,b) Extraoral and clinical view showing a swelling in the area...
Chapter 2.1
1. Figure 2.1.1 Diagrammatic representation of (a) a noncavitated and (b) a cavit...
2. Figure 2.1.2 Radiograph of tooth 74 (lower left first primary molar) showing a...
3. Figure 2.1.3 Abscess at the mucogingival junction of the buccal mucosa of toot...
4. Figure 2.1.4 Deep carious lesions on the lower right first and second premolar...
5. Figure 2.1.5 Selective removal of dentin. (a) Two deep lesions in an upper sec...
6. Figure 2.1.6 Selective enamel etching. (a) Initial situation. A dentin shadow ...
Chapter 2.2
1. Figure 2.2.1 Enamel cracks of the upper right central incisor and crown fractu...
2. Figure 2.2.2 Small enamel fractures of both upper central incisors.
3. Figure 2.2.3 (a) Enamel fracture of the upper right central incisor. Dentin is...
4. Figure 2.2.4 (a) Crown fracture. (b) Tooth fragment kept under moist condition...
5. Figure 2.2.5 (a) Crown fracture of the upper left lateral incisor. (b) The cro...
6. Figure 2.2.6 (a) 7‐year‐old patient with typical crown fracture of the upper r...
7. Figure 2.2.7 (a) Crown fracture. (b) Direct composite restoration under optima...
8. Figure 2.2.8 (a) 9‐year‐old boy with typical crown‐root fracture of the upper ...
9. Figure 2.2.9 (a) Crown‐root fracture. Surgical extrusion: (b) Extraction and r...
10. Figure 2.2.10 Crown fractures of upper central primary incisors in a 1.5‐year‐...
11. Figure 2.2.11 Crown‐root fracture of a primary incisor. Extraction is necessar...
Chapter 2.3
1. Figure 2.3.1 Tissues affected by root fracture injury: pulp (purple) and perio...
2. Figure 2.3.2 Routes for microbial infection of the root fracture injury site: ...
3. Figure 2.3.3 (a) Periapical radiograph (orthogonal exposure) suggesting a comp...
Chapter 3.1
1. Figure 3.1.1 Illustration of different crown fractures according to our sugges...
2. Figure 3.1.2 Strong proliferative pulp reaction following complicated crown fr...
3. Figure 3.1.3 Fast pulpal reaction with overgrowth of the pulp soft tissue thro...
4. Figure 3.1.4 Diagnostic procedure in complicated crown fracture – clinical pic...
5. Figure 3.1.5 (a) Complicated crown fracture. (b) Surgical removal of the injur...
6. Figure 3.1.6 (a) Complicated crown fracture. (b) Pulp amputation – fast handpi...
7. Figure 3.1.7 (a) x‐ray taken immediately after Cvek pulpotomy. (b) x‐ray taken...
8. Figure 3.1.8 (a) Complicated crown fracture. (b) Surgical removal of the pulp ...
9. Figure 3.1.9 (a) x‐ray taken 30 hours after injury. A large pulpal wound and i...
10. Figure 3.1.10 (a) x‐ray taken before extended pulpotpmy. (b) x‐ray taken 5 mon...
Chapter 3.2
1. Figure 3.2.1 (a) Preoperative placement of a composite, allowing for use of a ...
2. Figure 3.2.2 MTA, the material of choice for direct apexification.
3. Figure 3.2.3 (a,b) Total Fill RRM premixed: a bioceramic putty material that i...
4. Figure 3.2.4 (a) Delivery system for MTA/bioceramic (MAP System Produits Denta...
5. Figure 3.2.5 (a) Buchanan Hand Pluggers for condensation. (b) Machtou Hand Plu...
6. Figure 3.2.6 BL SuperEndo Beta for application of heated gutta‐percha during b...
7. Figure 3.2.7 (a) Preoperative status. (b) 4 weeks’ follow‐up. (c) Postoperativ...
8. Figure 3.2.8 (a) Periradicular radiolucency on tooth 36 in a 10‐year‐old boy. ...
Chapter 3.3
1. Figure 3.3.1 Diagram showing different aspects of the prognosis of successful ...
2. Figure 3.3.2 (a) Immature front tooth (11) with pulpal necrosis and a vestibul...
Chapter 4.1
1. Figure 4.1.1 (a,b) Preoperative bitewing radiographs.
2. Figure 4.1.2 Bleeding following coronal pulp removal.
3. Figure 4.1.3 Use of a wet cotton pellet to induce haemostasis by application o...
4. Figure 4.1.4 (a) Application of FS. (b) Pulp stumps following application of F...
5. Figure 4.1.5 Final restoration using a preformed metal crown.
6. Figure 4.1.6 Post‐ operative periapical radiograph showing a pulpotomy on a pr...
7. Figure 4.1.7 Application of Portland cement paste in the pulp chamber.
8. Figure 4.1.8 Postoperative radiograph after final restoration with a preformed...
Chapter 4.2
1. Figure 4.2.1 (a) Interradicular radiolucency indicating pulp necrosis after tr...
2. Figure 4.2.2 Deciduous teeth often have accessory lateral canals, which facili...
3. Figure 4.2.3 (a) A deep distal caries hampers efficient cleaning during intene...
4. Figure 4.2.4 Only the upper two‐thirds of the root canals of deciduous roots n...
5. Figure 4.2.5 (a,b) Traumatic luxation of tooth 51 in a 5‐year‐old boy with los...
6. Figure 4.2.6 (a) Hyperaemia of a trauma tooth after trephination. Especially i...
7. Figure 4.2.7 (a) Pain and swelling around tooth 65. Because tooth preservation...
8. Figure 4.2.8 In deciduous endodontics, a crown‐down technique is often advised...
9. Figure 4.2.9 Apical protrusion of the root canal dressing due to condensation ...
Chapter 4.3
1. Figure 4.3.1 Resorbable sutures after multiple extractions in a small child tr...
2. Figure 4.3.2 Danger of damaging the permanent tooth by excessive labial moveme...
3. Figure 4.3.3 Elevators should not be used against a freshly erupted tooth, bec...
4. Figure 4.3.4 Schematic procedure of splitting a lower deciduous molar prior to...
5. Figure 4.3.5 Radiograph of an ankylosed lower second deciduous molar. It was d...
Chapter 5.1
1. Figure 5.1.1 (a–d) Short‐term provisional adhesive restoration with patient’s ...
2. Figure 5.1.2 (a–f) Short‐term provisional adhesive restoration with a glass‐fi...
3. Figure 5.1.3 (a,b) Rochette‐type adhesive restoration.
4. Figure 5.1.4 (a–h) Situation with reduced space width (area 21) and coronal fr...
5. Figure 5.1.5 (a–f) 18‐year‐old patient (trauma experienced at age 8) with miss...
6. Figure 5.1.6 (a–f) 15‐year‐old patient (trauma experienced at age 8) with miss...
7. Figure 5.1.7 (a–f) 22‐year‐old patient showing minimal preparation at tooth 23...
Chapter 5.2
1. Figure 5.2.1 Dental trauma poster published by the Center of Dental Traumatolo...
2. Figure 5.2.2 Clinical situation after avulsion and fracture in the enamel on t...
3. Figure 5.2.3 Dental film of the upper first incisor region (taken outside of t...
4. Figure 5.2.4 Removal of the coagulum by rinsing with sterile isotonic saline s...
5. Figure 5.2.5 Opening of a NoResorb capsule.
6. Figure 5.2.6 Storage of an avulsed upper left central incisor in the medium of...
7. Figure 5.2.7 Replantation of an upper left central incisor (in this case, the ...
8. Figure 5.2.8 Etching of the enamel.
9. Figure 5.2.9 Etching of the enamel of the upper left central incisor conducted...
10. Figure 5.2.10 Conditioning of the enamel.
11. Figure 5.2.11 Conditioning of the enamel of the upper left central incisor con...
12. Figure 5.2.12 Fixation of the TTS with a composite of low viscosity (in this c...
13. Figure 5.2.13 Upper left central incisor following replantation and fixation o...
14. Figure 5.2.14 Dental film of the upper left central incisor as control after 2...
15. Figure 5.2.15 Clinical situation after 1 week. In the meantime, trepanation of...
16. Figure 5.2.16 Composite with fluorescence, which can be made visible with the ...
17. Figure 5.2.17 Clinical situation after 4 weeks.
18. Figure 5.2.18 Clinical situation after 3 months, when root canal treatment was...
19. Figure 5.2.19 Infection‐related root resorption on the upper left central inci...
20. Figure 5.2.20 Osseous replacement in the upper left central incisor. Radiograp...
21. Figure 5.2.21 Infraposition of the upper left central incisor by ankylosis. Cl...
Chapter 5.3
1. Figure 5.3.1 12 weeks after replantation, external root resorption becomes vis...
2. Figure 5.3.2 Positive response of the two upper front teeth to sensitivity tes...
3. Figure 5.3.3 (a–c) Progression of external root resorptions over 6 months.
4. Figure 5.3.4 Tooth size discrepancy of the upper front teeth.
5. Figure 5.3.5 (a,b) Autotransplantation of two premolars with open apex.
6. Figure 5.3.6 Clinical situation directly after surgery. The position of the tr...
7. Figure 5.3.7 Same patient as in Figure 5.3.6, occlusal view.
8. Figure 5.3.8 (a,b) The extracted front teeth give important information for th...
9. Figure 5.3.9 6 weeks after autotransplantation, the teeth can be moved aorthod...
10. Figure 5.3.10 (a–c) Remodelling the premolars into upper incisors, and continu...
11. Figure 5.3.11 (a,b) 6 months after autotransplantation, the periapical radiogr...
12. Figure 5.3.12 (a,b) 8 years after trauma, ankylosis of tooth 11 has led to und...
13. Figure 5.3.13 (a,b) Root canal treatment and autotransplantation of a premolar...
14. Figure 5.3.14 (a,b) 6 weeks after autrotransplantation, there are no pockets a...
15. Figure 5.3.15 (a,b) After adding a provisional composite veneer, the tooth can...
16. Figure 5.3.16 (a,b) Final composite veneer. The vertical bone defect has been ...
Chapter 5.4
1. Figure 5.4.1 9‐year‐old boy who has lost teeth 21 and 11 due to ankylosis (a a...
2. Figure 5.4.2 If tooth loss is monolateral, as in this 10‐year‐old boy (a and c...
3. Figure 5.4.3 12‐year‐old boy whose teeth 11 and 21 have been extracted due to ...
4. Figure 5.4.4 If the bone level between the deciduous molar and the adjacent pe...
5. Figure 5.4.5 7.2‐year‐old girl whose tooth 55 was prematurely lost. Due to the...
6. Figure 5.4.6 Ectodermal dysplasia patient at ages 6 (top) and 18 (bottom). The...
7. Figure 5.4.7 Extraction of teeth 75 and 85, due to their short roots and poste...
8. Figure 5.4.8 5‐year‐old boy affected by ectodermal dysplasia. The absence of t...
9. Figure 5.4.9 To ensure an anterior limit for the tongue and improve aesthetics...
10. Figure 5.4.10 Root and tooth movement maintains the height and width of the al...
11. Figure 5.4.11 Boy with ectodermal dysplasia (a and b) at ages 5 and 7 (e and f...
12. Figure 5.4.12 In case of aplasia of lateral incisors, the canine can be shifte...
13. Figure 5.4.13 In case of missing lateral incisors at the end of orthodontic tr...
Chapter 6.1
1. Figure 6.1.1 20‐month‐old boy with a primary herpetic gingivostomatitis exhibi...
2. Figure 6.1.2 16‐year‐old girl with a primary herpetic gingivostomatitis exhibi...
3. Figure 6.1.3 Reactivation of an HSV‐1 infection presenting as herpes labialis ...
4. Figure 6.1.4 Recurrence of VZV infection (shingles) exhibiting unilateral vesi...
5. Figure 6.1.5 Characteristic oral squamous papilloma in a 15‐year‐old boy prese...
6. Figure 6.1.6 Characteristic oral squamous papilloma in a 12‐year‐old girl pres...
7. Figure 6.1.7 7.5‐year‐old girl with common warts on (a) the right ring finger ...
8. Figure 6.1.8 5‐year old girl with a common wart on the upper left lip, confirm...
9. Figure 6.1.9 Epithelial hyperplasia in a 21‐year old man, characterised by mul...
10. Figure 6.1.10 (a) 5‐year old boy with hand‐foot‐and‐mouth disease exhibiting m...
11. Figure 6.1.11 HL in a 29‐year‐old man recently diagnosed with HIV, exhibiting ...
Chapter 6.2
1. Figure 6.2.1 13‐year‐old boy with a swelling on the lower right lip. (a) Extra...
2. Figure 6.2.2 Retention phenomenon on the left floor of the mouth.
3. Figure 6.2.3 Ranula on the right floor of the mouth in a 13‐year‐old boy.
4. Figure 6.2.4 Panoramic radiograph with a well‐demarcated osteolysis in the rig...
5. Figure 6.2.5 CBCT (3D Accuitomo 170, Morita Corp., Kyoto, Japan; field of view...
6. Figure 6.2.6 Eruption cyst on the anterior lower jaw in a neonate.
7. Figure 6.2.7 Panoramic radiograph of 14‐year‐old boy. Teeth 17, 27, 44, 45 and...
8. Figure 6.2.8 17‐year‐old girl with multiple osteolytic lesions and displacemen...
9. Figure 6.2.9 17‐year old girl with an ameloblastoma in the right mandible in t...
Chapter 6.3
1. Figure 6.3.1 Gingival swelling and acute myeloid leukaemia.
2. Figure 6.3.2 Thrush (Candida).
3. Figure 6.3.3 (a–c) Graft‐versus‐host disease.
Chapter 7.1
1. Figure 7.1.1 Hypomineralisation on (a) an occlusal and (b) a smooth surface wi...
2. Figure 7.1.2 Mild, small‐sized enamel breakdown on (a) a hypomineralised occlu...
3. Figure 7.1.3 Moderate, medium‐sized enamel breakdown on (a) a hypomineralised ...
4. Figure 7.1.4 Severe enamel breakdown on (a) a hypomineralised occlusal surface...
5. Figure 7.1.5 Influencing factors and possible treatment options in MIH‐related...
6. Figure 7.1.6 Clinical management of a moderate enamel breakdown on an occlusal...
Chapter 7.2
1. Figure 7.2.1 Deciduous molar with (a) ETW lesions on the occlusal surface, exh...
Chapter 7.3
1. Figure 7.3.1 CTS‐predisposing factors.
2. Figure 7.3.2 Cracked line visible in the distal region of the occlusal surface...
3. Figure 7.3.3 Diagnosis of CTS.
4. Figure 7.3.4 (a–d) Fracfinder – different sizes of instruments and diagnostic ...
5. Figure 7.3.5 Transillumination of the tooth can help detect cracks.

Edited by

PD Dr. med. dent. Klaus W. Neuhaus, MMA MAS
Clinic of Periodontology, Endodontology and Cariology
University Center for Dental Medicine Basel
University of Basel, Basel, Switzerland;
Private dental office, Herzogenbuchsee, Switzerland

Prof. em. Dr. med. dent. Adrian Lussi, dipl. Chem.Ing. ETHZ
Department of Preventive, Restorative and Pediatric Dentistry
School of Dental Medicine
University of Bern, Bern, Switzerland

This edition first published 2019
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Cover Illustration and Layout: BernadetteRawyler
Cover Images: © Meinzahn/Getty Images, © wScottLoy/Getty Images, © Image Source/Getty Images, © knape/Getty Images, Photo Credit (FOR 3 INSET PHOTOGRAPHS) Klaus W. Neuhaus

Contributors

Julia Amato
Department of Periodontology,
Endodontology and Cariology,
University Center for Dental Medicine Basel,
University of Basel, Basel, Switzerland

Wolfgang H. Arnold
Department of Biological and Material
Sciences in Dentistry, School of Dentistry,
Faculty of Health, Witten/Herdecke
University, Witten, Germany

Dick S. Barendregt
Department of Periodontology,
ACTA, Amsterdam, Netherlands;
Private dental office Proclin Rotterdam,
Netherlands

Michael M. Bornstein
Oral and Maxillofacial Radiology,
Applied Oral Sciences, Faculty of Dentistry,
The University of Hong Kong, Hong Kong,
China

Thiago Saads Carvalho
Department of Restorative,
Preventive and Pediatric Dentistry,
School for Dental Medicine,
University of Bern, Bern, Switzerland

Renata Chałas
Department of Conservative Dentistry
and Endodontics, Medical University of
Lublin, Lublin, Poland

Vivianne Chappuis
Department of Oral Surgery and
Stomatology, School of Dental Medicine,
University of Bern, Bern, Switzerland

Karl Dula
Department of Oral Surgery and
Stomatology, School for Dental Medicine,
Bern, Switzerland; Private dental office,
Chiasso, Switzerland

Edwin Eggink
Private dental office Proclin Rotterdam,
Netherlands

Andreas Filippi
Department of Oral Surgery and
Center of Dental Traumatology,
University Center for Dental
Medicine Basel,
University of Basel, Basel, Switzerland

Vlasios Goulioumis
Department of Operative and Preventive
Dentistry, School of Dentistry, Faculty of
Health, Witten/Herdecke University,
Witten, Germany

Stefan Hänni
Department of Preventive,
Restorative and Pediatric Dentistry,
School for Dental Medicine, University
of Bern, Bern, Switzerland; Private
endodontic office, Bern, Switzerland

Roswitha Heinrich‐Weltzien
Department of Preventive and Paediatric
Dentistry, Jena University Hospital,
Jena, Germany

Nicola P. Innes
Department of Paediatric Dentistry,
School of Dentistry, University of Dundee,
Dundee, United Kingdom

Samira Helena João‐Souza
Department of Restorative, Preventive
and Pediatric Dentistry, School for Dental
Medicine, University of Bern, Bern,
Switzerland

Hrvoje Jurić
Department of Paediatric and Preventive
Dentistry, School of Dental Medicine,
University of Zagreb, Zagreb, Croatia

Gabriel Krastl
Department of Conservative Dentistry
and Periodontology and Center of Dental
Traumatology, University Hospital of
Würzburg, Würzburg, Germany

Jan Kühnisch
Department of Conservative Dentistry
and Periodontology,
Ludwig‐Maximilians‐University,
Munich, Germany

Rafael Lazarin
Department of Oral Surgery and
Stomatology, School of Dental Medicine,
University of Bern, Bern, Switzerland

Maria Lessani
School of Dentistry, Birmingham, United
Kingdom; Private dental office, London,
United Kingdom

Manfred Leunisse
Clinic for Orthodontics, Rotterdam,
Netherlands

Marcel L. E. Linssen
Private dental office Proclin Rotterdam,
Netherlands

Adrian Lussi
Department of Preventive, Restorative
and Pediatric Dentistry, School of Dental
Medicine, University of Bern, Bern,
Switzerland

Birte Melsen
Department of Orthodontics, University of
Western Australia, Perth, Australia

Joana Monteiro
Department of Paediatric Dentistry,
Eastman Dental Hospital, London,
United Kingdom

Ella A. Naumova
Department of Biological and Material
Sciences in Dentistry, School of Dentistry,
Faculty of Health, Witten/Herdecke
University, Witten, Germany

Klaus W. Neuhaus
Clinic of Periodontology, Endodontology
and Cariology, University Center
for Dental Medicine Basel,
University of Basel, Basel, Switzerland;
Private dental office, Herzogenbuchsee,
Switzerland

Jakob Passweg
Department of Hematology, University
Hospital Basel, Basel, Switzerland

Isabelle Portenier
Department of Endodontics, Dental Faculty,
University of Oslo, Oslo, Norway;
Private dental clinic, Nyon, Switzerland and
Oslo, Norway

Adrian M. Ramseier
Department of Oral Health & Medicine,
University Center for Dental Medicine Basel,
University of Basel, Basel, Switzerland

Dan‐Krister Rechenberg
Clinic of Preventive Dentistry,
Periodontology and Cariology, Center of
Dental Medicine, University of Zurich,
Zurich, Switzerland

Nadja Rohr
Department of Reconstructive Dentistry,
University Center for Dental Medicine
Basel, University of Basel, Basel, Switzerland

Markus Schaffner
Department of Preventive, Restorative
and Pediatric Dentistry, School of Dental
Medicine, University of Bern, Bern,
Switzerland

Nathalie Scheidegger Stojan
Private dental office, Biel, Switzerland

Falk Schwendicke
Department of Operative and Preventive
Dentistry, Charité Centre for Dental
Medicine, Berlin, Germany

Richard Steffen
Clinic of Orthodontics and Paediatric
Dentistry, University Center for Dental
Medicine Basel,
University of Basel, Basel, Switzerland;
Private dental office, Weinfelden,
Switzerland

Eirini Stratigaki
Clinic of Orthodontics and Pediatric
Oral Health, University Center for Dental
Medicine Basel, University of Basel, Basel,
Switzerland

Valerie G. A. Suter
Department of Oral Surgery and
Stomatology, School of Dental Medicine,
University of Bern, Bern, Switzerland

Hubertus van Waes
Clinic of Orthodontics and Pediatric
Dentistry, Center of Dental Medicine,
University of Zurich, Zurich,
Switzerland

Carlalberta Verna
Department of Orthodontics and Paediatric
Dentistry, University Center for Dental
Medicine Basel, University of Basel, Basel,
Switzerland

Tuomas Waltimo
Department of Oral Health & Medicine
University Center for Dental
Medicine Basel,
University of Basel, Basel, Switzerland

Cynthia K. Y. Yiu
Paediatric Dentistry, Faculty of Dentistry,
The University of Hong Kong,
Hong Kong, China

Nicola U. Zitzmann
Department of Reconstructive Dentistry,
University Center for Dental Medicine
Basel, University of Basel, Basel,
Switzerland

Andrea Zürcher
Department of Oral Surgery and
Center of Dental Traumatology,
University Center for Dental
Medicine Basel,
University of Basel, Basel,
Switzerland

Preface

Dear readers,

Dental emergency situations are often demanding due to the patient’s pain, or due to time constraints on the dentists’ side. When children or adolescents suffer dental emergencies, the situation might be even more challenging because of the patients’ age, the worried patients, not rarely accompanied by loud screaming. In this setting it is demanding for the dental team to remain quiet and provide the necessary and considerate treatment.

This book aims at providing some assistance to dental practitioners in order to better manage potentially stressful situations with children and adolescents in the dental office.

The focus lies on the management of therapeutic demands.

The content of this book is not totally new. Knowledge can be obtained from books on dental traumatology, cariology, pediatric dentistry, endodontology, or orthodontics. However, this is the first time that a textbook particularly emphasizes how to manage emergency situations with young patients only, and which treatments potentially could be offered once the acute emergency is over.

While the first section of the book recapitulates the biologic and developmental differences between treatment of adults vs. children/adolescents, the following chapters emphasize how to manage tooth substance loss, how to deal with endodontic problems in deciduous teeth or in teeth with an open apex. Furthermore, general dental practitioners should be aware of the long‐term consequences of early tooth loss, and of methods to deal with that.

Because teeth are not the only possible cause for emergencies in the dental office, other chapters focus on oral health related problems and on the management of non‐infective conditions.

We are happy about the more than competent team of contributing authors. We chose authors that deal with young to very young patients every day in order to guarantee as much practical relevance as possible. At the same time the authors are experienced lecturers and have up‐to‐date theoretical knowledge included in their chapters.

We hope that reading this book help the readers to acquire a higher level of confidence while coping with demanding emergency situations of children and adolescents during daily work.

Klaus W. Neuhaus
Adrian Lussi

Invited Preface

Dental emergencies in children and adolescents are ‘grist for the mill’ for paediatric dentists and endodontists. However, during our initial dental training, we are mostly taught by individual disciplines, and therefore it is easy to miss the interdisciplinary nature of the care required for paediatric and adolescent emergencies that provides the best outcome for the patient.

To have a book that brings the elements of comprehensive emergency care together is of great benefit to clinicians. The editors have brought together a host of dental clinicians as authors who have a wealth of relevant experience that is shared in the text.

Emergencies in children are different to those for older individuals. As development is still occurring, this has great influence on treatment planning, as well as the ability to provide the best care for the child. Development includes both physical, psychological and behavioural aspects, and these need to be considered in both immediate and long‐term definitive care.

Treatment of emergencies has evolved over the years as the evidence has improved, however, there is still much to learn regarding the most appropriate care for the individual patient. For example, the chapter on management of deep carious lesions illustrates the vast changes that have evolved as the related evidence‐base increases in size and validity – treatment of the deep carious lesion is far less aggressive than in previous decades, as the importance of maintenance of pulpal health and ‘sealing’ of the lesion has become preeminent.

Another example is the chapter on regenerative endodontics, an area of clinical care that was non‐existent 25 years ago. The use of MTA, and now including newer calcium silicate‐based materials, has revolutionised endodontics. The ability to encourage healthy tissue to re‐establish itself in a root canal system previously filled with necrotic tissue creates the possibility of continued root development in a partially developed tooth and has wide‐ranging clinical consequences.

In paediatric and adolescent emergencies, treatment decisions often need to be made immediately, therefore a sound understanding of the short‐ and long‐term consequences of treatment options is vital, and the following text provides the clinician with a sound base to inform these decisions. The decision may be as dichotomous as whether to replant an avulsed permanent incisor or not – leading to the thought process which may include – how long has the extra‐oral time been? How long was the ‘dry time’? What storage medium has been used? How developed is the tooth? Is the soft tissue and/or bony socket damaged? Is the child capable of accepting care in the dental chair, or will sedation or a general anaesthesia be necessary? Will this change my treatment options or recommendations? What do I talk to the parents about? Do I have informed consent? Should I extirpate the pulpal tissue – now or later, or at all? When and how often is follow‐up? What tests should I undertake? All leading to the question – what is the best option for the individual patient?

This contextually broad but concise text provides the clinician with ample information on how to deal with emergencies, from pulpotomies to facial swellings to post‐trauma orthodontic tooth movement. The comprehensive nature of the text covering treatment of both the primary and permanent dentitions makes it a valuable reference text that should be in all dental clinics.

Prof. David Manton
The University of Melbourne
Melbourne, Australia

Acknowledgements

We would like to thank the following persons:

Bernadette Rawyler, ZMK Bern, for her wonderfully clear yet artistic figures in this book. You deserve the best!

Jessica Evans, Wiley, for encouraging to pursue the idea of compiling this book.

Jayadivya Saiprasad, Wiley, for her constant support and her prompt help whenever it was needed.

Monisha Swaminathan, Wiley, for her assistance in the production process.

Tim West, Wiley, for a tremendous job in copyediting the manuscript.

Susan Engelken, Wiley, for organizing the layout.

About the Companion Website

This book is accompanied by a companion website:

www.wiley.com/go/neuhaus/dental_emergencies

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The website includes multiple choice questions.

Unit 1
General Considerations for Emergency Management in Children and Adolescents