2014 Preventive Dental Sciences Department Pediatric Dentistry Division Table of Contents



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Form 1.8
Pediatric Dentistry Division

Rubric for Cavity Preparation and Restoration


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Rubber Dam

  • One quadrant is exposed

  • Floss tight to clamp

  • Allow patient breathing

Only 3 teeth are exposed, seepage of fluids, clamp unstable

A quadrant is exposed, follow all criteria

All criteria plus: Rubber dam is reverted and frame is not deviated

2. Cavity design and caries removal

  1. Preparation outline is rounded with no sharp angles.

  2. Groove extensions on buccal and lingual are no closer than 1.25 or 1.5mm the buccal or lingual surface, depending on the tooth.

  3. Occlusal depth is 1.5 mm in non carious areas.

  4. Buccal and lingual walls are slightly undercut.

Class I:

1. Extension at mesial or distal margin is no closer than 1.25 mm to proximal surface.

2. Mesial (or distal) wall is vertical or slightly divergent, depending on the extent of the caries.

Class II:

1. Isthmus (is) 1/3 intercuspal distance.*

2. Gingival wall is wide enough to support the smallest condenser.

3. Each indicated cavity wall visibly clears the adjacent tooth, but extends no farther than buccal or lingual line angles.

4. Buccal and lingual walls converge and paralleling respective external surface of the tooth.

Class III:

a. Incisal extensions is within 1 mm of incisal edge *

b. Depth of axial wall 0.75-1mm

Class V:

Undercut incisal and gingival wall within maximum and minimum range

d. All caries and defective areas are removed.*


Mistake in one or more of the critical steps(*) e.g soft caries was left with no intension of pulp capping.

Complete Critical steps* with proper retention and resistance forms. Plus cavity is not completely smooth.

Proper extension outline, convenience, resistance and retention forms. Floor and walls are smooth with complete critical steps (*).

3. Gingiva and adjacent tooth are un damaged

Injury to the gingiva causing extensive bleeding, enamel and/or to adjacent tooth

Slight gingival controlled bleeding, no injury to adjacent tooth

No injury to gingiva or adjustment tooth

4. Restoration:

  • All margins should be completely restored and closed with no excess.

  • The original surface anatomy is restored: *

  • The surface should be smooth and homogeneous with no voids.

Presence of fracture voids or under restoration

Proper anatomy and contour but may have premature contact

Proper anatomy and contact

5.Behavior guidance:

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more

6. Time*

Class I


Class II

Class III

Class V


> 45 minutes

> 90 minutes

> 60 minutes

> 30 minutes



30-45 minutes

60-90 minutes

45-60 minutes

15-30 minutes



< 30 minutes

< 60 minutes

< 45 minutes

< 15 minutes



Form 1.9
Pediatric Dentistry Division

Rubric for Stainless Steel Crown/Strip Crown/Class IV Permanent

Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Rubber Dam

  • One quadrant is exposed

  • Floss tight to clamp

  • Allow patient breathing

Only 3 teeth are exposed, seepage of fluids, clamp unstable

A quadrant is exposed, follow all criteria

All criteria plus: Rubber dam is reverted and frame is not deviated

2. Tooth Preparation and caries removal

a. Occlusal Reduction /Incisal Reduction *

    • 1-1.5mm compared to adjacent teeth

    • Follows original anatomy (except with pulpotomy)

b. Proximal Reduction:*

  • Break contacts

  • Are covergent to occlusal/incisal

  • End in feather-edge margin

  • No Ledges *

c. Buccal Lingual Surfaces and Bevel

SSC:

  • Removes sharp cusp tips and roundation of line angles

  • Bevel occlusal 1/3 of buccal and lingual

Strip:

  • Reduce labial and lingual surfaces 0.25 mm*

Class IV:

  • Extend preparation (Bevel) 2 mm beyond fracture line*

d. Complete Removed Caries *

e. Avoid Damage to Adjacent Teeth *


Mistake in one or more of the critical steps (*)

Complete only the critical steps(*) but not all other steps

Complete all critical (*) and other steps

3. SSC or CSC Adaptation*

    • Crown leveled with adjacent teeth *

    • Original Contacts restored *

  • No extensive blanching

  • Margins 1mm subgingivally and form smooth curve*

SSC: Difficult to seat and remove

  • No gaps at margins

  • Proper occlusion *

One or more Critical mistakes (*) e.g. under extended margins, the bite is opened

Only critical steps are completed (*) but with slight blanching

All critical steps (*) and other steps are completed without blanching

4. Cementation/Restoration:

Correct position Bucco lingually*



SSC

  • Properly remove remaining cement

  • Adequately produced proper occlusion and contact*

Strip/Class IV:

  • Composite restoration after acid etching

  • Excess composite is removed before curing

  • Strip form is removed and with no voids

  • Proper composite shade*

One or more Critical mistakes (*) e.g. open bite
Strip/Class IV: Voids or deficient areas

All critical steps are completed (*) SSC: but some cements on the strip crown lingual finishing is needed

All critical steps (*) are completed

5.Behavior guidance:

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more

6.Time *

  • Strip

  • SSC

  • Class IV

> 120 min

> 120 min

> 100 min


90-120 min

80 -120 min

90-100 min


< 90 min

< 80 min

< 90 min



Form 1.10
Pediatric Dentistry Division

Rubric for Formocresol Pulpotomy


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Rubber Dam

  • One quadrant is exposed

  • Floss tight to clamp

  • Allow patient breathing

Only 3 teeth are exposed, seepage of fluids, clamp unstable

A quadrant is exposed, follow all criteria

All criteria plus: Rubber dam is reverted and frame is not deviated

2. Access and deroofing

  1. Complete removal of caries*

  2. Proper opening for access. All pulp horns are uncovered and are readily accessible.

  3. Complete removal of the coronal pulp tissue *

  4. No perforation*

  5. Hemorrhage control*

One or more of the Critical mistakes (*) present

Excessive bleeding



Complete removal of caries and pulp tissue but with over extension or sharp edges.

Slight Bleeding on removal of the wet cotton pelete.



Complete removal of caries pulp tissue with proper access and extension.

No signs of Hemorrhage



3. Formocresol fixation and temporary restoration

Cotton pelete do not cover the pulp stumps or use peletes soaked with formocresol without fixation improper consistency for ZOE

Follow the steps but slight bleeding on removal of the pelete, slight soft ZOE mix.

Follow the steps with fixation firm consistency of ZOE

4. Behavior Guidance

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more

5.Time *

> 120 min

30- 120 min

< 30 min




Form 1.11
Pediatric Dentistry Division

Rubric for Extraction of Primary Teeth


Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Pre-operative precautions

    • Radiographic revision before extraction*

    • Sensation and noises associated with extraction is explained

    • Unfolded gauze (5x5 cm) is placed over the tongue and cover the oropharynx *

Mistake in one or more of the critical steps (*) or extract in full supine position without gauze protection


Complete only critical steps (*) but not other steps

Complete all the steps including critical steps*

2. Procedure

a. A straight or periosteal elevator is used to free the attached gingiva.

b. Firm apical pressure is applied while in mandible supporting the mandible, initial luxution is toward the buccal side.
For Molars: hold the pressure momentarily to expand the alveolar plate, return lingually and hold to expand the alveolar plate.


      • Alternate the buccal and lingual movements. When adequate freedom of movement, deliver the tooth to the buccal side, with slow, firm, continuous pressure.

For Anteriors: A rotative force is applied along the tooth’s long axis, delivering it through its path of least resistance.
c. The buccal and lingual plated of the alveolar bone is molded into normal conformity with digital pressure.

d. Folded sterile gauze is placed over the wound.



    • Time*

    • Mobile Tooth

    • Long rooted tooth

      • Molar

      • Interior

Did not follow the steps or long time for extraction.

6-10 minutes


> 15 minutes

> 10 minutes



Follow the steps and extraction time was relatively short

5 minutes


10-15 minutes

6-10 minutes



Follow the steps and extract in a very short time.

3 minutes


< 10 minutes

< 6 minutes

3. Post operative instruction

    • Bite on the gaze for 30 minutes *

    • Do not rinse forcibly for 24 hours*

    • Eat cold food

    • Do not use straw

    • Do not bite on lip or cheek *

    • Do not play with the wound

    • Written instruction is given*

    • Gauze is given

Mistake in one or more of the critical steps (*)

Complete only critical steps (*)

Complete all the steps including critical (*) and gave extra gauze.

4. Behavior guidance:

TSD, distraction, positive reinforcement, voice control



Uses none

Uses 1 or 2

Uses 3 or more


Form 1.12
Pediatric Dentistry Division

Rubric for Diet Evaluation

Steps and procedures

Instructor Evaluation

0

Not Competent

I

Competent

2

Proficient

1. Diet Evaluation

  • Information from the parent is accurately taken

  • Quality of food intake by patient was identified and described to the patient / parent. *

  • Cariogenic potential of the patient’s diet was identified and described to the patient / parent. *

One or more Critical mistakes (*)

Critical steps are completed (*)

Critical steps (*) and all other steps are completed

2. Recommendation to patient and parents

  • 5 food groups was explained using the pyramid *

  • Recommended amounts for the child to improve nutrition

  • Cariogenecity of the diet was explained *

  • Instruction about sweetened or fuzz beverages was given

  • Instruction about sticky solid CHO including fruits was given *

  • Safe snacks was suggested properly *

  • Time for sweets intake was suggested *

  • Encourage brushing after sweets *

One or more Critical mistakes (*) recommendation is given only to the parents

Critical steps are completed (*)

Critical steps (*) and all other steps are completed , used pictures and supplied the parents with the guide to good eating

3. Behavior guidance

TSD, positive reinforcement



Uses none

Uses 1

Uses 2

4. Time *

< 10 minutes

10-20 minutes

> 20 minutes



Form 1.13
Pediatric Dentistry Division

Rubric for Space Analysis

Steps and procedures

Instructor Evaluation

0

Not Competent

1

Competent

2

Proficient

1. Time

Procedure was completed in 20 minutes



> 20 minutes

20 minutes

< 20 minutes

2. Case selection

1. The case is not indicated for space analysis

2. Some of the incisors are primary

3. Any of the 1st permanent molars did not erupt yet or extracted.

4. Complete primary or permanent dentitions



1. The case is indicated for space analysis.

2. All upper and lower incisors are permanent.

3. 1st permanent molars are present.

4. Mixed dentition

5. Some teeth are fractured


1. The case is indicated for space analysis.

2. All upper and lower incisors are permanent.

3. 1st permanent molars are present.

4. Mixed dentition




3. Teeth measurements:

a. Sum of lower incisors (32,31,41,42)

interred in the form*

b. Sum of upper 11,12 and 21,22*


c. Space needed was identified by using the sum of 31, 21, 41, 42*



a. Too much variation in the sum

Or not interred in its place in the treatment form

b. Too much variation in the measurements of 11,12 or 21, 22
c. The sum of upper incisors was used
or misidentified for any of the sum of upper 345
or misplacement of the sums of either lower or upper 345 in the form

Some variations in the measurements with 80% accuracy and completed measurement entered in the form.

Correctly identified the sum of lower 345 and placed in its position in the form.


Measurement were 80% to 100% alemate and computed measurement

Interred in its place in the form


Correctly identified the sum of lower 345 and placed in its position in the form.



4. Detect space deficiency

  • Alignment of incisors were considered

    • MD dimension of central and lateral on each of right, left upper and lower arch were computed.

    • The sum was recorded by polygauge.

    • The anterior end of the polygauge was placed on the midline model.

    • A scratch on model corresponds to the distal end of the polygauge was placed on the correct position on the arch (teeth).




  • Space available is recorded

    • Measurements were recorded on the arch circumference.




  • Arch length deficiency were calculated

      • Subtract space available from space needed and placed in the form for each quadrant.

      • Negative, position or 0 measurements were recorded for each quadrant

      • Total was calculated for the arch

Measurements other than the sum of MD width of central and lateral incisors were used in its quadrant.
Or miscomputation of the corrected teeth
Or misrecording the sum of the polygauge.
Or a scratch on the model correspond to distal was placed either too bucally or lingually

Space not correctly measured


Or measurements were taken too far either bucally or lingually

Space needed was subtracted for space available

Or miscalculated

Some variations in the measurements with 80% accuracy.

Some variations in the measurements with 80% accuracy.

All steps were correctly followed

Total was not recorded

All steps were followed with 80-100% accuracy.

All steps were followed with 80-100% accuracy.

All measurement were recorded


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