NEET MDS Lessons
Pedodontics
Stainless Steel Crowns
Stainless steel crowns (SSCs) are a common restorative option for primary teeth, particularly in pediatric dentistry. They are especially useful for teeth with extensive carious lesions or structural damage, providing durability and protection for the underlying tooth structure.
Indications for Stainless Steel Crowns
- Primary Incisors or Canines:
- SSCs are indicated for primary incisors or canines that have extensive proximal lesions, especially when the incisal portion of the tooth is involved.
- They are particularly beneficial in cases where traditional restorative materials (like amalgam or composite) may not provide adequate strength or longevity.
Crown Selection and Preparation
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Crown Selection:
- An appropriate size of stainless steel crown is selected based on the dimensions of the tooth being restored.
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Contouring:
- The crown is contoured at the cervical margin to ensure a proper fit and to minimize the risk of gingival irritation.
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Polishing:
- The crown is polished to enhance its surface finish, which can help reduce plaque accumulation and improve esthetics.
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Cementation:
- The crown is cemented into place using a suitable dental cement, ensuring a secure fit even on teeth that have undergone significant carious structure removal.
Advantages of Stainless Steel Crowns
- Retention:
- SSCs provide excellent retention and can remain in place even when extensive portions of carious tooth structure have been removed.
- Durability:
- They are highly durable and can withstand the forces of mastication, making them ideal for primary teeth that are subject to wear and tear.
Esthetic Considerations
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Esthetic Limitations:
- One of the drawbacks of stainless steel crowns is their metallic appearance, which may not meet the esthetic requirements of some children and their parents.
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Open-Face Stainless Steel Crowns:
- To address esthetic concerns, a technique known as the open-face stainless steel crown can be employed.
- In this technique, most of the labial metal of the crown is cut away, creating a labial "window."
- This window is then restored with composite resin, allowing for a more natural appearance while still providing the strength and durability of the stainless steel crown.
The psychoanalytical theory, primarily developed by Sigmund Freud, provides a framework for understanding human behavior and personality through two key models: the Topographic Model and the Psychic Model (or Triad). Here’s a detailed explanation of these concepts:
1. Topographic Model
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Overview: Freud's Topographic Model describes the structure of the human mind in three distinct layers: the conscious, preconscious, and unconscious mind.
- Conscious Mind:
- This is the part of the mind that contains thoughts, feelings, and perceptions that we are currently aware of. It is the "tip of the iceberg" and represents about 10% of the total mind.
- Preconscious Mind:
- This layer contains thoughts and memories that are not currently in conscious awareness but can be easily brought to consciousness. It acts as a bridge between the conscious and unconscious mind.
- Unconscious Mind:
- The unconscious mind holds thoughts, memories, and desires that are not accessible to conscious awareness. It is much larger than the conscious mind, representing about 90% of the total mind. This part of the mind is believed to influence behavior and emotions significantly, often without the individual's awareness.
- Conscious Mind:
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Iceberg Analogy:
- Freud often likened the mind to an iceberg, where the visible part above the water represents the conscious mind, while the much larger part submerged beneath the surface represents the unconscious mind.
2. Psychic Model (Triad)
The Psychic Model consists of three components that interact to shape personality and behavior:
A. Id:
- Description: The Id is the most primitive part of the personality and is present from birth. It operates entirely in the unconscious and is driven by the pleasure principle, seeking immediate gratification of basic instincts and desires (e.g., hunger, thirst, sexual urges).
- Characteristics: The Id is impulsive and does not consider reality or the consequences of actions. It is the source of instinctual drives and desires.
B. Ego:
- Description: The Ego develops from the Id during the second to sixth month of life. It operates primarily in the conscious and preconscious mind and is governed by the reality principle.
- Function: The Ego mediates between the desires of the Id and the constraints of reality. It helps individuals understand that not all impulses can be immediately satisfied and that some delay is necessary. The Ego employs defense mechanisms to manage conflicts between the Id and the external world.
C. Superego:
- Description: The Superego develops later in childhood, typically around the age of 3 to 6 years, as children internalize the moral standards and values of their parents and society.
- Function: The Superego represents the ethical component of personality and strives for perfection. It consists of two parts: the conscience, which punishes the ego with feelings of guilt for wrongdoing, and the ideal self, which rewards the ego with feelings of pride for adhering to moral standards.
- Characteristics: The Superego can be seen as the internalized voice of authority, guiding behavior according to societal norms and values.