The Pediatric Dental Honors Experience, A Case Example of Comprehensive Care and Bilateral Space Maintenance

Cailey L. Treyz

Treyz, Cailey L. 
University of Pennsylvania School of Dental Medicine, Department of Preventive and Restorative Sciences, Division of Pediatric Dentistry


The goal of the pediatric dental honors program is to increase exposure in all aspects of pediatric dentistry. Comprehensive treatment was delivered to patients of varying backgrounds including medically and behaviorally complex patients. Participation in the pediatric dental resident seminar was required. Teaching experience occurred by assisting in the Pediatric Restorative and Space Maintenance Labs. Attendance at the 2021 AAPD annual meeting is planned as well as observation of oral conscious sedation and general anesthesia cases. As a case example, H.B. a 7 y/o F was comprehensively treated for caries removal and space maintenance. Following caries control, a lower lingual holding arch (LLHA) was fabricated to maintain leeway space.


Fabrication of the LLHA was achieved by seating prefabricated bands onto teeth #19 and #30. Bands were ligated with floss to prevent aspiration. Bands were selected based on the tightest mesio-distal fit to the height of the marginal ridge. An alginate impression was taken. The bands were then removed and seated into the impression. Staple clips were used to secure the bands to the alginate impression. The impression was immediately poured in dental stone. The model and prescription were sent to the laboratory where the appliance will be fabricated. When it is returned, it will be cemented and monitored for appropriate removal at future recall appointments.


Treatment was rendered to patients using a comprehensive approach. Oral hygiene instruction, nutritional counseling and anticipatory guidance were provided to patients and their caregivers. Preventative treatments such as prophylaxis, fluoride varnish and sealants were performed in addition to advanced restorative procedures including stainless steel crowns, composite resin restorations, extractions, silver diamine fluoride and space maintainers. Many procedures were performed utilizing nitrous oxide. Some patients required multidisciplinary care and collaboration with other restorative departments. Patients who could not be treated in the clinic due to behavior management or medical complexities were planned for treatment under general anesthesia and required consultation with their physicians. A total of 20 patients were treated.


The aim of the pediatric honors program is to expand both the clinical competence and didactic knowledge required to become a pediatric dentist. It provides a strong foundation in comprehensive treatment planning as well as non-pharmacological and pharmacological behavior management techniques. As a whole, it provides an excellent foundation on which to continue to build in a pediatric dental residency.