03 Caries Removal Flashcards
3 Most important things you can do for your patient
- Examine thoroughly, diagnose thoroughly
- Remove all caries
- Communicate, try to anticipate the future
What is a reason x-rays might not be read properly
The absence of a RL does not mean there isn’t a lesion
If the radiographic height of an interproximal lesion is __ to ____ times the size of a classic board type lesion then large loss of tooth structure and possible ________ of pulp is likely
2, 3, exposure
Large _____ lesions are often un-restorable and should not be tx planned as _______
Cervical, routine
Why is patient communication important with deep caries?
They need to know that it is likely the pulp is exposed and to expect, RCT, Posts, Crowns, etc
What are two accepted terms for removing caries
- Excavating carious dentin
2. Removing carious dentin
Stage 1 of Extensive caries removal
Penetrate with a high speed hand piece and establish a pulpal floor ____ mm into ______
0.5 mm, dentin
Stage 2
Extend the walls ______ at the pulpal floor and axial wall depth to……
Laterally
Isolate the carious lesion by moving and placing the walls 1/2 mm beyond the boundaries of the lesion
Place the wall in intact, stain free dej
In health, enamel is firmly attached to the ________ _______
Underlying dentin
What does demineralized enamel look like
Opaque, soft, chalky
What does carious dentin look like
Soft, mushy, gummy, leathery, tacky
When you start excavation with a spoon or round bur, why do you want to use the largest instrument that will fit
Largest instrument minimized the force per sq. mm.
It also reduces the chances of a pulp exposure
How are caries removed
Spiraling fashion, beginning with most superficial caries at the outer lateral walls.
As firm dentin is reached laterally, it is followed to the central area
What does sound dentin look like
Hard, glass-like
Why are the deepest, most central lesions removed last
So that if an exposure occurs, the least amount of bacteria is around when it happens
