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23 Radiology > 10 - Caries > Flashcards

10 - Caries Flashcards

1
Q

does xray shadow formation depend on density or composition

A

DENSITY! NOT composition

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2
Q

A demineralized region of tooth structure that has partially remineralized so that the total mineral content compared to sound tooth has not been reduced significantly [will OR will not] produce a lesion shadow.

A

will not

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3
Q

there must be what percent mineral loss for lesion to be radiographically apparent

A

30-35% mineral loss

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4
Q

[long/short] path absorbs more radiation - less dense shadow

A

LONG

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5
Q

[long/short] path - less absorption. denser shadow

A

SHORT

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6
Q

the greater the mass around the carious lesion the [more/less] radiation hits the sensor

A

LESS

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7
Q

demineralization [increases or decreases] shadow density

A

INCREASES

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8
Q

remineralization [increases or decreases] shadow density

A

DECREASES

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9
Q

xray beam direction is relative to what of lesion affects the lesion’s shadow

A

relative to LONG AXIS

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10
Q

parallel to long axis (horizontal) = [denser or less dense]

A

denser (Darker)

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11
Q

inclined to long axis (up or down) = [denser or less dense]

A

less dense (less dark)

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12
Q

___: Represents rapid severe progressive caries with no remineralization therefore high mineral loss & lucency

A

Active caries

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13
Q

Partially remineralized lesions (“X-ray” scars)

A

arrested caries

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14
Q

can you differentiate between active and arrested caries in one image? how do you do it?

A

cannot differentiate - another image at different time period is required to differentiate

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15
Q

what is the recommended interval between imaging examinations?

A

varies substantially -> 6 months-higher risk

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16
Q

lesion shadows often underestimate what

A

depth of demineralization (don’t confuse with bacterial infection)

17
Q

shallow enamel only lesions can produce what?

A

shadows in enamel or throw them over the dentin. these are not dentin lesions

18
Q

why is it not possible to reliably judge the depth of lesion with xray

A

due to variability of xray beam direction and degree of demineralization

19
Q

when can you detect change over time?

A

if irradiation geometry and exposure factors are constant between examinations

20
Q

how do you know if geometry or exposure has changed

A

look for interproximal contact overlap, cusp height, and interdental space consistency

21
Q

how can you classify lesion activity - progression, stasis, remineralization?

A

classifying enamel into equal halves and dentin into thirds - E1, E2, D1, D2, D3

22
Q

what are examples of diagnostic pitfalls

A
  1. cervical burnout
  2. CEJ
  3. periodontal ligament space
23
Q

what is the least dense region between CEJ and alveolar bone crest

A

cervical burnout

24
Q

how to determine between interproximal caries or cervical burnout

A

Interproximal caries - Occur in the region that extends
between the contact points of teeth apically to near the free
gingival margin. Irregular margins, discontinuity of the tooth
surface
Cervical burnout - Just apical to the CEJ

25
Q

VISUAL AND PERCEPTUAL ARTIFACT arises as a result of the differential stimulation and inhibition of neighboring receptors in the retina.

A

mach-band effect

26
Q

what does pit and fissure enamel caries look like on BW

A

too little loss of Ca relative to bulk of tooth to cast a shadow

27
Q

what does pit and fissure dentin caries look like on BW

A

Pit and fissure dentin caries - may cast a shadow but
dependent on degree of demineralization relative to tooth bulk.
Overall 50% dentin lesions - shadows. As lesions get bigger,
chance of shadow 1

28
Q

what % of interproximal enamel caries produce shadows? what is its diagnostic accuracy

A

15-25%; 50%

29
Q

can you replace extraoral BW with intraoral BW? when do use it?

A

NO! not a replacement for intraoral!
Only can be used when it is impossible to obtain intraoral images E.g. Uncooperative patients, severe gagging, large mandibular tori

30
Q

what caries is most likely to stop and not need a filling

A

non-cavitated

31
Q

what caries is more likely to progress

A

cavitated

32
Q

what is capable of converting from non-cavitated to cavitated

A

sharp probes

33
Q

when can caries progression stop from non-cavitated to dentin cavitated

A

stop at any stage

34
Q

Non-progressing enamel caries - surface layer has remineralized - body of the lesion is cut off from saliva with supersaturated Ca and PO- permanent radiographic “scar”

A

BW radiographic scars

35
Q

are BW radiographic scars a threat to the tooth

A

NO

36
Q

who has higher radiation dose - BW or CBCT

A

CBCT

37
Q

why is the use of CBCT discouraged?

A

requires more time for reading the images

38
Q

to asses caries activity over time, what must you look for

A

irradiation geomatry changes producing false changes in depth

23 Radiology (15 decks)

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