4 biological caries management Flashcards
what is detection?
determining the presence/absence of disease
what is diagnosis?
detection + knowing whether or not the disease is active or arrested such that appropriate tx can be planned
requirements for diagnosis
plaque chart full mouth prophylaxis good lighting inspect without drying for dentinal shadowing dry tooth for 5-10 seconds 2.5 magnification recommended probe can be used to gently remove debris from fissures bitewings temporary elective tooth separation
what are the special tests?
transillumination FOTI diagnodent plaque pH salivary flow rate
what are the options from visual detection?
0= no change after drying
1=opacity visible after drying
2=opacity visible without drying
3=localised enamel breakdown in opaque/discoloured enamel +/- discolouration from underlying dentine
4=cavity in enamel exposing underlying dentine
when is tactile assessment of caries used?
not for enamel caries
for dental caries
-residual caries in a cavity
-root caries
what is transillumination?
carious lesions absorb light
what are bitewings used for?
approximal lesions for intervention/prevention
safety net for occlusal lesions
what is temporary elective tooth separation used for?
interproximal caries only orthodontic separator between teeth review 2 days inspect surface for cavitation take silicone impression of approximal surface
root surface caries diagnosis requirements
clean teeth tactile assessment visual assessment -position in relation to gingival margin -dimensions of lesion -colour
how do you know if root surface caries are active?
texture- soft more bacterial loads so probable active
colour- lighter coloured lesion more bacterial load
site- closer to gingival margin
size- larger
what are the indications for non-operative management of root-surface caries
hard, dark, >1mm from gingival margin
not plaque trap
not rapidly progressing
px able to participate
describe secondary caries
demineralization, staining, soft around large ditched area, probe would drop in
lesion goes from out to in so if sound on outside no lesion
what is non-operative management of caries?
dietary analysis -reduce simple carbs OHI -remove plaque regularly -brushing and interdental increase fluoride exposue -tip balance towards remineralization
how is fluoride varnished used?
for at risk px
every 3-6 months
describe silver diamine fluoride
very effective caries arrest no need for drill no biological consequence good for px with limited cooperation bad aesthetics
what is ICON?
resin infiltration
good for approximal/smooth surface
etch, dry, infiltrate
when is a restoration indicated?
when lesions have advanced to obvious cavitation and where remineralisation techniques have reached their limits
when is a rest indicated in primary coronal lesions?
cavitated
enamel discolouration and surface destruction
plaque trap
when is a rest indicated in secondary caries?
frankly carious lesions
plaque trap
ditches wide enough for perio probe
when is a rest indicated in root surface caries?
pale/black lesion <1mm from gingival margin plaque trap px uncooperative soft feel with sharp probe
what type of lesions are fissure sealants used for?
radiographically visible occlusal caries, lesion extending into middle third of dentine heavily infected
vital pulp
what are the operative lesions for deeper carious lesions?
non-selective removal of carious tissue to hard dentine
selective removal to firm dentine
stepwise excavation tx
selective removal to soft dentine
what is the disadvantage of selective removal to firm dentine?
pulp exposure expected very poor prognosis for tooth vitality
what are the minimally invasive techniques?
repair and refurbishment of restorations preventative resin restoration ultrasonic minimal prep bioactive linings partial caries removal stepwise caries excavation
