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DG1002 - FOUNDATION CK > Caries > Flashcards

Caries Flashcards

1
Q

The following are components of which tooth tissue?

  • Inorganic (Calcium Hydroxyapatite) 95% by volume
  • Organic (Amelogenins & Enamelins)
  • Water
A

enamel

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2
Q

The following are components of which tooth tissue?

  • Inorganic (Calcium Hydroxyapatite) 50% by volume
  • Organic (Type 1 collagen)
  • Water
A

dentine

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3
Q

Which chemical is being described?
- An inorganic compound composed of calcium, phosphate, and hydroxide, found in the bones and teeth in a crystallised lattice-like form that gives these structures rigidity

A

calcium hydroxyapatite

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4
Q

What is the name of the hypothesis described that is used today regarding caries?

  • caries is caused by specific (pathogenic) plaque bacteria who’s activity depends upon their environment
A

ecological plaque hypothesis

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5
Q

What is being described?
- When there is no brushing, a thin layer that attaches to the tooth surface, plaque bacteria then attach themselves to it

A

acquired pellicle

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6
Q

What type of bacteria are the early colonisers that attach to the acquired pellicle and make the environment nice for the late colonisers of bacteria?

A

streptococcus

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7
Q

What are the main bacterias involved in caries?

A

Streptococci
- Streptococcus mutans

Lactobacilli
- Lactobacillus acidophilus

Actinomyces

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8
Q

What is the critical pH of enamel?

A

5.5

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9
Q

What is the resting pH of the mouth?

A

6.4

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10
Q

Which 2 types of bacteria in the acidic condition in the mouth generate a high hydrogen concentration, which then causes the loss of minerals such as calcium and phosphate from the enamel leading to demineralisation and subsequent development of caries? (demineralisation)

A
  • streptococcus mutans
  • lactobacillus
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11
Q

Which 2 components of enamel can be lost through demineralisation and therefore development pf caries?

A

calcium and phosphate

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12
Q

During remineralisation when pH is between 5-7.5, which two types of healthy plaque bacteria start to proliferate?
They also have a high hydrogen concentration which leads to calcium and phosphate and other minerals from saliva and fluoride diffusing back into the lesion (remineralisation)

A

streptococcus sanguis and streptococcus oralis

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13
Q

Gradually, plaque changes from Streptococci to a later coloniser bacteria which then multiply, what bacteria is the later coloniser?

A

actinomyces

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14
Q

Sucrose is a disaccharide and breaks down into which two monosaccharide components?

A

glucose and fructose

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15
Q

Saliva contains which 2 minerals which help with remineralisation?

A

calcium and phosphate

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16
Q

What is the name of the process whereby there is acid production by dental plaque?

A

Krebs cycle

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17
Q

Which type of bacteria have a low affinity sugar uptake system activated by a proton motive force (pmf)?
This allows the cell to continue to transport and metabolise sugars under acidic conditions which are not favourable to other bacteria, this helps streptococci to become dominant in cariogenic plaque

A

streptococci

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18
Q

What are 2 other factors that increase plaque pH?

A
  • bicarbonate buffering; high flows of saliva can increase the bicarbonate concentration and produce pH of 7.5-7.8, effective buffer against acids
  • saliva neutralisation; due to slight alkalinity saliva functions as a weak base to neutralise acid
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19
Q

What is the name of the following?

- a graph that shows what happens after the consumption of sugar in relation to dental caries

A

stephans curve

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20
Q

What type of lesion is being described?

  • is visible as a white spot on the enamel surface
  • has an intact surface
  • should not be probed
  • can be remineralised
  • does not require a filling
A

early carious lesion

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21
Q

The composition of which tissue is being described?

- composed of tightly packed hydroxyapatite crystals, organised in long columnar rods

A

enamel

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22
Q

What is being described?
- incremental growth lines or bands seen in tooth enamel. They represent the incremental pattern of enamel, the successive apposition of different layers of enamel during crown formation.

A

striae of Retzius (lines of Retzius)

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23
Q

As caries gets deeper, what shaped pattern does the lesion form with the apex towards the EDJ and base towards the tooth surface?

A

triangular pattern

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24
Q

(4 zones seen before complete disintegration of enamel)
What zone is being described?
- lies at the advancing front of the lesion
- slightly more porous than sound enamel
- it is not always present

A

zone 1: translucent zone

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25
Q

(4 zones seen before complete disintegration of enamel)
What zone is being described?
- this zone is usually present
- formed due to mineralisation

A

zone 2: dark zone

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26
Q

(4 zones seen before complete disintegration of enamel)
What zone is being described?
- found between the surface and the dark zone
- it is the area of greatest demineralisation

A

zone 3: body of the lesion

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27
Q

(4 zones seen before complete disintegration of enamel)
What zone is being described?
- relatively unaffected area
- greater resistance probably due to greater degree of mineralisation and greater fluoride concentration

A

zone 4: surface zone

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28
Q

What is the term used for when it is the first time caries has occurred in a tooth?

A

primary caries

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29
Q

What is the term used for when caries occurs around a restoration?

A

recurrent/secondary caries

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30
Q

What is the term used for when caries is left behind during a restoration, which can sometimes be done purposely as to not expose the nerve?

A

residual caries

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31
Q

What is the term used for caries that is generally hard and a darker brown/black colour and a decision is to be made whether intervention is needed?

A

inactive caries

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32
Q

What is the term used for caries that is generally soft, lighter brown/yellow colour and treatment is needed

A

active caries

33
Q

What are the 3 visual clinical examination methods that can be used to diagnose caries?

A
  • trans-illumination
  • detector dye
  • tooth separation
34
Q

What are the 5 diagnostic tests that can be used to diagnose caries?

A
  • radiographic
  • electrical conductance (ECM)
  • laser fluorescence (DIAGNOdent)
  • quantitative light fluorescence
  • surface resilience (RCM)
35
Q

Dentine caries stimulates a reparative response from the pulp producing which types of dentine for protection?

A
  • intratubular (secondary) dentine
  • reparative (tertiary) dentine at pulpal surface
36
Q

Which type of caries is being described?
- occlusal caries that is not obvious clinically but extensive on access - commonly seen in water fluoridated areas due to being mineralised on the tooth surface

A

occult caries

37
Q

Which method of visual inspection is being described?

  • uses a small rubber ring placed between teeth to move them apart (0.5mm)
  • takes a few days
  • allows direct vision of contact area
  • space closes spontaneously when ring is removed
A

tooth separation

38
Q

Which method of visual inspection is being described?

  • active ingredient propylene glycol with visible dye stain
  • said to bind to collagen cross-links and stain only the irreversibly damaged dentine zone
  • unfortunately, diffuses into porous dentine and can lead to significant removal of sound dentine
A

detector dye

39
Q

Which method of visual inspection is being described?

  • uses visible light and computer technology to create high-resolution digital images of occlusal, interproximal and smooth surfaces.
  • it demonstrates or confirms the presence of decay that cannot be seen radiographically, visually or through the use of a probe
A

trans-illumination

40
Q

Which method of diagnostic test to diagnose caries is being described?

  • based on the auto-fluorescence of teeth, when teeth are illuminated with high intensity blue light, they will start to emit light in the green part of the spectrum.
  • the fluorescence of the dental material has a direct relation with the mineral content of the enamel
A

quantitative light fluorescence

41
Q

If a white spot lesion is only detected when enamel is dry, how deep is the lesion?

A

approximately half way into the enamel

42
Q

If a white spot lesion is detected in wet enamel, how deep is the lesion?

A

approximately all the way through the enamel and demineralising the dentine

43
Q

What is the name given to the following caries detection scoring system?

  • aims at linking clinical appearance with underlying histology giving a score
  • this score is used in the patients notes to help decide on the treatment plan, as a tool for monitoring the carious process and dento-legally
A

MICDAS (modified international caries detection and assessment system)

44
Q

Which mICDAS score is the following?
- no or slight change in enamel translucency after prolonged air drying

A

0

45
Q

Which mICDAS score is the following?
- opacity or discolouration (white spot lesion), hardly visible on wet surface/easily visible on dry

A

1

46
Q

Which mICDAS score is the following?
- enamel opacity (white spot lesion) or greyish discolouration visible on wet surface

A

2

47
Q

Which mICDAS score is the following?
- localised enamel breakdown in opaque or discoloured enamel +/- greyish shadowing

A

3

48
Q

Which mICDAS score is the following?
- gross cavitation in opaque or discoloured enamel exposing stained dentine

A

4

49
Q

What are 6 aspects in order to visually detect caries?

A
  • good eyesight
  • good light
  • good access
  • a clean tooth
  • a dry surface
  • magnification
50
Q

What would be the recommended management plan for a caries free patient?

A

encourage to maintain OHI and diet

51
Q

What would be the recommended management plan for arrested decay?

A
  • OHI
  • diet advice
  • review and monitor
52
Q

What would be the recommended management plan for a white spot lesion confined to enamel?

A
  • fluoride application
  • OHI
  • diet advice
  • review and monitor
53
Q

What would be the recommended management plan for a white spot lesion confined to enamel with loss of some enamel integrity?

A
  • fluoride application
  • OHI
  • diet advice
  • review and monitor
54
Q

What would be the recommended management plan for occlusal caries just into the dentine?
(if low caries risk)

A
  • fissure seal
  • OHI
  • diet advice
  • review and monitor
55
Q

What are 6 examples of when to restore a caries lesion?

A
  • the tooth is painful to cold, heat, sweet
  • chewing is impaired because of sensitivity/pain
  • the pulp is endangered
  • the lesion can be judged definitely to have extended well into the dentine (visual/radiographic signs)
  • previous attempts to arrest the lesion have failed, evidence over several months or years that the lesion is progressing or cavitation has occurred
  • tooth drifting may occur through loss of a proximal contact area
56
Q

What is the preferred alternative to a PRR restoration for occlusal caries slightly into dentine?

A

seal and monitor to cut off lesion from nutrient supply and progressing

57
Q

Which type of dentine is being described?

  • always needs to be removed from the EDJ, leaving would continue to progress even after the tooth is restored
  • unable to create an adequate seal with composite and would be weak and allow leakage with amalgam
A

infected dentine

58
Q

Which type of dentine is being described?

- brown, discoloured, repairable dentine may be left at the EDJ during cavity prep

A

affected dentine

59
Q

What are the following characteristics of?

- soft, moist, light brown/yellow

A

infected dentine

60
Q

What are the following characteristics of?

- hard, firmer, leathery

A

affected dentine

61
Q

Which type of dentine can remain over the pulp in order to limit the chances of plural exposure?

A

affected dentine

62
Q

On a radiograph, when the pulp horns look like they have shrunk back due to caries, what has happened to cause this?

A

odontoblasts have been stimulated and tertiary dentine has been laid down

63
Q

What happens to caries when it reaches the EDJ?

A

balloons and spreads out laterally then spreads down towards the pulp

64
Q

Which type of enamel modification is being descried?

  • removes unsupported enamel prisms
  • increases surface area for bonding
  • provides sound enamel surface for optimal bonding
  • improves aesthetics
A

enamel bevel

65
Q

What is the ideal cavity prep for amalgam?

A
  • cavity undercuts: base of cavity is winder than surface in order to retain
  • locks/dovetails: can aid in displacement but removes a huge amount of tooth tissue
  • grooves/slots: further aids in preventing displacement, especially in cavities which are very wide
  • rounded internal line angles
  • wall angulation: require a 90 degree cavosurface angle
  • pulpo-axial line angles should be slightly rounded to minimise stress concentration
  • depth of cavity minimum 2mm
66
Q

What can result from poor depth and sharp internal line angles when prepping a cavity?

A
  • marginal enamel fracture: due to undermined enamel or irregular cavosurface
  • total cusp fracture: due to too little tooth structure left or margin placed too high up a cusp incline or sharp internal line angle
  • marginal fracture of restorative material: due to acute angle of amalgam at margin
  • total fracture of restorative material: due to inadequate depth or sharp line angle
67
Q 
What is the following cavity preparation system called?
Class I
Class II
Class III
Class IV
Class V
Class VI
A

blacks classification

68
Q

What class are the following cavity preps?

  • pit and fissure caries
  • occlusal surface of posterior teeth
  • palatal fissures and pits of upper molars
  • buccal fissures and pits of lower molars
  • palatal pits of upper anteriors
A

Class I

69
Q 
What class is the following cavity prep?
- proximal surfaces of posterior teeth
A

Class II

70
Q 
What class is the following cavity prep?
- originate on the proximal surfaces of anterior teeth, but do not involve the incisal angle
A

Class III

71
Q

What class is the following cavity prep?

  • involves the proximal surface of anterior teeth and includes the loss or removal of the incisal angle
  • sometimes as a result of trauma
A

Class IV

72
Q 
What class is the following cavity prep?
- on the gingival or cervical third of the facial and lingual surfaces of the crown of any tooth
A

Class V

73
Q 
What class is the following cavity prep?
- incisal edges of anteriors or cusp tips of posteriors
A

Class VI

74
Q

What is the criteria for a successful pulp cap? (6)

A
  • abscence of previous symptoms
  • normal vitality tests
  • young patient
  • small exposure in otherwise clean cavity
  • no saliva contamination
  • pale pink pulp tissue with minimal bleeding
75
Q

What technique should be used for deep caries?

A

stepwise
- remove caries and fill with GI to encourage tertiary dentine (leave infected dentine at the base)
- leave for 6 months
- remove remaining soft dentine
- restore with more permanent material

76
Q

What is meant by microleakage?

A

penetration of oral fluids and small numbers of bacteria and their toxic by-products between filling material and cavity walls

77
Q

What are 7 potential causes of microleakage?

A
  • difference in thermal expansion
  • polymerisation shrinkage
  • orientation of enamel prisms
  • cavity configuration
  • quality of filling technique
  • poor isolation
  • ditching
78
Q

What are 4 potential consequences of microleakage?

A
  • sensitivity
  • marginal discolouration
  • secondary caries
  • pulpal inflammation and potential necrosis
79
Q
A

DG1002 - FOUNDATION CK (11 decks)

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