Caries Flashcards
1
Q
Caries require 3 factors:
A
Bacteria, carbohydrates, tooth
2
Q
Caries progression can be three types:
A
Incipient, moderate, severe.
(enamel only, involving dentin, involving pulp)
3
Q
What is the typical location of proximal caries?
A
a few mm apical from the contact point
4
Q
How to diagnose caries?
A
Clinical exam is always necessary: occlusal caries are easy to diagnose clinically, Labial/ Buccal?palatal caries: easy to diagnose clinically
Proximal Caries:may be difficult to diagnose clinically.
5
Q
True or False: Radiography cannot reveal if a lesion is active or arrested
A
True
6
Q
True or False: Bitewing Radiographs are Best to assess for proximal and occlusal caries
A
True
7
Q
True or False: PA is good for identifying occlusal caries.
A
True
8
Q
True or False: PA is reliable for incipient caries
A
False
9
Q
True or False: CBCT is reliable for incipient caries
A
False
10
Q
What are the minimum factors required for the development of caries?
A
Tooth, Bacteria, Carbohydrates.
11
Q
Incipient caries are:
A
Dark or radiolucent area on the surface. Enamel only. 50% of lesions are actually visible on radiographs (50% not seen)
12
Q
Proximal caries are:
A
Triangular dark area with its base to tooth surface. A few mm apical from the contact point
13
Q
adumbration is more likely to be seen in which tooth?
A
A tooth that is triangular in cross section
14
Q
Moderate Lesions_ Proximal caries
A
appears dark triangle with base on Dentin enamel junction and apex directed toward pulp
15
Q
Moderate Lesions
A
Lesions extending more than halfway to the pulp
16
Q
Occlusal Caries location:
A
Narrow at the occlusal surface, usually at the deepest pit. Wider in Dentin, and looks like upside-down cauliflower,
17
Q
True or False: Occlusal Caries is easy to detect clinically
A
True
18
Q
Cervical (Root) Caries
A
Diffuse, rounded radiolucency below Cervical enamel junction, associated with gingival recession, more rapid decay of cementum and dentin (softer).
19
Q
Recurrent Caries
A
New Caries lesion after removal and restoration of caries lesions.
20
Q
xerostomia is defined as:
A
Dry mouth
21
Q
Xerostomia can come from:
A
Medications, Therapeutic Radiation, Sjogren’s Syndrome
22
Q
Xerostomia Caries begins at:
A
Cervical Region causing extensive decay
23
Q
Rampant Caries are:
A
Extensive Caries- encroaches on pulp quickly
24
Q
Rampant Caries are found on what types of patients:
A
Pediatric Patients, Patients with poor Diet, Socio-economic factors, Meth use Patients
25
Caries Imitators are defined as:
Not true Caries
26
Cervical burnout- Adumbration
Often aligns with alveolar crest and Cement Enamel Junction, Outer tooth surface typically maintained
27
Mach Band Effect is:
Optical illusion, Characteristic uniform, thin radiolucent line at enamel dentin interface. Its subtle
28
True or False: image Sharpening is a form of Caries imitator
True
29
Image Sharpening is defined as:
Post processing alteration of image contrast, can creat generalized, uniform radiolucent bands next to restorations.
30
Caries Imitators can also be Dental pits/fissures/anomalies:
Hypoplastic pits, concavities produced by RPD Clasps, typically more well defined.
31
Bone Destruction will be shown as:
Radiolucent
32
Bone Sclerosis will be shown as:
Radiopaque
33
Poorly defined will be shown as:
Diffuse
34
Periodontal disease originates from the:
Alveolar crest/PDL junction
35
Periapical Disease originates from:
The pulp at the apex of the tooth or from accessory canals
36
Furcation
in the posterior teeth where the tooth bifurcates or trifurcation.
37
Role of Radiography: Bone will show us
Amount of bone present, orientation of the alveolar crest, condition of alveolar crest, bone loss in furcation areas.
38
Role of Radiography: PDL
Width of Periodontal ligament, density of the lamina dura. (can't show ligament but will show space of ligament)
39
Role of Radiography: Local Factors
Presence of Calculus, overhanging restorations, crown/root
40
Diagnostic Steps:
Clinical exams, probing for pocket depth, Radiographs and clinical exams are complimentary
41
Bone Loss in Periapical and bitewing radiographs are:
shows bone loss on superior to inferior (also medial to distal) but does not show buccal to lingual
42
True or False: Pocket depth can not be found on Radiograph
True
43
True or False: Poor Geometry can create the appearance of bone loss or bone gain
True
44
True or False: Image density can create the appearance of bone loss or bone gain
True
45
Normal Alveolar Crest
0.5-2.0 mm apical to cemento enamel junction(parallel to line joining the CEJ of Adjoining teeth)
46
Alveolar Crest should Be ___________
Smooth
47
Alveolar Crest should be as dense as the __________ ________.
Lamina Dura
48
Lamina Dura and Alveolar Crest should have the same ___________
Density
49
Early Periodontitis
Loss of Crestal Cortication
(beware of image brightness setting and anatomically thin crest at anterior mandible)
50
Evidence of Early Periodontitis
Loss of sharp angle between lamina dura and crest
moderate widening of PDL near crest
Radiographic evidence of periodontitis is delayed compared to the clinical activity of the disease.
51
Early Destruction of Crestal Bone
Recession of Alveolar Crest, loss of crestal cortication,
52
Horizontal Bone Loss Defined:
Horizontal Bone Loss- crest of bone is parallel to CEJ line between adjoining teeth. The remaining bone is still horizontal but may be positioned apically
53
Vertical Bone Loss Defined:
Vertical Bone Loss: Crest of remaining bone is not parallel to the CEJ line between adjoining teeth (displays an oblique angulation to the CEJ line)
54
Classifying Bone Loss Healthy:
Healthy:.05-2.0 From CEJ
55
Classifying Bone Loss Early/Mild:
Up to 20% bone Loss
56
Classifying Bone Loss Moderate:
20-50% Bone Loss
57
Classifying Bone Loss Severe:
More than 50% bone Loss
58
Buccal or Lingual Bone Loss can be seen:
can see bi-level horizontal bone Level discrepancy
59
Factors of bone loss
Calculus, overhanging restorations, poor restoration contours.
60
Trauma without pulp exposure can cause:
Sterile Necrosis
61
Radiographic Exam: CBCT is
excellent for dental and periodical anatomy. Shows relationship of the lesion with cortical bones.
62
PA inflammatory Lesions will widen the
PDL space
63
Lesions commonly centered on ___________
Apex
64
If we have accessory canals we may have wider ________
Apex
65
Healthy Periapical Appearance:
Uniform, thin PDL, Uniform, thin Lamina Dura
66
Diseased Periapical Area:
Large restoration, PDL widening, LD displacement, LD loss or discontinuity (medial root), LD sclerosis (distal tooth), lesions centered on apices.
67
Pulp Calcification
Sclerotic response of tooth pulp tissues to trauma/inflammation, traumatic incident can be years prior.
68
Periapical Granuloma Definition:
Mass of chronic granulation tissues
69
Periapical abcess Definition:
Characterized by puss formation. May develop directly as an acute process or develop from pre-existing granuloma.
70
Periapical Cyst Definition:
A cyst is an epithelium lined cavity which is filled with fluid or semi-solid material.
71
True or False: Radicular Cyst is the Only cyst related to nonmetal pulp
True
72
Apical Periodontitis Definition:
Term that includes granuloma, access or small radicular cyst. This covers all three conditions (large region that displaces and expands adjacent structures are more likely to be radicular cysts.)
73
Regressive Changes occurs after:
eruption of the tooth
74
Attrition:
Physiologic
75
Abrasion:
Mechanical
76
Erosion:
Chemical
77
Attrition defined as:
Part of aging process, grinding of teeth (bruxism), incised, occlusal and inter proximal surfaces, (wearing away)
78
Abrasion Defined as:
Radiolucent defects at the cervical region, well defined semilunar defects, pulp chamber sclerosed.
79
Erosion defined as:
breaking down of teeth from outside factors, diet, acidic
80
Osteoclast resorbs
Resorb bone
81
Osteoblast make
Bone
82
Odontoclasts resorbs
Tooth
83
"clast"
destroys
84
External root resorption is caused by:
trauma, mechanical forces, presence of tumors or cysts, impacted teeth, osteosclerosis (increased density of bone), Ortho can cause external root resorption
85
Idiopathic means
unknown causes
86
Internal root resorption is caused by:
starts in the pulp canal (outline of the pulp chamber can be lost) trauma and idiopathic can cause internal resorption.
87
Three causes of Tooth Trauma:
Concussion, Luxation, Avulsion
88
Dental Fracture can be seen in three ways
Cornonal fracture, root fracture (vertical or horizontal), alveolar fracture.
89
if pulp canal is not seen, it is
an old fracture
90
if there's a J shaped radiolucency or widening PDL space on one surface of the root it would be a _____________ fracture
Vertical root fracture
91
Mandibular Fracture occur in
Subcondylar 30%
Angle 25%
Symphysis 22%
Body%
92
Anatomic Radiolucency
Absence of Bone
93
Pathologic Radiolucency
Destruction of Bone or replacement with sift tissue, fluid.
94
Radiolucencies with distinct borders are:
Slow growing, fluid filled balloon, soft tissue mass, has a barrier around pathology, hydraulic pressure.
95
Radiolucencies with Indistinct borders are:
Fast growing, destruction to different depth, no barrier to enclose the pathology.
96
Cyst defined as:
Cavity filled with fluid, lined by epithelium, connective tissue wall. Round and well defined.
97
Location of Cyst:
Usually inside bone, may be in soft tissues odontogenic cysts in tooth bearing areas.
98
Border of Cyst
Well defined and corticated
99
Shape of Cyst
Round or Oval
100
types of Radicular Cyst:
Periapical cyst, apical periodontal cyst, dental cyst
101
Radicular Cyst only associated with ______-_______ ___________
Non-vital Tooth
102
Location of Radicular Cyst:
Centered around apex, except when related to an accessory canal.
103
Border of Radicular Cyst:
Well defined, circular, corticated
104
Effects on Adjacent Structures of radicular cyst:
Displacement and resorption of roots, displaces the sinus, cortex, and inferior alveolar canal.
105
Dens in Dente:
infection in root that expands
106
Residual Cyst Defined as:
A dental cyst that develops after incomplete removal of a cyst. Commonly in edentulous area.
107
Dentigerous Cyst defined:
Always associated with crown of an impacted or unerupted tooth. Cyst of the Dental follicle .
108
Types of Dentigerous Cyst:
Central, Lateral, Circumference. Lesion starts from the CEJ.
109
Location of Dentigerous Cyst:
Most commonly mandibular 3rd molar and maxillary canine. Around the crown, attaches at CEJ.
110
Border of Dentigerous Cyst:
Well-corticated radiolucency.
111
Size of Dentigerous cyst:
if follicular space exceeds 3 mm in periodical radiographs, there is greater likelihood of dentigerous cyst. can be very large
112
Odontogenic Keratocyst border:
Corticated, smooth, round or Orval, scalloped
113
Effect on Adjacent structures of Odontogenic Keratocyst:
Minimal expansion in the body, some expansion in ramus.Displaces or resorbs teeth, but less than dentigerous cyst.
114
Nasopalatine Duct Cyst
Only seen in incisive canal cyst, at the midline of maxilla between centrals. Can cause separation of roots, circular or oval, well defined, heart shaped when nasal spine is superimposed.
115
Simple Bone Cyst
Traumatic Bone Cyst, Hemorrhagic Cyst, Cavity in Bone, In ages 17
116
Location of Simple Bone Cyst
Mandible, well defined or ill defined. Scalloped between roots, No symptoms, incidental finding (Male/Female 2:1)
117
Benign Tumor:
A tumor that does not spread to remote parts of the metastasis and does not invade adjacent normal tissues
118
Malignant Tumor:
Invades surrounding tissues, may metastasize to sites, and are likely to recur, and may be fatal to the patient
119
Benign (amelobblastoma)
Locally invasive, aggressive, yet benign
Multicystic (looks like soap bubbles)
More often in men in African men around age 40.
120
Periapical Cemento-osseous Dysplasia (PCOD, PCD, POD)
Mixed or radiopacity, pulp is vital, patient is asymptomatic, no clinical signs. Patients are mostly females African americas, 40yrs old
121
Location of PCOD
Seen in mandibular anterior areas, bilateral, multiple.
122
three stages of PCOD
Stage 1: Radiolucent, Stage 2: Mixed Stage 3: radiopaque.
123
Salivary Gland Depression is Called:
Stafne's Defect
124
Stafne's Defect is a submandibular Salivary Gland ________
Defect
125
Radiolucency near the angle of the mandible is due to ___________ Defect
Stafne's
126
True or False: There is no treatment needed for Stafne's Defect
True
127
Stafne's Defect is located below the __________ __________
Alveolar Canal
128
Cleft:
Involve lip, alveolar bone or palate or any combination.
129
Cleft Lip and Palate: Most common developmental craniofacial abnormality
May be associated with syndrome
130
Osteomyelitis
Infection of bone, involves marrow, cortex, periosteum, usually local source of infection. May have hematogenous source (infection spreading through bloodstream)
131
Osteomyelitis
We will see Radiolucency and Radiopacity
132
MRONJ
Medication Related Osteonecrosis of the Jaw (Bisphosphonate-related osteonecrosis of the jaw. Radiographic fetures are almost similar to Osteomyelitis.
133
Squamous Cell Carcinoma
Radiolucent bony defect
134
Border of Squamous Cell Carcinoma
Irregular, rarely smooth
135
Squamous Cell Carcinoma has widened ___ of few teeth with loss of _______ ______
Widened PDL of few teeth with loss of Lamina Dura.
136
Destruction of the cortex (destruction of Bone), and pathological fracture is seen in both: __________ and ________
Osteomyelitis and Cancer (Squamous Cell Carcinoma
137
Floating Teeth is a sign of
Squamous Cell Carcinoma (Cancer)
138
Irregular Bony destruction is a sign of:
Cancer
139
Anatomic Radiopacity:
Normal increased density of Bone
140
Pathologic Radiopacity:
Excess deposits of bone or (Calcification in soft tissue)
141
Radiopacity
Bony opacities (variation of normal/ bony diseases)
Dental Anomaly
Soft Tissue Calcifications
Foreign Body
142
Palatal Torus:
Hyperostosis (extra bone formation) or Exotosis (bone formation on outside of cortical plate)
143
Palatal Torus as a bony growth on middle third of the ______ _______
Hard Palate
144
___________ ____________ is On a PA or Pan Attached to and below the hard palate, Is well defined, corticated, lobulated, uniformly radiopaque.
Palatal Torus
145
Mandibular Torus defined as:
Lingual hyperostosis or exostosis near the mandibular premolars
146
__________ _________ is :Superimposed over cervical area of premolars, mostly bilateral, smooth, well defined, non corticated margin, uniformly radiopaque.
Mandibular Torus
147
Enostosis:
Bony Growth on the inside
148
Dense Bone Island or idiopathic Osteosclerosis is
Enostosis
149
________ Is Well defined, no Lucent border, no cortication, blends. Uniformly radiopaque, may resorb or displace roots.
Enostosis
150
Sclerosing Osteitis:
Body Tries to deposit extra bone due to the infection. It starts from root and travels to apex. Outer margin is not well defined.
151
Idiopathic Osteosclerosis Vs Sclerosing Osteitis
Well defined margins. Fuzzy Margins
Asymptomatic. Has/had symptoms
Tooth is normal. Carious or tooth w/ RCT
No tx needed. Extraction or RCT
152
Ondontoma can be two types
Compound and complex
153
"Oma" means
some type of tumor
154
Complex ondontoma is
no morphological similarity to a tooth
155
Compound
Similar to a tooth, may be small denticles.
156
Odontoma radiographically has
Enamel, dentin, pulp areas, follicle, tooth like entities.
157
Displaces adjacent teeth, prevents eruption of normal teeth, large _________ may expand the jaws, dentigerous cyst.
Odontoma
158
Sialolith
Obstruction of the salivary Duct
159
Obstruction of the salivary duct can be plugged from
mucus or calcification
160
Radiographic features of Sialolith:
Features are smooth, outline uniformly, calcified or layered.
161
Tonsillar Calcification is
Multiple irregular radiopacities, superimposed over ramus.
162
Carotid Calcifications
Near Angle of Mandible, Vertical, parallel, irregular, can be bilateral. in blood vessel.
163
Bilateral:
Both sides
164
What is the typical location of proximal caries?
Apical from the contact Point
165
What are the minimum factors required for the development of caries?
Bacteria, tooth, Carbohydrates
166
Adumbration is more likely to be seen in which tooth?
A tooth that is triangular in cross section
167
What radiographic features would indicate that a patient has radiation caries?
Caries in the cervical areas of many teeth
168
What is the best examination for detecting occlusal caries?
Clinical Exam
169
What is the radiographic appearance of an incipient proximal caries?
Triangular with the base on the proximal surface
170
What is the best way to differentiate active vs arrested caries?
Comparing radiographs over several months
171
When can a periapical lesion be on the distal side of a root? A distal lesion happens due to:
accessory Canal
172
What information cannot be obtained from a radiograph?
Pocket depth
173
What is the best radiographic feature of a vertical bone loss?
Crest is not parallel to the CEJ line
174
What is a radiographic feature of early periodontitis?
Recession of alveolar crest
175
What is more reliable radiographic examination for diagnosing periodontal disease?
Vertical Bitewing
176
Which examination can reliably differentiate periapical abscess, periapical granuloma and periapical cyst?
Because radiographs cannot differentiate between abscess, granuloma and a cyst, we conclude that biopsy would be the only way surely know.
177
THis is not a feature of plural or endodontic lesion
Crystal Bone recession
178
Which surface of a tooth is more likely to show dental floss trauma?
Distal
179
Reasons that cause external root resorption
External root resorption may happen due to periapical lesions, cysts or benign tumors, orthodontic tooth movement, impacted teeth, trauma and unknown reasons.
180
Reasons that can cuase internal root resorption:
Trauma and unknown reasons (idiopathic)
181
How do attrition, abrasion and erosion differ?
Attrition is physiologic wearing away of tooth. Abrasion is mechanical wearing away of tooth. Erosion is chemical wearing away of tooth, without bacteria.
182
What is the most common location of mandibular fracture?
Subcondylar
183
What are signs of a fracture?
Horizontal radiolucent line in the root, step deformity of the root, sclerosis (narrowing) of the pulp canal, circular root resorption, and narrowing of the PDL space
184
Your doctor has ordered periapical radiography for suspected fracture of the central incisor. What should be your technique to rule out fracture?
I will obtain three or four periapical radiographs by changing the vertical or horizontal angle of the PID.
185
How do concussion, luxation and avulsion differ?
In concussion, the traumatized tooth is not displaced. In luxation, the tooth is dislocated but still in the jaw. In avulsion, the tooth has fully come out of the socket.
186
What are a few features of dentigerous cyst
The radiolucent lesion is superimposed over the crown of an impacted canine, the lesion arises from the CEJ of the canine and the impacted canine is displaced. The border is corticated.
187
On a Panoramic radiograph, a radicular cyst has an oval shape. What can you conclude from this appearance? The cyst is:
in contact with a hard surface
188
What are a few features of stafne's defect?
The defect is non-corticated radiolucency near the angle of the mandible. It is not in the area of a tooth. It is inferior to the inferior alveolar canal. The adjacent teeth appear normal
189
A simple Bone Cyst
For a radicular cyst the lamina dura is displaced. The lamina dura in this radiograph is intact and uniformly wide. The tooth does not appear to be carious. The sharp cusps of all the teeth tells that the patient is young. A non-radiographic test would be a vitality test. A radicular cyst is associated with a non-vital tooth. Teeth adjacent to a simple bone cyst are vital.
190
How does the margin of malignant Tumor (cancer) differ from a benign tumor?
The margins of benign tumors are well defined while the margins of malignant tumor or cancer are irregular and poorly defined.
191
Which of the following lesions transform from a radiolucency to radiopacity in a later stage?
Periapical Cemento-osseous dysplasia
192
Radiographically which disease will have appearance similar to MRONJ?
Osteomyelitis
193
Radiographically, which disease will have appearance similar to osteomyelitis?
Malignant Tumor
194
What are a few features of ameloblastoma?
This is a multilocular lesion that has expanded the alveolar crest and the inferior border of the mandible. The roots of a few teeth are resorbed by this lesion.
195
Why does nasopalatine duct cyst have a heart shaped on the periapical radiograph?
Superimposition of the anterior nasal spine.
196
A uniformly radiopaque mass without any lucency in the mandibular premolar region is likely to be?
Mandibular Torus
197
What feature differentiates idiopathic osteosclerosis from sclerosis osteitis?
Vitality of Tooth
198
On a panoramic radiograph, an oval radiopacity is near the inferior border of the mandible. A part of this radiopacity is outside the bony margin of the mandible. This radiopacity is likely to be
A sialolith
199
On a panoramic radiograph, multiple irregular radiopacities are seen superimposed over ramus. These radiopacities are likely to be?
Tonsillary Calcification
200
A smooth bony growh on the buccal cortical plate of the maxillary molars is called
Hyperostosis
201
Idiopathic osteosclerosis is also known as
Dense bone Island
202
What are a few features of carotid calcification?
The radiopacity is almost vertical, with two irregular lines that are almost parallel. This radiopacity is about 45° from the angle of the mandible.
203
How does enostosis differ from exostosis? An exostosis is:
On the inside of a bone
