Caries Clinical Presentation And Diagnosis (1) Flashcards
What is the first way to diagnose caries?
Anatomical position
What are ways to describe anatomical position of caries?
Smooth surface - proximal or services
Occlusal - pit and fissure
Linear enamel caries
Root
What location of caries is shown?
Smooth surface
What surface are these caries found?
Inter-proximal
What location of caries is shown here?
Pits and fissures
What groove is C and D referring to and where does it start and end?
Central groove
Medial to distal surface
-grooves can extend over marginal ridges
What fissures are shown here and where do they terminate?
Fissure Developmental groove on lower first molar
Terminates at a pit
What are the types of terminations of fissure?
Shallow and self cleanable or deep, narrow and retentive
What types of fissure termination sites are cleanable?
V and U =cleanable
I and K = uncleanable
Name the 4 fissures?
What fissures completely penetrate the enamel?
Describe root caries
Root caries is a disease that is expressed as a soft, progressive lesion found on a tooth root surface that has lost its connective tissue attachment and thereby has become exposed to the environment of the oral cavity.
What pH does demineralisation occur in coronal caries?
5.5
What pH can the demineralisation occur in root caries?
6.7 , can cause caries
What bacteria are involved in root caries? (Specific)
Gram-positive anaerobes
Streptococcus sobrinus (in combination with S. mutans it is a determinant of having a caries lesion).
Actinomyces
What in the diet can promote caries?
Carbohydrates … sucrose
What demographic is more likely to get root caries?
Older people, sweeter diet
How do inactive (arrested) caries present?
Well-defined.
Dark brownish or black in colour. Smooth, shiny surface.
Hard on probing with moderate pressure. Usually not covered with plaque. Cavitation may be/is present.
How do active caries present clinically?
Yellowish, light brown.
Soft or leathery on probing with light pressure. Covered by visible plaque.
Cavitation may or may not be present.
How would you classify a carie by length?
GRADE 1-4
What are 3 ways to derive the texture of a root carie?
Hard
Leathery
Soft
Is an active carie, hard, leathery or soft?
Leathery or soft
Describe lesions 1-4?
What is acute caries?
Usually in children
Effect large number of teeth
What has caused this type of acute caries?
Radiation caries
Why does radiation cause caries?
- reduces the saliva, parotid glands get affected there will be no saliva in mouth.
- brushing is painful
- mucositis can be seen (red and inflamed gums)
What are 3 ways to rate caries based on their progression?
- Acute
- Chronic
- Arrested
Where are chronic caries usually located?
Occlusion anterior surfaces
What are arrested caries?
Static
Show sclerosis of dentinal tubules and secondary dentin formation (brown)
What type of caries is shown here, based on progression?
Arrested
Brown marks
What are the 3 layers of arrested caries?
- Surface layer
- Pigmented zone
- Sclerotic zone
What zone of arrested dental caries is leathery and brown?
Zone 1 - surface zone
What zone of arrested dental caries is hard and dark brown?
Zone 2: pigmented zone
What zone of arrested dental caries is hard and white?
Zone 3 : sclerotic zone
Is there bacteria in the sclerotic zone?
No
What is caries-infected vs caries-affected dentin?
Caries infected dentin -> outermost, irreplaceable, necrotic zone of destruction
It is dark brown, soft, wet, mushy
Caries-affected dentin -> inner layer of various dentin which can be repaired by the dentin-pulp complex
Paler brown, harder, “ sticky and scratchy‘’dentin
What is the mineral content of the infection dentin?
– Mineral component has dissolved away due to acid attack.
– Collagen matrix has been denatured.
– Bacterial load very high.
– Dentine tubular structure destroyed.
What is the mineral content of affected dentin?
– Mineral dissolution still occurs but lesser extend.
– Collagen is still damaged by proteolysis but to a lesser extend so permitting dentine repair.
– Bacterial load lessens but there are still bacteria present.
– Dentine tubular structure returns gradually within the depths of this zone.
What layer needs to be clinically removed, infected or affected dentin?
Infected
Why do we need to remove the infected dentin?
– Cannot be repaired.
– Poor quality bonding substrate fir adhesive materials to achieve adequate seal.
Why can the affected layer not be removed?
– Deepest layer (4):
– Hypermineralized translucent dentine.
– Reparative reactions of the dentine-pulp complex.
