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Operative Dentistry > Caries Diagnosis and Management > Flashcards

Caries Diagnosis and Management Flashcards

1
Q

Define “caries”

A

Dental caries is an infectious microbiologic disease of the teeth that results in localized dissolution of the calcified tissues

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2
Q

Define dental plaque

A

a gelatinous mass of bacteria adhering to the tooth surface

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3
Q

___ is involved in caries initiation, while ____ are able to withstand acidic environment and lead to progression of caries

A

STREPTOCOCCUS MUTANS is involved in caries initiation, while LACTOBACILLI are able to withstand acidic environment and lead to progression of caries

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4
Q

Tightly packed enamel rods are made up of ____

A

hydroxyapatite

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5
Q

Each enamel rod originates at ___ an terminates at the ____

A

Each enamel rod originates at DEJ an terminates at the EXTERNAL SURFACE

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6
Q

What is Straie of Retzius?

A

The core of enamel rods. It is higher in organic content

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7
Q

What allows for the dissolution of underlying dentin even before actual cavitation of enamel occurs?

A

Porosity of enamel rods, which allow for the movement of small molecules and ions

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8
Q

What area of the tooth is least resistant to caries ttack?

A

DEJ - which is why lateral spreading of caries occurs once bacteria have invaded enamel

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9
Q

Why is dentin more prone to acid attack?

A

because it contains higher organic content than enamel (ie. less mineral)

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10
Q

Dentinal tubules provide a direct pathway for the ingress of ___ and the egress of ___

A

Dentinal tubules provide a direct pathway for the ingress of ACIDS and the egress of MINERALS

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11
Q

The time for progression from incipient caries to clinical caries (cavitation) on smooth surfaces is estimated to be:

A

18 months, plus or minus 6 months

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12
Q

caries are classified into 4 categories:

A
  1. incipient
  2. moderate
  3. advanced
  4. extensive
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13
Q

The class of caries which is the first evidence of carious activity within enamel is called

A

incipient carious lesions

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14
Q

T/F: incipient caries have not reached the DEJ

A

true

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15
Q

In which class of caries is remineralization possible?

A

incipient

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16
Q

How do incipient caries appear clinically?

A
  • opaque white when dried, disappears when wet

- may only appear as a faint radiolucency on radiograph

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17
Q

When the carious lesion has advanced into dentin and remineralization is no longer possible, this is known as

A

moderate caries

18
Q

At which point is remineralization no longer possible and tooth must be restored?

A

Once caries have reached the DEJ

19
Q

What are advanced caries?

A

When the lesion is advancing towards the pulp.
Treatment is required (prep and resto)
May require a root canal or extraction

20
Q

Define extensive caries

A
  • acute or rampant caries, infectious disease process causing rapid damage to teeth.
  • numerous soft, light coloured lesions in the mouth
21
Q

How to treat extensive caries?

A

Root canal if restorable, exo if not

22
Q

Clinical characteristics of normal enamel when hydrated, dessicated, surface texture, and surface hardness

A

Hydrated: translucent
Dessicated: translucent
Surface texture: smooth
Surface hardness: hard

23
Q

Clinical characteristics of hypocalcified enamel when hydrated, dessicated, surface texture, and surface hardness

A

Hydrated: opaque
Dessicated: opaque
Surface texture: smooth
Surface hardness: hard

24
Q

Clinical characteristics of incipient caries when hydrated, dessicated, surface texture, and surface hardness

A

Hydrated: translucent
Dessicated: opaque
Surface texture: smooth (could be roughened too)
Surface hardness: softened

25
Q

Clinical characteristics of active caries when hydrated, dessicated, surface texture, and surface hardness

A

Hydrated: opaque
Dessicated: opaque
Surface texture: cavitated
Surface hardness: very soft

26
Q

Clinical characteristics of arrested caries when hydrated, dessicated, surface texture, and surface hardness

A

Hydrated: opaque, dark
Dessicated: opaque, dark
Surface texture: roughened
Surface hardness: hard

27
Q

Where does recurrent decay typically occur?

A

at the cavosurface junction

28
Q

What types of caries involve the cementum and are commonly associated with periodontal disease?

A

root caries

29
Q

Color of arrested decay

A

brown or black. Shiny

30
Q

Define Cervical Burnout

A

Diffuse radiolucency with ill defined borders of proximal surfaces between CEJ and alveolar crest

31
Q

When a uniformly dark shade meets a uniformly light shade, what occurs?

A

Mach Band effect is observed in which the dark shade looks darker and the light shade looks lighter

32
Q

dark shades in xrays are ___ and light shades are ___

A

dark - radiolucent

light - radiopaque

33
Q

Best diagnostic tool for class II caries?

A

BW

34
Q

As it moves towards the pulp, what shape does a class ii lesion follow radiographically?

A

2 cone tips (big small big small….or tip of dark cone on enamel to head of cone in dentin)

35
Q

How are Class III lesions diagnosed?

A

primarily clinically, with radiographs as an adjunct

36
Q

etiology of class IV lesions

A

usually trauma

37
Q

Etiology of non carious class V lesions

A

Erosion - chemical dissolution due to acid exposure
Abrasion - physical dissolution due to frictional forces
Abfraction - loss of tooth structures due to flexural forces

38
Q

Where are abrasion lesions typically observed?

A

They typically start around the CEJ where enamel is thin and progress to cementum.
V-shaped with apex pointing apically

39
Q

What might you observe in gingival tissue due to abrasion lesions?

A

increased keratinization due to chronic trauma of tissues

40
Q

In abfraction, what shape is the lesion due to tension and compression?

A

tension - V

compression - C

Operative Dentistry (11 decks)

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