Caries diagnosis and treatment planning

Question 1

Why should radiographs and clinical examination be used for caries diagnosis?

Answer 1

Bitewings only 79% caries detection
Combination 90% caries detection

Question 2

Radiographic diagnoses

Answer 2

Bitewings
Lateral oblique jaw view
OPT

Question 3

Bitewing advantages

Answer 3

Surface inaccessible to clinical exam
Depth of lesion can be assessed
Non-invasive
Radiographs can be re-examined and comparisons made. They have a greater diagnostic yield when compared to clinical examination alone. Detection of lesions increases 2-8x which otherwise appeared clinically sound.

Question 4

Limitations of radiographs in diagnosis of caries

Answer 4

Age/Co-operation issues
Occlusal caries may not be visible
Triangular radiolucencies
Underestimate extent of lesion
DNA Damage due to ionising radiation

Question 5

Advantages of lateral oblique jaw view

Answer 5

Avoids intra oral film
less co-operative ability required

Question 6

Advantages of OPT

Answer 6

Increased radiation dose
Detect occlusal dentine lesions
Lower sensitivity for caries diagnosis esp in detection of approximal lesions

Question 7

What is DSR

Answer 7

Digital subtraction radiography
Determines qualitative changes that occur between 2 digital radiographic images taken at different times
Shows progression or regression