Caries Interpretation

Question 1

one of the most prevalent human
diseases

Answer 1

DENTAL CARIES

Question 2

decreasing prevalence rate finally
occurred in —’s

Answer 2

1980

Question 3

DENTAL CARIES
Epidemiology
* disease of

Answer 3

“civilized” societies

Question 4

DENTAL CARIES
Epidemiology
associated with

Answer 4

highly refined sugar and
retentive food diets that remains
prevalent in lower socio-economic groups.

Question 5

DENTAL CARIES
Epidemiology
greatest cause of tooth loss < or equal to – years

Answer 5

35

Question 6

DENTAL CARIES
Pathophysiology
related to

Answer 6

bacterial adhesion to tooth
surfaces and plaque formation

Question 7

DENTAL CARIES
Pathophysiology
plaque composed of

Answer 7

polysaccharide/enzyme
matrix with bacterial colonies that attach to
tooth surfaces

Question 8

Bacteria metabolize dietary carbohydrate
producing

Answer 8

acid byproducts that lower pH
below 5.5 threshold to decalcify teeth

Question 9

DENTAL CARIES
Predisposing Factors
(5)

Answer 9

1. bacteria –varies
2. diet –glucose
3. plaque retention
4. OH compliance
5. saliva - concentrations of salivary glycoproteins
   and immunoglobulins

Question 10

1. bacteria –varies
   - dependent on host
   (3)

Answer 10

a. lactobacillus casei
b. streptococcus mutans
c. actinomyces viscosus

Question 11

DENTAL CARIES Signs
ranges from —
to gross —

Answer 11

slight
demineralization

coronal
decay

Question 12

defects appear as violations of
(3)

Answer 12

i. - smooth surfaces, usually at
inaccessible areas
ii. - pit and fissures of occlusal
and occasional proximal surfaces

Question 13

DENTAL CARIES
Diagnosis
(3)

Answer 13

i. easy to diagnose
ii. Not so easy to stage
iii. Harder to treatment plan

Question 14

Periapical Radiography
(2)

Answer 14

1. Helpful for caries detection if XCP technique used to
   minimize linear distortion in the vertical dimension
2. Horizontal angulation must project non-overlapped
   contacts

Question 15

Vertical Bitewings
Not as useful because
(2)

Answer 15

a. technique problems from bending of the film
b. Difficulty placing film to open contacts

Question 16

Factors affecting Caries Presentation
(9)

Answer 16

1. Angle of the x-ray beam
2. Placement of the image receptor
3. Location of the proximal carious lesion
   (i.e. exactly cervical to the contact or slightly
   buccal/lingual)
4. Degree of hypomineralization
5. Exposure factors; low kV vs high kV;
6. Degree of cavitation
7. Ambient light intensity
8. Monitor contrast resolution calibration
9. Selection of postprocessing algorithms on
   digital images

Question 17

Factors affecting perception of digital
display
(3)

Answer 17

• monitor resolution
• monitor luminescence
• background lighting affect

Question 18

standard commercial grade desktop monitors
have been shown to be inferior for

Answer 18

diagnostic
medical radiology

Question 19

CARIES
IC=
MC=
AC=
RSC-
R RC=
B/Li =

Answer 19

Initial caries
Moderate caries
Advanced caries
Root surface caries
Recurrent caries
B or Li caries

Question 20

initial caries
(2)

Answer 20

in enamel layer
ranges from a demineralization defect at the proximal surface and can extend axillary to contact the DEJ

Question 21

moderate caries
(2)

Answer 21

spreading vertically at the DEJ and/or
extending axillary < half way in dentin layer

Question 22

advanced caries
(1)

Answer 22

> or equal to halfway in dentin layer and can extend axillary to contact the pulp

Question 23

Root caries- appearance:
- –% prevalence in geriatric population
- Most common in

Answer 23

Saucerized or scooped-out
50
B premolar regions,
then, followed by Li & interproximal areas

Question 24

B or Li caries
Difficult to localize on a single view bc…

Answer 24

May superimpose pulp

Question 25

International Caries Detection and Assessment System

Answer 25

ICDAS
* E1
* E2
* D1
* D2
* D3

Question 26

E1

Answer 26

Lesion within outer ½ of enamel

Question 27

E2

Answer 27

Lesion within inner ½ of enamel

Question 28

D1

Answer 28

lesion within outer 1/3 of dentin

Question 29

D2

Answer 29

lesion within middle 1/3 of dentin

Question 30

D3

Answer 30

lesion within inner 1/3 of dentin

Question 31

E1 Interproximal Caries

Answer 31

• Penetrates < ½ the enamel thickness as a
  radiolucent notch on the outer surface of the
  tooth

Question 32

E2 Interproximal Caries
(3)

Answer 32

• Penetrates > ½ the enamel thickness
• May have an isosceles triangular outline with the
  base at the proximal surface
• Does NOT extend to DEJ

Question 33

D1 Interproximal Caries
(3)

Answer 33

• Undermines enamel and extends into dentin
• at or axial to the DEJ
• Penetrates < 1/3 the outer peripheral dentin thickness

Question 34

D2 Interproximal Caries
(2)

Answer 34

• The dentin lesion is a more extensive dentin lesion
• Penetrates to mid 1/3 of the dentin thickness

Question 35

D3 Interproximal Caries
(2)

Answer 35

• The dentin lesion is more extensive than the enamel
  lesion
• Penetrates > 2/3 (or inner 1/3) of the dentin thickness

Question 36

Interproximal “Burn out”
(2)

Answer 36

A. The dentin artifact simulates caries
B. Lesion is outlined by normal anatomic structures and is a relative radiolucency

Question 37

Incipient Occlusal Caries
* Difficult to detect on radiographs due to
(2)

Answer 37

• small width of the lesion
• density of superimposing enamel

Question 38

Moderate Occlusal Caries
(2)

Answer 38

• Broad-based thin radiolucent zone in dentin with
  no changes in enamel
• Noticed as a relative increase in opacity between
  pulp and caries

Question 39

Severe Occlusal Caries

Answer 39

• Undermined enamel with gross loss of tooth
  structure