Caries Interpretation Flashcards
one of the most prevalent human
diseases
DENTAL CARIES
decreasing prevalence rate finally
occurred in —’s
1980
DENTAL CARIES
Epidemiology
* disease of
“civilized” societies
DENTAL CARIES
Epidemiology
associated with
highly refined sugar and
retentive food diets that remains
prevalent in lower socio-economic groups.
DENTAL CARIES
Epidemiology
greatest cause of tooth loss < or equal to – years
35
DENTAL CARIES
Pathophysiology
related to
bacterial adhesion to tooth
surfaces and plaque formation
DENTAL CARIES
Pathophysiology
plaque composed of
polysaccharide/enzyme
matrix with bacterial colonies that attach to
tooth surfaces
Bacteria metabolize dietary carbohydrate
producing
acid byproducts that lower pH
below 5.5 threshold to decalcify teeth
DENTAL CARIES
Predisposing Factors
(5)
- bacteria –varies
- diet –glucose
- plaque retention
- OH compliance
- saliva - concentrations of salivary glycoproteins
and immunoglobulins
- bacteria –varies
- dependent on host
(3)
a. lactobacillus casei
b. streptococcus mutans
c. actinomyces viscosus
DENTAL CARIES Signs
ranges from —
to gross —
slight
demineralization
coronal
decay
defects appear as violations of
(3)
i. - smooth surfaces, usually at
inaccessible areas
ii. - pit and fissures of occlusal
and occasional proximal surfaces
DENTAL CARIES
Diagnosis
(3)
i. easy to diagnose
ii. Not so easy to stage
iii. Harder to treatment plan
Periapical Radiography
(2)
- Helpful for caries detection if XCP technique used to
minimize linear distortion in the vertical dimension - Horizontal angulation must project non-overlapped
contacts
Vertical Bitewings
Not as useful because
(2)
a. technique problems from bending of the film
b. Difficulty placing film to open contacts
Factors affecting Caries Presentation
(9)
- Angle of the x-ray beam
- Placement of the image receptor
- Location of the proximal carious lesion
(i.e. exactly cervical to the contact or slightly
buccal/lingual) - Degree of hypomineralization
- Exposure factors; low kV vs high kV;
- Degree of cavitation
- Ambient light intensity
- Monitor contrast resolution calibration
- Selection of postprocessing algorithms on
digital images
Factors affecting perception of digital
display
(3)
- monitor resolution
- monitor luminescence
- background lighting affect
standard commercial grade desktop monitors
have been shown to be inferior for
diagnostic
medical radiology
CARIES
IC=
MC=
AC=
RSC-
R RC=
B/Li =
Initial caries
Moderate caries
Advanced caries
Root surface caries
Recurrent caries
B or Li caries
initial caries
(2)
in enamel layer
ranges from a demineralization defect at the proximal surface and can extend axillary to contact the DEJ
moderate caries
(2)
spreading vertically at the DEJ and/or
extending axillary < half way in dentin layer
advanced caries
(1)
> or equal to halfway in dentin layer and can extend axillary to contact the pulp
Root caries- appearance:
- –% prevalence in geriatric population
- Most common in
Saucerized or scooped-out
50
B premolar regions,
then, followed by Li & interproximal areas
B or Li caries
Difficult to localize on a single view bc…
May superimpose pulp
International Caries Detection and Assessment System
ICDAS
* E1
* E2
* D1
* D2
* D3
E1
Lesion within outer ½ of enamel
E2
Lesion within inner ½ of enamel
D1
lesion within outer 1/3 of dentin
D2
lesion within middle 1/3 of dentin
D3
lesion within inner 1/3 of dentin
E1 Interproximal Caries
- Penetrates < ½ the enamel thickness as a
radiolucent notch on the outer surface of the
tooth
E2 Interproximal Caries
(3)
- Penetrates > ½ the enamel thickness
- May have an isosceles triangular outline with the
base at the proximal surface - Does NOT extend to DEJ
D1 Interproximal Caries
(3)
- Undermines enamel and extends into dentin
- at or axial to the DEJ
- Penetrates < 1/3 the outer peripheral dentin thickness
D2 Interproximal Caries
(2)
- The dentin lesion is a more extensive dentin lesion
- Penetrates to mid 1/3 of the dentin thickness
D3 Interproximal Caries
(2)
- The dentin lesion is more extensive than the enamel
lesion - Penetrates > 2/3 (or inner 1/3) of the dentin thickness
Interproximal “Burn out”
(2)
A. The dentin artifact simulates caries
B. Lesion is outlined by normal anatomic structures and is a relative radiolucency
Incipient Occlusal Caries
* Difficult to detect on radiographs due to
(2)
- small width of the lesion
- density of superimposing enamel
Moderate Occlusal Caries
(2)
- Broad-based thin radiolucent zone in dentin with
no changes in enamel - Noticed as a relative increase in opacity between
pulp and caries
Severe Occlusal Caries
- Undermined enamel with gross loss of tooth
structure
