caries interpretation Flashcards
caries prevalence
- one of the most prevalent human
diseases - decreasing prevalence rate finally
occurred in 1980’s
caries a dx of?
civilized society
caries associated with what diets? socio-economic?
highly refined sugar and retentive food diets that remains prevalent in lower socio-economic groups.
greatest cause of tooth loss <35 years
caries
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
- bacteria –varies- dependent on host
a. lactobacillus casei
b. streptococcus mutans
c. actinomyces viscosus - diet –glucose
- plaque retention
- OH compliance
- saliva - concentrations of salivary glycoproteins and immunoglobulins
DENTAL CARIES Signs, ranges?
ranges from slight demineralization to gross coronal decay
defects of caries appear as violations of:
i. - smooth surfaces, usually at
inaccessible areas
ii. - pit and fissures of occlusal
and occasional proximal surfaces
diagnosis of caries
i. easy to diagnose
ii. Not so easy to stage
iii. Harder to treatment plan
preffered image for caries diagnosis
bitewings (horizontal)
what is acceptable HA for horizontal bitewings
anyhting less than 1/2 enamel overlapped
PA’s and caries detection
- Helpful for caries detection if XCP technique used to minimize linear distortion in the vertical dimension
- Horizontal angulation must project non-overlappedcontacts
vertical bitewings not as useful because?
a. technique problems from bending of the film
b. Difficulty placing film to open contacts
when could a vert BW work?
high palate
Factors affecting Caries Presentation
1. Angle of?
2. Placement of?
3. Location of?
4. Degree of?
5. Exposure?
6. cavitation?
7. light intensity?
8. Monitor?
9. postprocessing algorithms on digital images?
- 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
- monitor resolution
- monitor luminescence
- background lighting affect
medical image grade monitors for dentistry ?
not proven to be necessary
caries classification system used at UMKC
IC=Initial caries
MC=Moderate caries
AC=Advanced caries
RSC-Root surface caries
R RC=Recurrent caries
B/Li = B or Li caries
IC
UMKC class?
IC
UMKC class
IC
MC
UMKC class?
MC
AC
umkc class
AC
umkc class?
AC
app? demo? common areas?
RSC
- Saucerized or scooped-out appearance
- 50% prevalence in geriatric population due to bone loss
- Most common in B premolar regions,
then, followed by Li & interproximal areas
RSC
RC
recurrent caries, occur at restoration margins
RC
more common side/why? easily localized?
B/Li caries
occurring on B/L surfaces
usually on buccal (tongue can remove L plaque)
Difficult to localize on a single view
May superimpose pulp
likely B carie
International Caries Detection and Assessment System classes
- E1
- E2
- D1
- D2
- D3
E1-D3 classified
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
ICDAS class
E1
E2 Interproximal Caries
- Penetrates > ½ the enamel thickness
- May have an isosceles triangular outline with the
base at the proximal surface - Does NOT extend to DEJ
ICDAS class
E2
D1 Interproximal Caries
- Undermines enamel and extends into dentin
- at or axial to the DEJ
- Penetrates < 1/3 the outer peripheral dentin thickness
ICDAS class
D1
D2 Interproximal Caries
- The dentin lesion is a more extensive dentin lesion
- Penetrates to mid 1/3 of the dentin thickness
ICDAS class
D2
ICDAS class
D2
D3 Interproximal Caries
- The dentin lesion is more extensive than the enamel lesion
- Penetrates > 2/3 (or inner 1/3) of the dentin thickness
ICDAS class
D3
ICDAS class
D3
Interproximal “Burn out”
A. The dentin artifact simulates caries
B. Lesion is outlined by normal anatomic structures and is a relative radiolucency
what is this lesion?
cervical burnout
B/L line angles are not aligned
burnout
Incipient Occlusal Caries on radiographs
- Difficult to detect on radiographs due to
- small width of the lesion
- density of superimposing enamel
Moderate Occlusal Caries on radiographs
- Broad-based thin radiolucent zone in dentin with no changes in enamel
- Noticed as a relative increase in opacity between pulp and caries
moderate occlusal caries
Severe Occlusal Caries on radiogrpahs
- Undermined enamel with gross loss of tooth structure
