Caries Interpretation Flashcards
what is the epidemiology of dental caries
- one of the most prevalent human diseases
- decreasing prevalence rate finally occured in 1980’s
- disease of “civilized” societies
what are dental caries associated with
highly refined sugar and retentive food diets that remains prevalent in lower socio- economic groups
what is the greatest cause of tooth loss over 35 years old
dental caries
what is the pathophysiology of dental caries
- related to bacterial adhesion to tooth surfaces and plaque formation
- bacteria metabolize dietary carbohydrate producing acid byproducts that lower pH below 5.5 threshold to decalcify teeth
what is plaque composed of
polysaccharide/eznyme matrix with bacterial colonies that attach to tooth surfaces
what are predisposing factors of dental caries
- bacteria- lactobacillus casei, streptococcus mutans, actinomyces viscosus
- diet- glucose
- plaque retention
- OH compliance
- saliva- concentrations of salivary glycoproteins and immunoglobulins
what does the type of bacteria in caries depend on
host
what is the range of dental caries
from slight demineralization to gross coronal decay
dental caries defects appear as violations of:
- smooth surfaces, usually at inaccessible areas
- pit and fissures of occlusal and occasional proximal caries
what is the diagnosis of dental caries
- easy to diagnose
- not so easy to stage
- harder to treatment plan
what radiographs are preferred with interproximal caries
horizontal (standard) bitewings
what is periapical radiography helpful for
caries detection if XCP technique used to minimize linear distortion in the vertical dimension
horizontal angulation must project _____
non-overlapped contacts
why are vertical bietwings not as useful
- technique problems from bending of the film
- difficulty placing film to open contacts
what are the factors affecting caries presentation
- angle of the x- ray beam
- placement of the image receptor
- location of the proximal carious lesion
- degree of hypomineralization
- exposure factors; low Kv vs high Kv;
- degree of cavitation
- ambient light intensity
- monitor contract resolution calibration
- selection of post processing algorithms on digital images
can you use periapical radiographs for interproximal caries diangoses
yes if they are parallel
what are factors affecting perception of digital display
- monitor resolution
- monitor luminescence
- background lighting affect
standard commerical grade desktop monitors have been shown to be _____ for diagnostic medical radiology
inferior
describe initial caries
- in enamel layer
- ranges from a demineralization defect at the proximal surface can extend axially to contact the DEJ
describe moderate caries
-spreading vertically at the DEJ and/or
- extending axially less than half way in dentin layer
describe advanced caries
greater than or equal to half way in dentin layer and can extend axially to contact the pulp
describe root surface caries
- saucerized or scooped out appearance
- 50% prevalance in geriatric population
- most common in B premolar regions then Li and interproximal areas
why are Buccal or Lingual caries difficutl to localize on a single view
may superimpose pulp
descrbie E1 lesions
- lesion within outer 1/2 enamel
- appears as radiolucent notch on the outer surface of the tooth
describe E2 lesions
- lesion within inner 1/2 enamel
- may have isosceles triangular outline with the base at the proximal surface
- does not extend to DEJ
describe D1 lesions
- lesions within outer 1/3 of dentin
- undermines enamel and extends into dentin
- at or axial to the DEJ
describe D2 lesions
- lesion within middle 1/3 of dentin
- the dentin lesion is a more extensive dentin lesion
describe D3 lesions
- lesion within inner 1/3 dentin
- the dentin lesion is more extensive than the enamel lesion
what are the two different ways to classify caries (ssytems)
- caries classification - UMKC SOD method
- International caries detection and Assessment System (ICDAS)
what is interproximal burn out
- the dentin artifact stimulates caries
- lesion is outlines by normal anatomic structures and is a relative radiolucency
why are incipient occlusal caries hard to detect on radiographs
- small width of the lesion
- density of superimposing enamel
describe moderate occlusal caries
- broad based thin radiolucent zone in dentin with no changes in enamel
- noticed as a relative increase in opacity between pulp and caries
describe severe occlusal caries
undermined enamel with gross loss of tooth structure
