Caries Interpretation

Question 1

what is the epidemiology of dental caries

Answer 1

• one of the most prevalent human diseases
• decreasing prevalence rate finally occured in 1980’s
• disease of “civilized” societies

Question 2

what are dental caries associated with

Answer 2

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

Question 3

what is the greatest cause of tooth loss over 35 years old

Answer 3

dental caries

Question 4

what is the pathophysiology of dental caries

Answer 4

• 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

Question 5

what is plaque composed of

Answer 5

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

Question 6

what are predisposing factors of dental caries

Answer 6

• bacteria- lactobacillus casei, streptococcus mutans, actinomyces viscosus
• diet- glucose
• plaque retention
• OH compliance
• saliva- concentrations of salivary glycoproteins and immunoglobulins

Question 7

what does the type of bacteria in caries depend on

Answer 7

host

Question 8

what is the range of dental caries

Answer 8

from slight demineralization to gross coronal decay

Question 9

dental caries defects appear as violations of:

Answer 9

• smooth surfaces, usually at inaccessible areas
• pit and fissures of occlusal and occasional proximal caries

Question 10

what is the diagnosis of dental caries

Answer 10

• easy to diagnose
• not so easy to stage
• harder to treatment plan

Question 11

what radiographs are preferred with interproximal caries

Answer 11

horizontal (standard) bitewings

Question 12

what is periapical radiography helpful for

Answer 12

caries detection if XCP technique used to minimize linear distortion in the vertical dimension

Question 13

horizontal angulation must project _____

Answer 13

non-overlapped contacts

Question 14

why are vertical bietwings not as useful

Answer 14

• technique problems from bending of the film
• difficulty placing film to open contacts

Question 15

what are the factors affecting caries presentation

Answer 15

• 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

Question 16

can you use periapical radiographs for interproximal caries diangoses

Answer 16

yes if they are parallel

Question 17

what are factors affecting perception of digital display

Answer 17

• monitor resolution
• monitor luminescence
• background lighting affect

Question 18

standard commerical grade desktop monitors have been shown to be _____ for diagnostic medical radiology

Answer 18

inferior

Question 19

describe initial caries

Answer 19

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

Question 20

describe moderate caries

Answer 20

-spreading vertically at the DEJ and/or
- extending axially less than half way in dentin layer

Question 21

describe advanced caries

Answer 21

greater than or equal to half way in dentin layer and can extend axially to contact the pulp

Question 22

describe root surface caries

Answer 22

• saucerized or scooped out appearance
• 50% prevalance in geriatric population
• most common in B premolar regions then Li and interproximal areas

Question 23

why are Buccal or Lingual caries difficutl to localize on a single view

Answer 23

may superimpose pulp

Question 24

descrbie E1 lesions

Answer 24

• lesion within outer 1/2 enamel
• appears as radiolucent notch on the outer surface of the tooth

Question 25

describe E2 lesions

Answer 25

• lesion within inner 1/2 enamel
• may have isosceles triangular outline with the base at the proximal surface
• does not extend to DEJ

Question 26

describe D1 lesions

Answer 26

• lesions within outer 1/3 of dentin
• undermines enamel and extends into dentin
• at or axial to the DEJ

Question 27

describe D2 lesions

Answer 27

• lesion within middle 1/3 of dentin
• the dentin lesion is a more extensive dentin lesion

Question 28

describe D3 lesions

Answer 28

• lesion within inner 1/3 dentin
• the dentin lesion is more extensive than the enamel lesion

Question 29

what are the two different ways to classify caries (ssytems)

Answer 29

• caries classification - UMKC SOD method
• International caries detection and Assessment System (ICDAS)

Question 30

what is interproximal burn out

Answer 30

• the dentin artifact stimulates caries
• lesion is outlines by normal anatomic structures and is a relative radiolucency

Question 31

why are incipient occlusal caries hard to detect on radiographs

Answer 31

• small width of the lesion
• density of superimposing enamel

Question 32

describe moderate occlusal caries

Answer 32

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

Question 33

describe severe occlusal caries

Answer 33

undermined enamel with gross loss of tooth structure