Caries Interpretation Flashcards
disease mechanism of caries
INFECTIOUS DISEASE
demineralization of tooth structure, dynamic process
requires presene of bacteria and a diet containing fermented carbohydrates
group of bacteria that plays a centeral role in caries mechanism
streptococcus mutans –> DEMINERALIZATION PROCESS
contributing factors to caries
- bacteria
- plaque or biofilm
streptoccocu mutans
Diet
- FERMENTABLE CARBS
Radiograh most useful in detecting careis?
BITEWING
then peri-apical
then panoramic
then cone beam CT
a good bitewing radiogrpah includes what?
from distal of canines for premolar shots and all the way back to the posterior of the molars for the molar shots
buccal and lingual caries are what class?
Class V
same with root surfaces
- class V
What is the caries susceptible zone?
CONTACT POINT – and down
interproximal
- between the contact point og the teeth and the gingival margin
do caries occur apiocal to the gingival margin
not usually
- but different with case of gingival recession pt.
DESCRIBE INCIPIENT LESION
DO NOT EXTEND INTO DEJ
- are within the enamel of the tooth
- caries susceptible zone
triangle with broad base at outer surface
describe location of interproximal careis
SPREAD ALONG DEJ
spread INTO DENTIN
- second triangle with base AT DEJ
- some cases, lesion may appear not to have oentrated the enamel
major difference we see with primary dentition
primary teeth have THINNER ENAMEL – so it can reach the dentin more quickly and seem to spread rapidly
general rule fo when to treat lesion vs not
if spread into DEJ (into the dentin – more likely for treatment vs incipient)
anterior caries
same type of thing happening where it is starting on the enamel
how to differentiate between a lesion and a radioluscent filling material?
lesion
- DIFFUSE MARGIN
restoration
- WELL-DEFINED MARGIN
OCCLUSAL CARIES
describe a large one
- easily observed
- appears as large, dark circles in the crowns
- pulp exposure can not always be determined
OCCLUSAL CARIES
describe a small one
not very effective at decting when looking radiographically (harder to)
may be seen as thin radiolucent line or cup shaed zone underlyinh occlusal ensmel
minimum to no changes in enamle
what does he mean by rampant caries?
all over the dentiion
more likely to occur in the younger pt. population in the primary dentition
rampant careis mostly seen in? other reasons
flourishing or spreading - due to lack of being checked and in younger patients with poor oral hygeine and poor diet
also DUE TO RADIATION TX CARIES
describe root surface caries
Cratering the roots of the teeth, involving CEMENTUM
can be buccal/ lingual/ proximal
saucer like radiolucensy
maybe confused with cervical burnout
how do root caries form?
due to gingival recession
- so only expect these in patietns who have poor periodontium and have recession (caries do not form from beneath gingiva)
root surface caries could be confused with?
cervical burnout
*take note of the bone levels
describe cervical burnout
apparent radiolucency below the CEJ due to anatomy or a gap betweeen the enamel and bone covering the root
BETWEEN BONE AND ENAMEL
no root caries unless there is alveolar bone loss
describe recurent caries
around the margins of existing restorations
AKA Secondary caries
general description of diagnostic confounders
these are things that may look like caries but are NOT
general description of diagnostic confounders
these are things that may look like caries but are NOT
do NOT go purely by radiographic imaging but look at clinical exam too
list of diagnostic confounders
- pits and fissures
- cervical burnout
- mach band effect
- dental anomolies
- hypoplastic pitis
- concavitities produced by wear
buccal pit looks?
well - defined radioluscent circular
MACH BAND EFFECT is a?
a diagnostic confounder
describe mach band effect
OPTICAL ILLUSION
- the eye has a built in “edge-enhancment’ where there is lateral inhibitionin the neurons in the retina when looking at edges with slightly different shades of gray
anywhere where there is a slightly contrasting edge
mach band effect can lead to?
false positives
- false diagnosis of caries
enamel hypoplasia implication?
can look like a radioluscency
- but it is a dental anomaly and likely more localized to a tooth due to a developmental problem
concavity seen? looks? what do you do?
looks maybe like a carious lesion but check it clinically as it can be produced by wear (like denture wearing)
T/F you can accuratley see the extend of caries on a radiograph
false
- will always be deeper probably
- have structures overlapping it
-
overlap in a bitewing could be from?
horizontal orientation of the xray beam
remineralizaton occurs where? implication?
takes place on the outermost surface because mineral-containing solutions from saliva cannot diffuse into the body of the lesion
Can x-rays tell you the activity of a carous lesion?
NO – cannot tell if it is active or arrested in a radiogrpah alone
micro-radiograph?
can show a snapshot
subtraction radiography
attempting to determine progress or not of two radiographs taken at different times to tell the difference over time
