Caries Interpretation

Question 1

disease mechanism of caries

Answer 1

INFECTIOUS DISEASE

demineralization of tooth structure, dynamic process

requires presene of bacteria and a diet containing fermented carbohydrates

Question 2

group of bacteria that plays a centeral role in caries mechanism

Answer 2

streptococcus mutans –> DEMINERALIZATION PROCESS

Question 3

contributing factors to caries

Answer 3

1. bacteria
   - plaque or biofilm
   streptoccocu mutans

Diet
- FERMENTABLE CARBS

Question 4

Radiograh most useful in detecting careis?

Answer 4

BITEWING
then peri-apical

then panoramic
then cone beam CT

Question 5

a good bitewing radiogrpah includes what?

Answer 5

from distal of canines for premolar shots and all the way back to the posterior of the molars for the molar shots

Question 6

buccal and lingual caries are what class?

Answer 6

Class V
same with root surfaces
- class V

Question 7

What is the caries susceptible zone?

Answer 7

CONTACT POINT – and down
interproximal
- between the contact point og the teeth and the gingival margin

Question 8

do caries occur apiocal to the gingival margin

Answer 8

not usually

- but different with case of gingival recession pt.

Question 9

DESCRIBE INCIPIENT LESION

Answer 9

DO NOT EXTEND INTO DEJ
- are within the enamel of the tooth
- caries susceptible zone
triangle with broad base at outer surface

Question 10

describe location of interproximal careis

Answer 10

SPREAD ALONG DEJ

spread INTO DENTIN

• second triangle with base AT DEJ
• some cases, lesion may appear not to have oentrated the enamel

Question 11

major difference we see with primary dentition

Answer 11

primary teeth have THINNER ENAMEL – so it can reach the dentin more quickly and seem to spread rapidly

Question 12

general rule fo when to treat lesion vs not

Answer 12

if spread into DEJ (into the dentin – more likely for treatment vs incipient)

Question 13

anterior caries

Answer 13

same type of thing happening where it is starting on the enamel

Question 14

how to differentiate between a lesion and a radioluscent filling material?

Answer 14

lesion
- DIFFUSE MARGIN

restoration
- WELL-DEFINED MARGIN

Question 15

OCCLUSAL CARIES

describe a large one

Answer 15

1. easily observed
2. appears as large, dark circles in the crowns
3. pulp exposure can not always be determined

Question 16

OCCLUSAL CARIES

describe a small one

Answer 16

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

Question 17

what does he mean by rampant caries?

Answer 17

all over the dentiion

more likely to occur in the younger pt. population in the primary dentition

Question 18

rampant careis mostly seen in? other reasons

Answer 18

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

Question 19

describe root surface caries

Answer 19

Cratering the roots of the teeth, involving CEMENTUM

can be buccal/ lingual/ proximal

saucer like radiolucensy

maybe confused with cervical burnout

Question 20

how do root caries form?

Answer 20

due to gingival recession
- so only expect these in patietns who have poor periodontium and have recession (caries do not form from beneath gingiva)

Question 21

root surface caries could be confused with?

Answer 21

cervical burnout

*take note of the bone levels

Question 22

describe cervical burnout

Answer 22

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

Question 23

describe recurent caries

Answer 23

around the margins of existing restorations

AKA Secondary caries

Question 24

general description of diagnostic confounders

Answer 24

these are things that may look like caries but are NOT

Question 25

general description of diagnostic confounders

Answer 25

these are things that may look like caries but are NOT

do NOT go purely by radiographic imaging but look at clinical exam too

Question 26

list of diagnostic confounders

Answer 26

1. pits and fissures
2. cervical burnout
3. mach band effect
4. dental anomolies
   - hypoplastic pitis
   - concavitities produced by wear

Question 27

buccal pit looks?

Answer 27

well - defined radioluscent circular

Question 28

MACH BAND EFFECT is a?

Answer 28

a diagnostic confounder

Question 29

describe mach band effect

Answer 29

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

Question 30

mach band effect can lead to?

Answer 30

false positives

- false diagnosis of caries

Question 31

enamel hypoplasia implication?

Answer 31

can look like a radioluscency

- but it is a dental anomaly and likely more localized to a tooth due to a developmental problem

Question 32

concavity seen? looks? what do you do?

Answer 32

looks maybe like a carious lesion but check it clinically as it can be produced by wear (like denture wearing)

Question 33

T/F you can accuratley see the extend of caries on a radiograph

Answer 33

false
- will always be deeper probably
- have structures overlapping it
-

Question 34

overlap in a bitewing could be from?

Answer 34

horizontal orientation of the xray beam

Question 35

remineralizaton occurs where? implication?

Answer 35

takes place on the outermost surface because mineral-containing solutions from saliva cannot diffuse into the body of the lesion

Question 36

Can x-rays tell you the activity of a carous lesion?

Answer 36

NO – cannot tell if it is active or arrested in a radiogrpah alone

Question 37

micro-radiograph?

Answer 37

can show a snapshot

Question 38

subtraction radiography

Answer 38

attempting to determine progress or not of two radiographs taken at different times to tell the difference over time