Caries removal Flashcards
How large should a cavity be to access caries?
As small as possible to minimum destruction of tooth structure. But to allow:
Visual access to caries
Instrument access to caries
What is the minimal concept?
Adhesive materials require minimal cavity design not GV black design
What are the requirements for Mi cavity design?
Adequate visual access
Adequate instrument access to remove caries
No extension for prevention
Smaller cavities = Greater tooth strength
How are composite restorations better than amalgams?
Smaller cavity preparations maximize the strength of tooth structure
Less need for mechanical restoration
They are more aesthetic
How should caries be preventatively managed?
Early lesion diagnosis is key
Early disease diagnosis is even better (STOP the disease)
Can you repair rather than replace amalgams and composites? Should you do this?
Repair of such restorations rather then replacement is increasingly considered to be a viable alternative to replacement.
Treating defective restorations with sealants, repair or refurbishing is an effective way to pre-serve and treat existing restorations.
Growing evidence is indicating similar outcomes in patients with low and medium caries risk compared to replaced restorations and are clinically acceptable over a 12-year follow-up of clinical service.
Teeth with repaired restorations are less likely to require aggressive interventions like endodontic treatment or extraction.
How much caries is it necessary to remove?
Only remove infected dentine (Not affected dentine)
Little correlation between extent of bacterial infection and dentine hardness
What did FIJI GIC study show?
Internal remineralization was demonstrated as a significant increase in the remineralized dentine under the GC Fuji IX
When should calcium hydroxide be used?
Calcium hydroxide is only indicated for suspected pulpal or near pulpal exposure as it will prevent remineralization of carious dentine by GIC.
Can composite resin be bound to demineralized enamel?
No
What is the problem with using caries detection dye?
Can lead to unnecessary removal of tooth structure because it stains not only infected detine but also less mineralized dentine.
What are the limitations to using fluorescence methods for caries detection with sopro life camera?
Wavelength has some scatter problems and poor enamel penetrations + fissures.
What are the advantages and disadvantages to chemomechanical caries removal?
Adv:
Selective removal of infected carious dentine, conserves affected and sound dentine
No LA
Disadv:
Need good instrument access (Large lesions are best, root caries lesions, or deep difficult cases)
Very, very slow technique c.f. mechanical burs
