Cariology and Radiology Flashcards
must be visible in order to see incipient caries
interproximal spaces
BW
used to view crowns of both max and mand
used to view early periodontal bone loss
BW: should include alveolar crest b/c this is where bone loss starts
Full mouth series
14 PAs and 4 BW
best for viewing post caries
BW
what percent of post caries would be missed without BW
1/2
Acute caries
Rapid, common in deciduous teeth, tubules larger and less mineralized
chronic caries
in older patients, slow, large surface lesion, permanent teeth
larger surface lesion caries
chronic
arrested caries
Static, does so on own, leathery feeling, become self cleansing
Primary caries (origin)
originate on unrestored surfaces, “unrestored”
Secondary caries (origin)
Also called recurrent, in immediate vicinity of a previous restoration
Rampant caries
widespread, well progressed
Where can you see a secondary caries on a radiograph
“under the box”
Diagnosis of occlusal caries
clinically, can see
Interproximal caries types (2)
incipient and moderate
incipient caries penetrates
less than half way through enamel
incipient caries visible how
clinically as a white spot, V-shaped
Moderate interproximal caries
extends more than half way through the enamel but does not involve the DEJ
Shape of caries progression
Two triangles with wide base at enamel and wide base at dentin
Advanced interproximal caries
caries at or through the DEJ and extends no more than halfway through the dentin to the pulp, spreads along DEJ
Act as a tract for advanced interproximal caries bacteria to travel
dentinal tubules
Severe interproximal caries
of enamel and dentin MORE than halfway through the dentin towards the pulp
Appearance of caries on radiograph
radiolucent
How to remember caries progression
SAMI the fish is swimming to the pulp (from enamel to dentin to pulp)
How the caries triangles point
both apices of triangles point to the pulp
How the caries triangles point
both apices of triangles point to the pulp
linear line on a radiograph
probably a fracture, caries do not travel linearly
How you see occlusal caries
Cannot see radiographically until it enters the dentin
When you can see occlusal caries radiographically
Once it is advanced (in the dentin)
Shape of occlusal caries radiographically
diamond, forms a cone once it reaches the
Why occlusal caries (class one in pits and fissures) appears diamond shaped
follows enamel rods (diverging)
Buccal/lingual caries-how to see first
mostly clinically
appearance of B/L caries
well defined peripheral walls, like looking into a hole
What must be true for cervical/cemental caries
only when periodontum is compromised (bone loss)
Appearance of cementum/cervical caries
scooped out appearance, cementum is thin, ABOVE the level of the bone, saucer shaped
Most susceptible to cervical caries
elderly (periodontal loss)
If you do the Dew, the Dew will do you
don’t drink 10 sodas a day, you will get cervical caries
Cervical Burnout vs caries
Can Extend BELOW level of bone, caries DOES NOT, also can be linear
What is cervical burnout?
Where is it?
How do you check it?
-Can extend BELOW the level of the bone and are more linear in appearance
-Radiolucent artifact (a structure or appearance not normally present on the radiograph and is produced
by artificial means) caused by changes in density and shape of the tooth at the cervical margin
- Can check against another BW or PA and whatever created the artifact in one view may not be there in
another view
Where interproximal caries is
at contact
When do you use SAMI
interproximal caries
idiopathic cervical resorption
resorption below the level of the bone
radiation caries
cancer patients, get xerostomia because salivary glands are affected, RAPID, appear the same as cervical caries
Sound tooth tissue/Caries Ratio
advanced lesion, appears on outside and inside, but tooth is thicker between the two triangles so the photons do not transmit. The normal tooth between does not appear radiolucent
% decalcification needed to see caries radiographically
40%
Sound tooth tissue caries clinical appearance vs radiographic
clinical lesion is bigger than the radiographic lesion
Technical errors
overlapping, poor contrast, too light
too much kVp
overpenetration which causes peripheral burnout, appears as open contacts and miss incipient lesions
Mach band effect
see radiolucency where it is not?
floating teeth
from toothbrush abrasion
gold and amalgam
attenuate the x-ray beam
Flat tops and slight caries appearance
bruxism/attrition
Hypoplastic incisor
Turner’s tooth
Requirements for Caries Formation
Suceptible host
Microorganisms
Appropriate substance (carbs/plaque)
Most common caries among early children
interproximal-they depend on their parents
Most common caries among elderly
cemental/cervical due to periodontal disease
masks occlusal caries (when are they visible)
surrounding tooth strucute- not visible until dentin is penetrated
lesions which are first visible (clinical or radiograph)
Clinical always
Restorations will have _________ defined typical C shape for class III restorations in ant teeth
more defined (not diffuse margins)
