Carious lesions Flashcards
What are the indications that the tooth has caries?
Seen on radiograph - shadow in tooth not up to the pulp
Patient description - cold is worse than hot, main pain is with sweet things
frosty white lesion on tooth
brown spots in fissures
What equiptment is needed when treating a carious lesion
Rubber dam and kit
examination kit
Cons kit
LA - topical
Fast and slow handpiece
Number 6 and 7 bur
Rose head bur
Finishing kit - polishing and flame shaped/rugby ball bur
What colour and texture is infected dentine?
Soft, leathery, yellow and brown
How does infected dentine feel and what instruments should be used to remove it?
Feels scratchy
Use rose head burs
Use excavator
What colour is affected dentine and how does it feel?
Feels firm and scratchy
Any colour but yellow or brown
What is stepwise excavation?
Remove infected dentine and leave affected dentine
Place layer of calcium hydroxide over affected dentine
Restore cavity with RMGIC e.g. Fuji II
Check a few weeks later to ensure symptomless
After symptomless then remove at least 2mm and apply permanent restoration
What are the indications for putting in an amalgam restoration?
Large load bearing cavity
patient with high risk of caries
subgingival margin
Poor moisture control
What is the association between amalgam and gamma?
Dental amalgam is a high copper alloy with decreased gamma 2 phase
This phase is responsible for the increased corrosion and creep and dirching so reducing gamma 2 is good
What does cavity prep for an amalgam require?
Undercut
margin angle >70º
Cavo-surface angle >90°
Pits and grooves is more retention is required
No overhangs or unsupported enamel
What additional equipment is needed in an amalgam restoration?
Amalgam carrier
Dappens pot
Matrix pot
Wooden wedges
Articulating paper
When might you need to use bonded amalgam?
When there is cuspal loss and retention may be compromised
What material might be used when bonding amalgam?
RMGIC (Fuji liner)
do not light cure
Apply amalgam while RMGIC is wet
This should be applied to dentine only
When might a patient not qualify for a permanent restoration?
When they are at high caries risk
Poor oral hygiene
increased risk factors
Caries extends beyond the gingiva
What additional equipment is needed when doing a composite restoration?
Shade guide
composite gun
etchant gel
microbrushes
Dentine bonding agent
For anterior teeth what is needed to aid the retention of a composite restoration?
Bevel on the labial surface
