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D2 Fall > Clinical Radiology - Radiographic Interpretation of Dental Caries > Flashcards

Clinical Radiology - Radiographic Interpretation of Dental Caries Flashcards

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1
Q

What % of adults experience dental caries before 30 years old?

A

90%

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2
Q

What is the prevalence of dental caries among youth aged 2-19 years old?

A

50%

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3
Q

Multifactorial disease involving many complex risk and protective factors

A

Dental caries

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4
Q

Carious lesions are characterized by localized ____________ of teeth by _____________ (acid demineralization)

A

destruction; microorganisms

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5
Q

What is the dynamic process that happens to your teeth?

A

Demineralization and remineralization

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6
Q

Which process?

Decrease in pH

A

Demineralization

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7
Q

Which process?

Dissolution of Ca and PO4

A

Demineralization

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8
Q

Continuum of net mineral loss

A

Dental caries

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9
Q

What changes occur from demineralization?

A

Changes in color/glossiness
Cavitation
Dentin
Pulp exposure
Destruction

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10
Q

Teeth (enamel, dentin, cementum) are
_________ (more/less) dense and absorb more X-rays

A

more

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11
Q

Gums, cheeks, pulp are _________ (more/less) dense and X-rays pass through more easily

A

less

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12
Q

What does demineralization result in?

A

Less tissue density, so less X-Rays are absorbed

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13
Q

What are the 5 sites of carious lesions?

A

Occlusal (pits and fissures)
Recurrent (secondary)
Smooth surface (facial/lingual)
Root (radicular)
Interproximal

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14
Q

Describe the progression of dental caries

A

Enamel - outer 1/2 to inner 1/2
Dentin - outer 1/3, middle 1/3, inner 1/3, to directly involving pulp

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15
Q

Initial demineralization starts on walls of pits and fissures, and are hard to detect clinically and radiographically

A

Early stages of occlusal caries

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16
Q

What is the first clinical sign of occlusal caries?

A

White spot

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17
Q

Incipient lesions (enamel only) are not detected radiographically. If detected radiographically, lesions are most likely in dentin

A

Initial stages of occlusal caries

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18
Q

Diffuse radiolucency below enamel-occlusal surface

A

Lesions in dentin of occlusal caries

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19
Q

As lesions progress, disruption of enamel may become evident

A

Lesions in dentin of occlusal caries

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20
Q

Advanced lesions may show direct pulp involvement

A

Lesions in dentin of occlusal caries

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21
Q

Caries adjacent to margins of restorations

A

Recurrent/secondary lesions

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22
Q

Diffuse radiolucency below restorations

A

Recurrent/secondary lesions

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23
Q

Usually close to gingival margin

A

Smooth surface caries (facial/lingual)

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24
Q

Sharply defined round or oval radiolucency

A

Smooth surface caries (facial/lingual)

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25
Q

Correlation w/ clinical examination is important

A

Smooth surface caries (facial/lingual)

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26
Q

Diffuse radiolucency below the CEJ, gingival recession

A

Root surface/radicular caries

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27
Q

Cementum is a thin layer, it is not as ________ as enamel

A

dense

28
Q

T/F: Cervical burnout is considered a carious lesion

A

FALSE

29
Q

Collar-shaped or wedge-shaped radiolucent artifact

A

Cervical burnout

30
Q

Between CEJ and alveolar bone

A

Cervical burnout

31
Q

2 scenarios:

Cervical area not covered by bone or enamel
Anatomy of cervical area in posterior teeth

A

Cervical burnout

32
Q

Arise at or slightly below contact point of 2 adjacent teeth

A

Interproximal caries

33
Q

Clinical direct visualization usually not possible

A

Interproximal caries

34
Q

As lesion progresses and dentin is affected, translucent enamel may show gray discolored dentin on marginal ridges

A

Interproximal caries

35
Q

In enamel, radiolucency (frequently triangular) with base at proximal surface near contact point

A

Interproximal caries

36
Q

In dentin, radiolucency (frequently triangular) with base at DEJ

A

Interproximal caries

37
Q

What’s the best radiographic exam to detect carious lesions?

A

Bitewings for posterior teeth
PAs for anterior teeth

38
Q

On this type of radiograph, carious lesions are usually only seen when large enough to be clinically apparent

A

Pano

39
Q

Results are controversial; can cause ghost images, noise, configuration of arches, etc

A

Extraoral bitewing

40
Q

Which bitewing provides greater detail?

A

Intraoral

41
Q

When are extraoral bitewings indicated?

A

Pt unable to cooperate
Severe gag reflex
Severe anatomic limitations

42
Q

Clinical examination may be able to identify carious lesions on which surfaces of teeth?

A

Occlusal surfaces and smooth surfaces (facial/lingual)

43
Q

When are lesions on interproximal surfaces clinically detectable?

A

Advanced stages

44
Q

Which X-Ray can show carious lesions in early stages?

A

Bitewing

45
Q

Approximately how many interproximal surface caries cannot be seen clinically?

A

1/2

46
Q

What % of demineralization is required before a carious lesion can be visualized?

A

25-50%

47
Q

T/F: X-Rays underestimate the actual depth of the lesion

A

True

48
Q

Superficial layers of non-cavitated lesions
may remineralize

A

Arrested carious lesion

49
Q

Are arrested carious lesions discernible on X-Rays?

A

No, but activity may be monitored radiographically

50
Q

How do you monitor the activity of a lesion?

A

Take an X-Ray that day, and then a second image at another time

51
Q

Can you determine if a lesion is cavitated on an X-Ray?

A

NO

52
Q

Which interproximal carious lesion classification?

No radiolucency

A

E0

53
Q

Which interproximal carious lesion classification?

Radiolucency in outer 1/2 of enamel

A

E1

54
Q

Which interproximal carious lesion classification?

Radiolucency in inner 1/2 of enamel

A

E2

55
Q

Which interproximal carious lesion classification?

Radiolucency in outer 1/3 of dentin

A

D1

56
Q

Which interproximal carious lesion classification?

Radiolucency in middle 1/3 of dentin

A

D2

57
Q

Which interproximal carious lesion classification?

Radiolucency in inner 1/3 of dentin

A

D3

58
Q

Which interproximal carious lesion classification?

Initial ultrastructural changes are not detectable

A

E0

59
Q

Which interproximal carious lesion classification?

Not cavitated

A

E1 and E2

60
Q

Which interproximal carious lesion classification?

May present a triangular shape or diffuse radiolucency

A

E1 and E2

61
Q

Which interproximal carious lesion classification?

33% to 85% cavitated

A

D1

62
Q

Which interproximal carious lesion classification?

Spreads along DEJ

A

D1

63
Q

Which interproximal carious lesion classification?

Most likely cavitated

A

D2

64
Q

Which interproximal carious lesion classification?

Lesion > halfway to the pulp

A

D2

65
Q

Which interproximal carious lesion classification?

Cavitated

A

D3

66
Q

Which interproximal carious lesion classification?

Lesion may directly involve pulp

A

D3

67
Q

Well defined radiolucencies on interproximal surfaces (anterior teeth) may be what?

A

Older radiolucent restorative material

(not used anymore)

D2 Fall (16 decks)

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