CON-B tutorial 3 + 4 : Caries histopathology/detection Flashcards
What could’ve caused these white spot lesions?
-Not brushing well
-excessive carbohydrates
-High freq sugar intake
(This patient had orthodontic treatment, tooth bracket, as he was missing a lateral incisor, plaque accumulated on this bracket and caused early caries)
What is non-operative care?
Prevention e.g using fluoride toothpaste, making patients aware of the importance of good tooth cleaning, sensible diet.
Spot the white spot lesion on this radiograph:
On the distal aspect of the lower 1st molar.
How does the white spot lesion look like on the proximal surface + inside of the tooth.
-No cavitation on the surface of the tooth but demineralisation
-inside the tooth there is cavitation that has reached the enamel dentine junction.
How severe are the caries lesions in this patient?
-Lower canines, dentine is exposed causing caries to progress quicker
-Upper left central incisor has black lesions (caries arrested, harder)
-Only need to remove the soft, brown affected dentine.
-Texture is v important.
What can you see in this image?
-demineralisation in the white spot area.
-Dentine is brown, suggesting caries dentine so it is active
How would you treat this tooth?
-Only remove the soften dentine that affected using an excavator.
-Preserve as much of the tooth structure possible.
-We leave the harder, affected dentine alone.
-It’s better to remove less enamel as possible, making it easy/better ground for restorations
-Stop when the dentine becomes hard and stained
Why might it not be necessary to remove dentine from the cavity floor?
Risk of accidental pulp exposure, so only do partial caries removal, never remove all the caries
What can you see in this Bitewing radiograph?
Second premolar has some demineralisation along the marginal ridge, distally
-Second molar has a stained composite but in radiograph there is a deep radiolucency suggesting deep caries. (Show this to patient)
-Radiolucency also present on 1st molar, under restoration = caries
How was this treated? flash card 9
- Caries removed and resin composite restoration.
How can we test pulp sensitivity?
Electric pulp test
Putting dry ice on tooth
What are the steps for removing/treating caries?
- Gain access to the caries (drill the smallest hole possible)
- Remove soft caries, stop when the caries gets harder, dark and stained.
3.DO not remove all caries - Make sure not to remove too much caries from the cavity floor since this could expose the pulp.
- Seal the deal - remember to preserve as much healthy tooth as possible
