Dental Caries and Classification Flashcards
A multifacorial infectious disease that attacks teeth by certain bacteria if the conditions are permissible, causing destruction (demineralization/ dissolution) of the tooth
dental caries (C)
stages of caries
A. incipient (reversible); just started, can remineralize
B. small (operative1); in the enamel, just started into DEJ
C. moderate- into the dentin
D. extensive- reparative dentin is being made from the pulp
caries classification by location
- pit and fissure caries
- smooth surface caries
- root surface caries
pit and fissure caries…
pits and fissures on the occlusal surfaces of posterior teeth, buccal and lingual surfaces of molars, lingual surfaces of maxillary anterior teeth
smooth surface caries…
on the surfaces that are “pit and fissure” free
root surface caries
more in elderly, follows an advanced gingival recession
caries classification by rate
active, arrested, recurrent/secondary caries
rampant (acute) caries
rapidly invading, softer lesions
ex: nursing bottle caries, radiation caries, meth mouth
chronic caries
type of active caries; slow, long standing, dark in color and so there is a good chance of remineralization in early stages (reverse the demineralization process)
arrested caries
not showing any further progression; smooth and polished like surface
recurrent/secondary caries
caries under a preexisting faulty restoration
Class I caries
Pits and fissures of: occlusal surfaces of premolars and molars; buccal or lingual pits/fissure of the molars; lingual pit near the cingulum of the maxillary incisors.
Class II
Involving the proximal surfaces (mesial and distal) of premolars and molars; smooth surface posterior teeth
class III
proximal (mesial and distal) surfaces of incisors and canines
class IV
proximal surfaces of incisors and canines, but also will involve the incisal edge (due to trauma)
Class V
gingival third (the area near the gingiva) of the facial or lingual surfaces of any tooth
Class VI
Involve the incisal edges of anterior teeth and the cusp tips of posterior teeth; Carious lesions are rare
according to GV Black, the ____ of the lesion dictated the ____ of the cavity preparation
location; design
fundamental concepts for all tooth preparation
1- removal of dental caries
2- removal of weak tooth structure to provide well supported, sound hard tissue
3- pulp protection
healthy state is reestablishing…
- tooth not diseased anymore
- normal form and function
- esthetically pleasing where indicated (anterior zone of oral cavity)
junction of two surfaces
line angles
junction of three surfaces
point angle
cavity walls that extend to the outer tooth surface
external walls
cavity walls that do not extend to the outer tooth surface
internal walls
cavity walls according to the proximity to the external surface
internal and external walls
cavity walls according to the angulation from the long axis
axial walls and perpendicular walls
cavity walls parallel to the long axis
axial walls
cavity wall perpendicular to the long axis
pulpal wall
axial and pulpal walls are _____ walls
internal
isthmus of a class I preparation
the narrowest portion of the cavity preparation
isthmus of a class II prep
a portion of the cavity connecting an occlusal portion and a proximal portion together
in class I cavity preps, the isthmus connects the two _____
dovetails
dovetail design includes:
each marginal fossa and the developmental grooves around the marginal pits
the junction between the external walls of the cavity prep and the uncut tooth surface
cavosurface angle
6 principles of cavity preparation
- outline form
- resistance form
- retention form
- convenience form
- finishing
- debridement
the shape of the cavity prep; perimeter of the tooth preparation in width, length, and depth
outline form
factors governing outline form:
- conservation of tooth structure
- location and the extent of the carious lesion
- position of pit and fissure dictate the outline
two outline form approaches
extension for prevention and conservative approach
extension for prevention
Extensive tooth preparation; Unnecessary loss of healthy tooth structure
conservative approach
Preservation of the remaining tooth structure; minimal extension of the outline form
the entire carious area should be removed and ____
any weak enamel
___ more conservative than _____
composite; amalgam
Place ____ on sound strong tooth structure…unsupported enamel is removed
margins (cavosurface margin)
Resistance form: design features of cavity prep to allow remaining tooth structure and the restoration to withstand _____
forces that are principally directed towards the long axis of the tooth
Primary resistance:
1- removal of undermined surface enamel
2- flat pulpal floor and cavity wall angulation
3- cavity prep depth
4- well defined rounded internal line angles
5- type of restorative material
cavosurface margin should not terminate on ____ or ____ to prevent its fracture
unsupported or undermined (weakened) enamel
_____ results in rotation of the restoration (micromovement) that results in a wedging effect on the supporting dentin bridge
cup shaped cavity
should have a ____ cavity in which the pulpal floor is perpendicular to the ____ of the tooth
box shaped; long axis
adequate depth is needed to provide enough _____ to prevent its fracture under load
thickness of amalgam
minimum amalgam thickness to withstand forces:
1.5 mm
well defined rounded internal line and point angles:
- placing line angles to delineate the walls
- sharp line angles are not recommended in any restoration
- sharp line angles act as stress concentration areas
amalgam has a low ____, thus amalgam ____ is of prime importance
edge strength; margin
cavosurface margin has to establish a _____ amalgam margin
90 degree (butt-joint margin)
reinforcement of the amalgam restoration at the margin by maintaining an angle of ____
80-90 degrees
retention form: design features of the cavity prep that prevent ____ of the restoration by ____ or ____ forces
dislodgement; lifting; tipping
amalgam does not bond to tooth structure, thus increasing the ____ of the walls that contact the amalgam, increasing _____
surface area; friction
retention form: making opposing walls ____ or slightly ____ toward the _____
parallel; converging; occlusal
convenience form: sufficient access to the cavity, to facilitate ____ and ____ of the cavity prep and the insertion of the restorative material
visibility; instrumentation
____ for complete removal of decay
visibility
the diameter of the small end of the smallest condenser should fit passively into the prepared cavity; aka the ____ should be at least ___ mm
isthmus; 1.0
finishing: finishing the ____ to prevent ___ or ____ outline
cavosurface margin (enamel margin); jagged; rough
finishing to achieve the best ____
marginal seal
the final step before the cavity prep receives the restoration
debridement
rinsing the cavity is done with ____ and _____ to remove debris and wash away dentinal shavings (smear layer)
air/water spray syringe; high suction evacuation
want to free cavity from ____ caused by ____
moisture; blood and saliva
