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5th yr- Finals- CSA revision > enamel and dentine caries chemistry > Flashcards

enamel and dentine caries chemistry Flashcards

1
Q

Define dental caries

A

A localised chemical dissolution of tooth surface brought about by metabolism activity in a microbial deposit (dental biofilm) covering a tooth surface at any given time

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2
Q

What is dental caries maintained by

A

Frequent dietary supply of fermentable carbohydrates

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3
Q

Where does dental caries commonly form

A

Pits and grooves
fissures in the occlusal surface
approximate surfaces cereal to the contact point
along the gingival margin §

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4
Q

What is enamel made up of

A

Calcium hydroxyapatite

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5
Q

Describe the physical properties of enamel

A
  1. Highly mineralised
  2. Withstands both shearing and impact forces
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6
Q

Describe the physical properties of dentine

A
  1. Flexible and compressible
  2. Poor abrasion resistance
  3. Poor crack resistance
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7
Q

What happens to enamel when is it exposed to acid

A

Enamel dissolution occurred

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8
Q

What causes enamel dissolution

A

Overlyign plaque biofilm and the proproteolytic action of bacteria on the protein content of enamel

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9
Q

What does acid dissolution enamel produce

A

irregular crystal outlines

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10
Q

what does an initial caries lesion look like

A

A white spot lesion

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11
Q

Describe a white spot lesion

A

Opaque white spots

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12
Q

Why do white spot lesions have this appearance

A

As the sub surface enamel has become porous as result of the mineral being dissolved by the acid produced by plaque bacteria

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13
Q

What happens as the porosity of a carious lesion increases

A

The lesion may take up a stain becoming a brown spot lesion
Will eventually cavities to expose dentine

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14
Q

What can we do to non caveatted enamel caries lesions

A

We can arrest them

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15
Q

What is tertiary dentine

A

An umbrella term used to describe all hard tissue deposited on the plural surface in response to an external stimulus

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16
Q

Give examples of eternal stimuli that could stimulate the production of tertiary dentine

A
  1. Caries
  2. Attrition
  3. Cavity prep
  4. MIcro leakage
  5. Trauma
17
Q

Give examples of tertiary dentine

A
  1. Reactionary dentine
  2. Reparative dentine
18
Q

What is reactionary dentine

A

Dentine forming in response to milder irritation resulting in dentine with an irregular appearance with fewer tubules

19
Q

What is reparative dentine

A

Dentine forming in repose to stronger stimuli by odontoblast like cells following the death of the original odontoblasts

20
Q

What can reparative dentine allow for

A

If plural exposure occurs can help with pulp exposure healing by forming a mineralised bridge

21
Q

What is sclerotic dentine

A

Tissue formed when dentinal tibias fill in as a repose to an external stimulus
appears transparent

22
Q

What happens to the pulp when a carious lesion forms

A

gets inflamed

23
Q

What causes the pulp to die

A

Bacterial infiltration of the dentine tubules and penetration of the pulp space with bacteria

24
Q

If we are treating a tooth with a deep carious lesion what should we do

A

Work under rubber dam to prevent salivary bacterial contamination

25
Q

Talk through how smooth surface caries spreads into dentine

A
  1. Plaque layer forms on the enamel surface
  2. Acid dissolution of enamel prisms increases porosity allowing acid attacks to advice through the enamel
  3. Acid spreads also the enamel dentine junction laterally
  4. dentinal tubules decrease in volume
  5. enamel surface cavities plaque bacteria invades the lesion and penetrated the dental tubules
  6. this is infected dentine
26
Q

Why should we restore teeth

A
  1. Restore the function, form and aesthetics of the tooth
  2. To protect the pulp dentine complex
27
Q

What should we take into consideration when determining what treatment option to go for

A

Patients caries risk and motivation

28
Q

How can we describe dentine

A
  1. Hard
  2. Firm
  3. Leathery
  4. Soft
29
Q

What is soft dentine

A

Dentine that deform with pressure and be faulty scooped with an excavator
also known as caries infected dentine

30
Q

What is leathery dentine

A

Dentine that does not deform with an instrument but can still be easily lifted with an excavator
also known as caries affected dentine

31
Q

What is firm dentine

A

Dentine that is physically resistant to hand excavation

32
Q

What is hard dentine

A

Sound dentine that creates a scratchy sound upon probing

33
Q

What do we mean by deep carious lesion

A

Radiographic evidence of caries reaching the inner third or quarter of the dentine
still clear band of dentine between pulp and radiolucency

34
Q

What management lesions can we consider when treating Deep carious lesion

A
  1. Non selective complete removal of caries
  2. Selective removal of caries until we reach firm dentine
  3. Selective removal of dentine to soft
  4. Stepwise excavation
35
Q

What factors do we consider when deciding the treatment options for a Depp carious lesion

A
  1. Lesion depth
  2. Lesion activity
  3. Patient motivation
  4. Location of lesion
36
Q

What should we warn patient of when we treat a deep carious lesion

A

There is a chance that we explse the pulp which can lead to RXT or XLA
We may opt to leave some affected non carious dentine behind

37
Q

What is stepwise excavation

A

Involves carious tissue removal in two stages
stage 1: removal of caries but leaving a soft carious tissue over the pulp, placing decal and GIC
State 2: review renter the lesion and further excavate in hopes tertiary dentine has been placed over the pulp. restore with permanent restoration

we can opt to not re enter and just monitor for symptoms

38
Q

State the critical pH for enamel

A

5.5

5th yr- Finals- CSA revision (19 decks)

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