Exam 5- Class II comp, caries/pulp protection, Class III Flashcards
Anatomy of a Caries: Which layer am I?? Teeming with bacteria, Acts as Nidus* of S.Mutans and Lactobacillus, Soft or leathery…Often, but not always, heavily stained. MUST be removed
Outer Carious Dentin
Outer carious dentin: what does it feel like? Can we leave it in the tooth?
soft, leathery…MUST BE REMOVED!
Anatomy of a Caries: Which layer am I?? Zone of bacterial invasion, Infected with bacteria, Infected Dentin, Collagen is denatured, Caries detecting stains work well here, Color can vary from dark to dentin colored depending on the growth rate of the disease, Cannot be remineralized- must be removed
TURBID LAYER (THE WAR ZONE)
Which layer is the zone of bacterial invasion?
the TURBID layer
Anatomy of a Caries: Which layer am I?? Deepest layer-No bacteria present-Affected Dentin-Advancing front-De-mineralized but collagen cross-linking intact-Capable of remineralization-Can be stained due to porosity & bacterial products-not nec remove
Transparent layer
Which layer of caries can I leave there?
The transparent layer
Does infected dentin contain bacteria?
Yes
Infected/Affected Dentin: Unable to remineralize
Infected Dentin
Infected/Affected Dentin: Able to remineralize
Affected Dentin
Infected/Affected Dentin: Stains with caries detecting solutions
BOTH infected and affected (so caries detecting solution can make us too aggressive!
How long does tertiary dentin take to develop?
20-40 days (schedule patient and check on progress)
Which hormone is released by the still healthy pulp to produce tertiary dentin?
TGF-B1 (Transforming Growth Factor)
Caries is considered _______, it has times of remineralization and demineralization.
Episodic
What is the CRITICAL pH for demineralization?
5.5
Is it necessary to restore white spot lesions?
NO! (check w radiographs tho)
Caries to the ____ SHOULD BE RESTORED! While caries PAST the _____ MUST be restored.
DEJ…DEJ
What do you use to remove the DEEPEST areas of recurrent decay near the pulp?
Hand instruments!
What type of caries are light yellow, soft/moist, and rapidly progressing?
ACUTE caries
What type of caries are darker, leathery and firm, and slowly progressing?
Chronic caries yo
What type of caries are dark brown/black, are very firm (mineralized), are NOT active-so we do NOT remove it!
Sclerotic or Arrested Caries
What type of caries is common in older and immunecompromised patients?
Root Caries
There is more complex ______ when the caries is sub gingival.
Bacteria
WHAT DOES ICDAS stand for???
International Caries Detection and Assessment System
What level of ICDAS is this and What is the Tx? Sound tooth surface,no caries change after air drying (5 sec),No hypoplasia, wear, erosion and other non-caries phenomena.
0…sealant
What level of ICDAS is this and What is the Tx? First visual change in enamel seen only after air drying colored change “thin” limited to the confines of the pit and fissure area
1…sealant
What level of ICDAS is this and What is the Tx? Distinct visual change in enamel seen even when wet, white or colored, “wider” than the fissure/fossa
2…sealant
What level of ICDAS is this and What is the Tx? Localized enamel breakdown, no visible dentin or underlying shadow
discontinuity of surface enamel, widening of fissure
3….Sealant/ PRR