FINALS Flashcards by KARIL LOUIS S. BRAGA

What are the non-surgical therapies for dental caries?

Modifying the biofilm
Diet management
Anti Microbials
Fluorides

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Concepts in modifying the biofilm

Saliva and management of salivary dysfunction
Oral Hygiene Practices

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Known anti-microbials for teeth

CHX (chlorhexidine)
Iodine
Xylitol

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What are examples of minimal invasive dentistry

Laser
Chemomechanical caries removal
Air abrasion
Silver Diamine
Pits and fissure Sealants
Atraumatic Restorative Treatment (ART)

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Goals in managing carious Lesions

Inactivation/ control of the disease process
Preservation of the dental hart tissue
Avoidance of initiating the cycle of re-restorations
Preservation of the tooth for as long as possible

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It focuses on treating oral diseases, not just the signs and symptoms of oral disease

Minimally invasive dentistry

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Ultimate goal of Minimally invasive dentistry

Prevent disease from occurring
if disease exists, to eradicate it and prevent its recurrence

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Factors to consider when opting for non-surgical therapy or restorative treatment on the patient

Age
Level of anxiety
Ability of cooperation
Parent’s acceptance

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Factors to consider when opting for non-surgical therapy or restorative treatment on the tooth

Cavity size
Pulp vitality
Aesthetic implications
Time to exfoliation
Lesion activity

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Other factors to consider when opting for non-surgical therapy or restorative treatment

dentist expertise
Costs
Dental equipment availability

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Various methods of removing carious tissue

Non-selective removal to hard dentine
Selective removal to firm dentin
Selective removal to soft dentine
Stepwise technique

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Explain Non-selective removal to hard dentine

Complete excavation
Complete caries removal
Only a small layer of hard dentin remains

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Explain selective removal to firm dentin

Removal of carious tissue in firm dentine. Make sure that other layers are not totally excavated

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Explain stepwise technique

It is a two-step excavation
remove soft dentin and use GIC for temporary sealing
Second step of temporary restoration removal, caries removal to firm dentin and placing a permanent restoration.

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used to cut enamel and dentin or the hard tissues

Laser in dentistry

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Other uses of laser in dentistry

Cavity preparation
Caries removal
Surface roughening and etching
Enameloplasty
Excavation of pits and fissured for sealant placement

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it alters the surface characteristic of enamel

Argon laser

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It increases resistance to dental caries by reducing rate of demineralization

Laser in dentistry

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Commonly used lasers in dentistry

CO2
Er: YAG (erbium-doped yttrium aluminum garnet)
Nd:YAG (Neodymium- doped yttrium aluminum garnet)
Diode
Argon

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Carbonated hydroxyapatite in enamel is heated at temperatures greater than __C in laser dentistry

400C

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Effect of laser on carious lesion

Laser is absorbed, heat is generated, water vaporization and ablation happens esp. on carious lesion with more water content.

It is a method of gentle treatment of caries where it uses gel that softens the caries and saves sound tooth structure

Chemomechanical caries Removal

Brands used in CMCR

caridex, carisolv, Papacarie, Carie-care

Time required in this CMCR is 5-8 minutes

Papacarie

Applicator unit is required in this CMCR

Caridex

Advantage of CMCR

- reduces or eliminates use of drill and local anes. - Minimal thermal changes, vibration, and pain. - Reduce risk of pulpal expose - Conserves tooth structure - Removal of infected dentin only (specified)

Disadvantage of CMCR

- Use of other instruments to remove caries - solution leaves many overhangs and undercuts - large volumes of solution needed - takes time

Procedure of CMCR

- Cover cavity with gel - Wait for carious dentin to soften - Carefully remove soft dentin - Repeat until caries free - Fill the cavity

Proteolytic agent in CMCR

chemical debridement by Papain gel

structureless matrix layer present in necrotic zone of dentinal caries

Mantle

in CMCR: clinical efficacy of caries removal was highest with __ followed by __ and __

Airotor, Carisolv, Papacarie

Patient acceptance of CMCR was highest with __ followed by ___ and least by ___

Papacarie, Carisolv, Airotor

uses compressed air to propel aluminum oxide particles

Air abrasive technology

Air abrasion was first developed and described by ___ in __ improved and combined by __

Dr. Robert B Black 1950 Dr. Rainey

He introduced the first commercially available unit of Air abrasion called ___ in 1951

S.S White Air-dent

Advantages of air abrasion

No anesthesia no heat, vibration, or sound no damage to tooth - less risk of fracturing enamel

disadvantages of air abrasion

Can cause sensitivity - cannot be used to treat and repair deep cavities Contraindication for p. with pulmonary disease

A cosmetic blackening of teeth in Japan for 900 years that halt caries process and prevent new formation

Silver Diamine Fluoride

Other effects of Silver Diamine Fluoride

Desensitizes teeth Protects pulp Treat infected root canal

SDF contains (plus its use)

Ammonia (solvent) Silver (antimicrobial, control plaque) Fluoride (enhance remineralization)

main disadvantage of Silver Diamine

Lesions treated will be stained black - less patient/ parent acceptance

Modifies pits and fissures into smooth surfaces Protects teeth from bacterial colonization Protect teeth from fermentable substrates toot can be cleaned easily

Pits and fissures sealants

Steps for Pits and fissure sealants

1. Tooth is cleaned and dried 2. Application of etching solution 3. liquid sealant is applied 4. Curing light hardens sealant

Removing decalcified tooth tissue using only hand instruments and restoring cavity with an adhesive filling material

Atraumatic restorative treatment (ART)

who invented ART, and when and where

Prof. Jo Frencken in South africa 1996

developed for use in community and field settings (rural and developing countries)

Atraumatic restorative Treatment

Advantage of ART

makes restorative treatment accessible for all - conservation of sound tooth structure painless and friendly procedure sterilization is simplified cost effective

Contraindications for ART

History of long time pain Swelling, abscess or fistula near carious tooth exposed pulp inaccessible areas of the tooth to hand instrument

ART instruments

Mouth mirror, explorer, cotton pliers, spoon excavator, enamel hatchet, carver, plastic filling instrument, mixing pad and spatula

Materials for ART

cotton rolls, cotton pellets, petroleum jelly, plastic strip, wedges, GIC type 9

ART procedure

Carious lesion before procedure teeth should be asymptomatic unsupported enamel is removed using hatchet tooth is isolated from moisture using cotton rolls and pellets cavity conditioner is applied on cavity walls GIC is mixed accdng surface of cement should be glossy to indicate moisture - ion exchange takes place occlusion is checked and adjusted finished restoration should be protected from oral environment for 5 mins