Gross Caries Flashcards

1
Q

What is a d1 lesion

A

clinically detectable enamel lesions with intact surfaces

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2
Q

What is a d2 lesion

A

clinically detectable cavities limited to enamel

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3
Q

What is a d3 lesion

A

clinically detectable lesions in dentine

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4
Q

What is caries infected dentine

A

Caries-infected dentin is a superficial necrotic zone of vastly demineralized substrate with degenerated collagen fibrils that lost their cross-linking

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5
Q

What is caries affected dentine

A

Caries-affected dentin is considered a variation of reactionary dentin, formed in reaction to bland stimuli like caries, presenting small alterations in the cross-linking of its collagen fibrils

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6
Q

How does caries affected dentine contrast with sound dentine

A

By the mineralized precipitates within the tubules

composite bond isn’t great to affected dentine

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7
Q

Why do we want a good restorative seal

A

We want to seal in caries and bacteria so there is no way of them surviving
need to take away the source of food so they die

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8
Q

Why do we want to maintain the pulp

A

if it becomes non vital then it is a more complex treatment with a worse prognosis

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9
Q

Why do we want to remove carious tissues

A

to create conditions for long lasting resotrations. It will fall out otherwise and caries will progress

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10
Q

Why is gross caries on smooth surfaces worrying

A

due to easy accessibility

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11
Q

What are the 3 aims when dealing with caries

A

achieving a good restorative seal
maintaining pulpal health
maximise restoration success

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12
Q

What is the ethos behind dealing with caries

A
  1. assess reason for caries
  2. address oral environment
  3. restore if necessary
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13
Q

What do we look at when addressing oral environment

A

Looking at diet, risk of caries, etc

want to try and change the balance in the mouth to promote remineralisation

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14
Q

Why should you be cautious when prescribing high fluoride items

A

Doesn’t prevent decay - NEED TO BRUSH PROPERLY, fluoride may encourage laziness

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15
Q

Who is root caries often present in

A

older px

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16
Q

If you change the oral environment what can happen to a carious lesion

A

remineralise into an arrested carious lesion

17
Q

What is the theory behind partial caries removal

A

access cavity
remove caries at periphery and adj
remove infected dentine
maximise cavity for longevity

18
Q

What is the issue with partial caries removal

A

saliva makes it hard to see

not suitable for all materials

19
Q

What is the theory for stepwise technique

A
  1. access cavity
  2. remove caries at periphery and ADJ
  3. remove infected dentine (if you can)
  4. maximize cavity for longevity
20
Q

What makes stepwise technique different from partial caries removal

A

w Only diff is few months later is you go back into the cavity later and you restore is later with something more permanent

21
Q

When do you do a direct pulp cap

A

if you expose the pulp and it is

  1. vital
  2. not hyperaemic
  3. no pain or transient
22
Q

What are the materials used for a direct pulp cap

A

MTA
RMGI
CaOH
not ledermix

23
Q

What can you do a pulpotomy

A

same conditions for direct pulp cap

24
Q

What is pulpotomy not so proven for

A

closed apices

25
Q

What material do you use for partial caries removal

A

depends on clinical situation
sub gingival means moisture contamination risk so not composite
don’t want amalgam for aesthetics in smooth surface
deep restoration for molars - amalgam is good

26
Q

What is step 1 in stepwise caries removal

A

put RMGI over caries

27
Q

What is step 2 in stepwise caries removal

A

6 months later reenter
remove hardened dentine
and restore

28
Q

Which is better, partial caries removal or stepwise technique

A

both have same failure rate but PCR has higher vitality rate

not much difference - do the easiest done