Interpretation of dental caries Flashcards
What is one of the most prevalent human diseases?
dental caries
Prevalence rate of dental caries finally started decreasing in ______
1980s
What is the epidemiology of dental caries?
- disease of “civilized” societies
- associated with highly refined sugar and retentive food diets that remains prevalent in lower socio-economic groups
- greatest cause of tooth loss in people 35 and younger
Dental caries are related to bacterial adhesion to tooth surfaces and _______ formation
plaque
What is plaque composed of?
polysaccharide/enzyme matrix with bacterial colonies that attach to tooth surfaces
Bacteria metabolize dietary carbohydrate producing acid byproducts that lower pH below ___ threshold to decalcify teeth
5.5
What are the predisposing factors of dental caries?
- bacteria
- diet
- plaque retention
- OH compliance
- saliva
What type of bacteria are using associated with dental caries?
– varies and is dependent on host
a. lactobacillus casei
b. streptococcus mutans
c. actinomyces viscosus
What part of the diet is a predisposing factor to dental caries?
glucose
What in the saliva can determine the risk of dental caries?
concentrations of salivary glycoproteins and immunoglobulins
What is the range of signs of dental caries?
ranges from slight demineralization to gross coronal decay
Where are dental caries usually?
defects appear as violations of
i. - smooth surfaces, usually at inaccessible areas
ii. - pit and fissures of occlusal and occasional proximal surfaces
Are dental caries easy to diagnose?
- easy to diagnose
- Not so easy to stage
- Harder to treatment plan
What is the standard radiograph that is preferred for caries diagnosis?
horizontal bitewing radiograph
If the contacts are overlapped in the bitewing radiograph what was wrong?
incorrect horizontal angle
Are Radiographs Necessary for Diagnosing Interproximal Caries?
YES!
Clinically you can diagnose without a radiograph
- hard to stage without a radiograph
- interproximal caries are hard to see clincally
Is periapical radiography useful for caries diagnosis?
Yes if…
- XCP technique used to minimize linear distortion in the vertical dimension
- Horizontal angulation must project non-overlapped contacts
Are vertical bitewings useful for caries diagnosis?
Not as useful because
a. technique problems from bending of the film
b. Difficulty placing film to open contacts
What are factors that affect caries presentation in x-rays?
(9)
- Angle of the x-ray beam
- Placement of the image receptor
- Location of the proximal carious lesion
- Degree of hypomineralization
- Exposure factors; low kV vs high kV;
- Degree of cavitation
- Ambient light intensity
- Monitor contrast resolution calibration
- Selection of postprocessing algorithms on digital images
What are factors that affect the perception of the digital display of caries?
- monitor resolution
- monitor luminescence
- background lighting affect
Standard commercial grade desktop monitors have been shown to be _______ for diagnostic medical radiology
inferior
What are the abbreviatons for different types of caries?
IC=Initial caries
MC=Moderate caries
AC=Advanced caries
RSC=Root surface caries
RC=Recurrent caries
B/Li = B or Li caries
What are the characteristics of initial caries?
- in enamel layer
- ranges from a demineralization defect at the proximal surface and can extend axially to contact the DEJ
What type of caries
initial caries
What are the characteristics of moderate caries?
- spreading vertically at the DEJ
and/or - extending axially less than halfway in dentin layer
What type of caries
moderate caries
What type of caries
moderate caries
What type of caries
inital caries
What are the characteristics of advanced caries?
- more than halfway into the dentin layer and an extend axially to contact the pulp
What type of caries
advanced caries
What type of caries
advanced caries
What type of caries
moderate caries
What type of caries
inital caries
What type of caries
advanced caries
What are the characteristics of root surface caries?
- Saucerized or scooped-out appearance
- 50% prevalence in geriatric population
- Most common in B premolar regions, then, followed by Li & interproximal areas
root surface caries
recurrent caries
Buccal or lingual caries
What are the characteristics of buccal/lingual caries?
- Difficult to localize on a single view
- May superimpose pulp
What are the international caries detection and assessment system classification?
- E1
- E2
- D1
- D2
- D3
What is E1 caries?
Lesion within outer ½ of enamel
What is E2 caries?
Lesion within inner ½ of enamel
What is D1 caries?
Lesion within outer 1/3 of dentin
What is D2 caries?
Lesion within middle 1/3 of dentin
What is D3 caries?
Lesion within inner 1/3 of dentin
What International Caries Detection and Assessment System rank is this?
E1
What International Caries Detection and Assessment System rank is this?
E2
What International Caries Detection and Assessment System rank is this?
D1
What International Caries Detection and Assessment System rank is this?
D2
What International Caries Detection and Assessment System rank is this?
D3
What is the definition for E1 interproximal caries?
Penetrates < ½ the enamel thickness as a radiolucent notch on the outer surface of the tooth
What International Caries Detection and Assessment System rank is this?
E1
What is the definition of E2 interproximal caries?
- Penetrates > ½ the enamel thickness
- May have an isosceles triangular outline with the base at the proximal surface
- Does NOT extend to DEJ
What International Caries Detection and Assessment System rank is this?
E2
What is the definition of D1 interproximal caries?
- Undermines enamel and extends into dentin
- at or axial to the DEJ
- Penetrates < 1/3 the outer peripheral dentin thickness
What International Caries Detection and Assessment System rank is this?
D1
What International Caries Detection and Assessment System rank is this?
D1
What is the definition of D1 interproximal caries?
- The dentin lesion is a more extensive dentin lesion
- Penetrates to mid 1/3 of the dentin thickness
What International Caries Detection and Assessment System rank is this?
D2
What International Caries Detection and Assessment System rank is this?
D2
What is the definition of D3 interproximal caries?
- The dentin lesion is more extensive than the enamel lesion
- Penetrates > 2/3 (or inner 1/3) of the dentin thickness
What International Caries Detection and Assessment System rank is this?
D3
What International Caries Detection and Assessment System rank is this?
D3
What is interproximal “burn out”?
- The dentin artifact simulates caries
- Lesion is outlined by normal anatomic structures and is a relative radiolucency
burn out
burn out
burn out
What is the internet definiton of burn out because I couldn’t understand it?
Cervical burnout is caused by overpenetration of the x-ray in thinner areas of the tooth
Why are incipient occlusal caries difficult to detect with radiographs?
- small width of the lesion
- density of superimposing enamel
What do moderate occlusal caries look like?
- Broad-based thin radiolucent zone in dentin with no changes in enamel
- Noticed as a relative increase in opacity between pulp and caries
What type of caries/location is this?
Moderate Occlusal Caries
What are severe occlusal caries?
Undermined enamel with gross loss of tooth structure
