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ICP > L3: Dentine Caries > Flashcards

L3: Dentine Caries Flashcards

1
Q

what is the composition of dentine?

A

70% organic
20% inorganic
10% water

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2
Q

what is the difference between tertiary and regular dentine?

A

tertiary is LESS mineralised

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3
Q

what is the pulp-dentine complex?

A

a response between the dentine and pulp when there is injury

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4
Q

what are the three components of a pulp-dentine complex?

A
  1. Tubular sclerosis
  2. Reactionary dentine
  3. Inflammation of the pulp
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5
Q

What is tubular sclerosis?

A

A component of the pulp-dentine complex leads to an increasing tubular obliteration = enormously reduces dentinal permeability

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6
Q

what do odontoblasts do in tubular sclerosis?

A

1) Odontoblasts retract from the acid stimulus

2) Odontoblasts increase formation of peritubular dentine

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7
Q

what is peritubular dentin?

A

a relatively dense mineralized tissue that surrounds the tubules of coronal tooth dentine

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8
Q

During tubular sclerosis, what is the tracts distal (along) to the occlusion (blockage) called?

A

Dead Tracts

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9
Q

Visually, how does tubular sclerosis differ from regular dentine?

A

More translucent on ground section due to higher mineralisation

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10
Q

What is reactionary dentine?

A

Secondary dentine formed at pulp dentine interface; serves to increase distance between pulp and noxious stimulus

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11
Q

For Low stimulus, describe the:

1) Rate of deposition of dentine
2) Tubules

A

1) Slow rate of deposition of dentine

2) Tubules regular

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12
Q

For High stimulus, describe the:

1) Rate of deposition of dentine
2) Tubules

A

1) High rate of deposition of dentine

2) Tubules irregular

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13
Q

What happens to dentine if odontoblasts die?

A

Atubular calcification may be formed by pulpal cells

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14
Q

what is pulpitis?

A

inflammation of the pulp

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15
Q

What is the three symptoms of pulpitis?

A

1) Increased blood flow-vascular dilation
2) Oedema

3 )Migration of neutrophils and macrophages (acute inflammation) plasma cells and lymphocytes (chronic inflammation)

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16
Q

what is the shape of an enamel lesions?

A

1) Cone-shaped

2) Apex pointing to dentine

17
Q

at what part of the tooth does caries spread rapidly in a lateral direction?

A

EDJ

18
Q

Why do caries spread laterally rapidly at the EDJ?

A

Higher organic content and low fluoride of this region of enamel

19
Q

What is the visual representation of caries lesion in the enamel?

A

Tooth is bluish white

20
Q

Which surface of the tooth is more likely to have caries?

A

Fissure caries dentine surface areas involved greater than smooth surface caries

21
Q

During early caries lesion, describe:

1) Odontoblast response
2) Sterility of lesion and condition of enamel
3) Radiographic representation

A

1) - tubular sclerosis
- reactionary dentine.

2) Lesion is sterile, enamel intact no microorganisms

3) - Reduction in pulpal volume due to reactionary dentine formation
- Demineralisation of enamel (Darker marks on xray)

22
Q

What is early cavitation?

A

Following extensive subsurface demineralisation of enamel, surface may fracture and microorganisms penetrate occurs before or after caries has affected dentine

23
Q

What are the two main classes of microorganisms found in carious lesion?

A

1) Acidogenic (lactobacilli) bacteria

2) Proteolytic bacteria

24
Q

What is the movement of acidogenic bacteria in dentine tubules?

A

Acidogenic bacteria penetrate dentine tubules acid diffuses ahead

25
Q

What is the function of acidogenic bacteria in dentine tubules?

A

Causes demineralisation

26
Q

What is the movement of proteolytic bacteria in dentine tubules?

A

Remains in superficial region of dentine

27
Q

Where is multiplying bacteria found?

A

Multiplying bacteria lie parrallel to line of dentine tubules

28
Q

What is the function of proteolytic bacteria in dentine tubules?

A

Destroy organic matrix to form liquefaction foci

29
Q

What is liquefaction foci?

A

Liquified areas of dentine

30
Q

What are transverse clefts?

A

What is liquefaction foci?
Liquified areas of dentine
What are transverse clefts?
Liquefactive foci coalesce (gathering) form transverse clefts at right angles to dentine tubules

31
Q

During dental treatment, which dentine is removed in the early cavitation carious lesion?

A

Soft infected dentine

  • keep the tubular sclerosis dentine as it is often intact
32
Q

What is advanced carious destruction?

A

Dentine destruction greater and tubular sclerosis destroyed, bacteria penetrate almost to pulp in advance zone of sterile demineralisation

33
Q

What happens to odontoblasts in advanced carious destruction?

A

Odontoblast may degenerate

34
Q

What happens to pulp in advanced carious destruction?

A

Marked pulpitis

35
Q

During dental treatment, what is removed in the advanced carious destruction lesion?

A

Remove soft dentine but beware exposure of pulp

ICP (20 decks)

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