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Fixed Prosthodontics I > L3a: Caries and Dental Plaque > Flashcards

L3a: Caries and Dental Plaque Flashcards

1
Q

What does caries cause to the tooth?

A
  • It weakens the tooth as it demineralizes the hard tissue
  • This can lead to pulpal necrosis that may need Root Canal Treatment.
  • This process could lead to further loss of tooth structure.
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2
Q

Refer to one factor contributing to caries development.

A
  • Plaque (bacteria) is one of the factors needed for dental caries to develop
  • it also affects the gums and subsequently the bone around the teeth.
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3
Q

What does the caries process affect?

A

The caries process affects the mineralized tissues of the teeth (enamel, dentine and cementum)

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4
Q

What is dental caries caused by?

A

It is caused by the action of microorganisms on fermentable carbohydrates in the diet.

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5
Q

What is used for caries detection?

A
  • Sharp Eyes’ +/-Magnification
  • Good Illumination
  • Clean tooth surface
  • Examine wet and dry
  • Round/Ball-ended explorers NOT SHARP PROBE
  • Time
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6
Q

Where does dental caries develop?

A
  • Pits/Fissures posterior teeth or cingulum
  • Approximal enamel in relation to contact areas with adjacent teeth
  • The cervical one third of the crown or, following gingival recession, the exposed root
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7
Q

Which is Black’s classification of Caries lesion?

A
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8
Q

Which views should be taken through radiographs for special investigations of caries?

A
  • Bitewings
  • Dental Panoramic Tomograph
  • Periapical
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9
Q

What does sensitivity testing include?

A
  • Sensibility vs Vitality Testing
  • Temperature
  • Electrical Pulp Tester
  • Test Cavity
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10
Q

Which is the sequence of accessing Caries?

A
  • Diagnosis
  • Operative
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11
Q

What does Diagnosis include in order to access Caries?

A
  • Detect caries
  • Determine activity
  • Determine need for treatment
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12
Q

What does Operative part of accessing Caries include?

A
  • Gain access
  • Identify interface between sound and carious
  • Excavate caries
  • Determine material
  • Modify cavity
  • Restore
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13
Q

Which are the aims of Enamel preparations?

A
  • Gain access to full extent of deeper carious dentine
  • Remove demineralized/weakened carious enamel
  • Create sound peripheral margin to seal with restorative material
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14
Q

Which is the Equipment used for Enamel preparations?

A
  • Air-rotor (High Speed >250,000rpm)
  • Diamond burs
  • Hand chisels
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15
Q

Which is the sequence of carious dentin removal?

A
  • Identify caries-infected dentine with probe (soft, wet, dark brown)
  • Identify peripheral extent to EDJ
  • Excavate peripherally first (clear EDJ)
  • Move towards pulp (anatomically and histologically)
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16
Q

Which is the equipment used for carious dentin removal?

A
  • Slow speed handpiece(<5000rpm)
  • Rose head steel burs
  • Hand excavators
17
Q

Through which methods can you deal with caries in fixed prosthodontics?

A
  • Foundation restorations: You may decide its ideal to prepare a heavily restored tooth in order to provide structural support.
  • Core restorations (+/- posts): When there is lack of coronal tooth structure you may decide to create a core with/without a post to increase the surface area for supporting a crown
18
Q

What is dental plaque?

A
  • a general term for the complex microbial community embedded in a matrix of salivary and bacterial origin (biofilm) and found on the tooth surface.
19
Q

What happens during dental plaque formation?

A
  • aggregation of bacteria and products onto the tooth surface
  • ability of S. mutans to adhere to the tooth surface
20
Q

What is development of dental plaque?

A

this is a specific sequence of events and NOT a random build-up of material and organisms on the tooth surface.

21
Q

Which are the steps that contribute in the formation of dental plaque?

A

1) Acquired Enamel Pellicle 1μm thick, deposited on clean tooth surface almost immediately. Complete in 2 hrs.
2) So-called ‘pioneering species’ of bacteria (from the bacteria in the saliva) will adhere to the acquired pellicle.
3) Pioneering species multiply and form a confluent layer
- Ability to utilize salivary glycoproteins via glycosidases.
- Ability to cleave IgA via IgA proteases.
4) Accumulated bacterial growth leads to (2-7 days after initial formation of plaque):
- decreased oxygen tension
- eventual growth of anaerobic bacteria (rods and filaments).
- increased diversity
5) Plaque maturity (attained at stagnant sites)

22
Q

(a) What is the acquired enamel pellicle composed of?

A
  • Proteins
  • lipids and glycoproteins from bacteria
  • saliva
  • gingival crevicular fluid.
23
Q

Where do the components of the acquired enamel pellicle derive from?

A
  • Host derived
  • Bacteria derived
24
Q

Which are the host derived components of the acquired enamel pellicle?

A
  • Acidic, proline-rich proteins – promotes adherence of bacteria.
  • Amylase
  • Lysozyme
  • Albumin
  • Immunoglobulins
25
Q

Which are the bacteria derived components of the acquired enamel pellicle?

A
  • Glycosyl transferases (glucosyl- and fructosyl transferases)
  • Glucans, Fructans
  • Bacterial cell fragments
26
Q

What do host and bacteria derived components of the acquired enamel pellicle act as?

A

As receptors for bacterial adhesion

27
Q

Which species contribute to plaque maturity?

A
  • Streptococci = approx.15%
  • Actinomyces
  • Anaerobic rods and filaments increase
28
Q

What is the accumulation of bacteria on the teeth the result of?

A

Accumulation of bacteria on the teeth is the result of the balance between:

  • Adhesion
  • Growth of bacteria (growth rates)
  • Removal of bacteria via physical forces and plaque interactions/competitions
29
Q

What is the presence of dental plaque often associated with?

A

Presence of dental plaque is often associated with inflammation of the soft tissue.

30
Q

What can this (inflammation of soft tissue) lead to? How can this affect the restorative procedure?

A
  • This can lead to extensive bleeding during any restorative procedure and affect the final aesthetics as there could be recession, thus making the junction between the prosthesis and the tooth visible.
31
Q

What could presence of caries lead to?

A
  • Presence of caries could lead to progression and irritation of the pulp.
  • This could lead to the need of root canal treatment.
  • Furthermore, it could result in root caries or secondary caries and thus lead to failure of the prosthesis.

It is important to have good foundations before a complex aesthetic prosthesis is fabricated on.

Fixed Prosthodontics I (12 decks)

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