Lecture 8 Flashcards
What is necessary to detect dental caries?
Both a careful clinical examination and interpretation are necessary.
Why are dental images important for caries detection?
A dental examination for caries cannot be considered complete without dental images.
Dental images enable dental professionals to identify carious lesions not visible clinically and allow evaluation of the extent and severity of carious lesions.
What is dental caries?
Dental caries, or tooth decay, is the localized destruction of teeth by microorganisms.
What happens to the tooth structure due to dental caries?
Normal mineralized tooth structure (enamel, dentin, cementum) is altered and destroyed.
Where does the term “caries” originate, and what does it mean?
The term “caries” comes from the Latin word cariosus, meaning “rottenness,” which refers to the “rotting of the teeth.”
What are the components of an intraoral examination?
- Visual: Look for discoloration.
- Dental instrumentation: Use restorative explorers.
- Transillumination:
• Especially useful in the anterior region.
• Involves a transilluminator device or using a mirror to reflect light.
How are carious lesions identified on a dental image?
Decreased density allows greater penetration of x-rays in the carious area, making the lesion appear radiolucent (dark or black) on the image.
What is required for a dental image to be diagnostic for caries?
Images must be of diagnostic quality, and a bite-wing image used to detect dental caries must exhibit open contacts.
What is interproximal caries?
Interproximal caries are caries found between two teeth.
What defines advanced interproximal caries?
Advanced interproximal caries extend to or through the dentinoenamel junction (DEJ) and into the dentin but do not extend more than half the distance toward the pulp.
What defines severe interproximal caries?
Severe interproximal caries extend through enamel, through dentin, and more than half the distance toward the pulp.
What are occlusal caries, and why are they difficult to detect?
Occlusal caries are located on the chewing surfaces of teeth. They are difficult to see on dental images due to the superimposition of dense buccal and lingual enamel cusps. They are typically not visible on a dental image until they reach the dentinoenamel junction (DEJ).
What are incipient occlusal caries, and how are they detected?
Incipient occlusal caries cannot be seen on a dental image. They must be detected clinically using an explorer.
What are moderate occlusal caries, and how do they appear?
Moderate occlusal caries extend into dentin and appear as a very thin radiolucent line. This radiolucency is located under the enamel of the occlusal surface. On a dental image, little or no change is noted in enamel.
What defines severe occlusal caries?
Severe occlusal caries extend into dentin and appear as a large radiolucency on a dental image.
Why are buccal and lingual caries difficult to detect?
The superimposition of normal tooth structure densities makes buccal and lingual caries hard to detect on dental images. These caries are best detected clinically.
What do root surface caries involve?
Root surface caries involve only the roots of teeth.
Which parts of the tooth are affected by root caries?
The cementum and dentin located just below the cervical region of the tooth are affected.
What precedes the caries process in root caries?
Bone loss and corresponding gingival recession precede the caries process and result in exposed root surfaces.
Where do secondary or recurrent caries occur?
Recurrent caries occur adjacent to a pre-existing restoration.
Why do recurrent caries occur in the region of a restoration?
Recurrent caries occur due to inadequate cavity preparation, defective margins, or incomplete removal of caries before placement of the restoration material.
How do recurrent caries appear on a dental image?
Recurrent caries appear as a radiolucent area just beneath a restoration.
What does the term ‘rampant’ mean?
The term ‘rampant’ means ‘growing or spreading unchecked.’
What is rampant caries?
Rampant caries is advanced and severe caries that affect numerous teeth.
Who is typically affected by rampant caries?
Rampant caries is typically seen in children with poor dietary habits or in adults with decreased salivary flow.
What conditions resemble caries?
Conditions that resemble caries include: Cervical Burnout, Restorative Materials, Attrition, Abrasion, Abfraction, Pathology.
What is cervical burnout?
Cervical burnout is a radiolucent artifact seen on dental images that may be confused with caries.
Why does cervical burnout occur?
Cervical burnout occurs due to:
• Root concavities found in the area (e.g., maxillary root anatomy).
• Transition from enamel to the absence of enamel.
• Contrast between enamel and alveolar bone.
What is a fracture?
A fracture is the breaking of a part.
Which structures can exhibit fractures?
The maxilla, mandible, and teeth may all exhibit fractures.
When is dental imaging indicated for fractures?
Dental imaging is indicated whenever a fracture is evident or suspected.
What are examples of fractures?
Examples include:
• Jaw fracture.
• Crown fracture (crown fx).
• Root fracture (root fx).
What may trauma result in?
Trauma may result in the displacement of teeth.
What is luxation?
Luxation is the abnormal displacement of teeth.
How is luxation categorized?
Luxation is categorized as either intrusion or extrusion.
What is intrusion?
Intrusion refers to the abnormal displacement of a tooth into bone.
What is extrusion?
Extrusion refers to the abnormal displacement of a tooth out of bone.
What is dental avulsion?
Dental avulsion is the complete displacement of a tooth from the alveolar bone.
How is an avulsed tooth identified on a dental image?
An avulsed tooth is not seen on a dental image; instead, a periapical image reveals a tooth socket without a tooth.
What are the two types of resorption?
The two types are physiologic and pathologic resorption.
What is physiologic resorption?
Physiologic resorption is a process seen with the normal shedding of primary teeth.
How does physiologic resorption occur?
The roots of a primary tooth are resorbed as the permanent successor moves in an occlusal direction, and the primary tooth is shed when root resorption is complete.
What is pathologic resorption?
Pathologic resorption is a regressive alteration of tooth structure observed when a tooth is subjected to abnormal stimuli.
How can pathologic resorption be described?
Pathologic resorption can be described as external or internal, depending on the location of the resorption process.
What are the two types of resorption?
The two types of resorption are physiologic and pathologic.
What is physiologic resorption?
Physiologic resorption is a process seen with the normal shedding of primary teeth.
How does physiologic resorption occur?
The roots of a primary tooth are resorbed as the permanent successor moves in an occlusal direction. The primary tooth is shed when root resorption is complete.
What is pathologic resorption?
Pathologic resorption is a regressive alteration of tooth structure observed when a tooth is subjected to abnormal stimuli.
How is pathologic resorption classified?
Pathologic resorption can be classified as external or internal, depending on the location of the resorption process.
What is external resorption?
External resorption is the destruction of root structure along the periphery of the root surface.
Which region is most often affected by external resorption?
The apical region is most often involved in external resorption.
What is internal resorption?
Internal resorption is the destruction of dentin around the pulp cavity within the crown or root of a tooth.
What factors can stimulate the internal resorption process?
Factors such as trauma, pulp capping, and pulp polyps are believed to stimulate internal resorption. These factors serve as irritants and cause chronic inflammation of the pulp, which destroys the surrounding dentin.
What are the clinical findings of internal resorption?
Internal resorption is generally asymptomatic. The incisors are most often affected.
What are the treatment options for internal resorption?
Treatment is variable:
• Endodontic therapy may be used if the resorptive process has not physically weakened the tooth.
• Extraction is recommended if the tooth is weakened by the resorptive process or if a root perforation exists.
What are the types of pulpal lesions?
The types of pulpal lesions are:
• Pulpal Sclerosis
• Pulp Canal Obliteration
• Pulp Stones
What is pulpal sclerosis?
Pulpal sclerosis is a diffuse calcification of the pulp chamber and pulp canals.
What is the cause of pulpal sclerosis?
The cause of pulpal sclerosis is unknown, but it is associated with aging.
How does pulpal sclerosis appear on a dental image?
On a dental image, a pulp cavity of decreased size with very thin pulp canals is seen.
What are the clinical findings of pulpal sclerosis?
Pulpal sclerosis has no clinical features and is considered an incidental finding. It has little clinical significance unless endodontic therapy is indicated.
