Lecture 8 - Acquired Abnormailities

Question 1

Dental Caries Pathology

Answer 1

Requires bacteria & diet containing fermentable carbohydrates (S. mutans)

1) Bacteria accumulates on tooth -> Bacterial plaque (biofilm)
2) Bacteria produce lactic acid from fermentation of carbs
3) Acid demineralizes dental hard tissues (carious lesion)
4) Bacteria penetrates into hard tissues and forms cavity after severe demineraliztion

Question 2

Factors affecting radiographic appearance of caries

Answer 2

Actual caries deeper than appears radiographically

• Buccolingual thickness of tooth (thicker tooth, harder to see caries)
• 2D film
• X-ray beam angle
• Exposure factors (lower kVp, higher contrast)

Question 3

Incipient Caries

Answer 3

<1/2 thickness of enamel

Question 4

Moderate Caries

Answer 4

> 1/2 thickness of enamel to DEJ

Question 5

Advanced Caries

Answer 5

Through DEJ up to 1/2 through dentin

Question 6

Infected Dentin

Answer 6

Bacteria present in tooth, needs to be removed

Question 7

Affected Dentin

Answer 7

Hard, discolored dentin with no/few bacteria
Indicates leading edge of carious lesion
Don’t need to remove

Question 8

Severe Caries

Answer 8

More than 1/2 way through dentin

Question 9

Typical radiographic appearance of caries

Answer 9

• Radiolucent lesion (demineralized)

- Early lesion looks like triangle w/ base at surfacet start below gingival margin (distinguish from cervical burnout)

Question 10

Mach Band/Effect

Answer 10

Optical illusion on increased radiolucency at DEJ

Question 11

Clinical cavitation

Answer 11

Lesions may present with or without clinical cavitation
Lesion always active if cavitation
Lesion in dentin > 1/2way to pulp is always cavitated

Question 12

Treatment of Clinical Cavitation

Answer 12

Cavitated lesions require operative tx
Non-operative intervention -> arrest progression, promote remineralization
Depends on: pt’s caries hx, age, and site of lesion