Management of approximal caries Flashcards
Where does the caries reach when there is cavitation?
middle third of dentine
How does enamel appear clinically when there is a carious approximal lesion?
grey shadow or opacity
dark staining showing through enamel
chalky appearance of demineralised enamel
large ditch at margin of fractured enamel
What % demineralisation is required for caries to be detected on radiographs?
30-40%
What is the issue of overlapping contact points in radiographs?
more difficult to detect approximal caries
When do we take invasive interventions in the carious process?
when it is likely to have reached …
- middle third
- inner third
of dentine
and it is clinically certain it has cavitation
when uncertain if reached outer third of dentine
When do we take non-invasive/micro-invasive interventions in the carious process?
when uncertain if reached outer third of dentine
when cavitation is unlikely
when it is clinically certain no cavitation
When should we not do any intervention?
no active caries
What are some factors affecting material choice?
moisture control
patient compliance
caries risk - amalgam has less caries rates
operator skill/experience
cost and time available
enamel margins
Out of composite, GIC and amalgam, which has the highest moisture sensitivity?
amalgam is low
GIC is low (works better in moist environments)
composite is high (requires dry field)
Out of composite, GIC and amalgam, which has the best wear resistance?
amalgam is high (excellent wear resistance)
composite is moderate (wears over time)
GIC is low (prone to erosion)
Out of composite, GIC and amalgam, which has the best use case?
composite - aesthetic restorations in posterior and anterior teeth
GIC - only for non-load-bearing areas and high caries risk patients
amalgam - for posterior restorations with high occlusal load
Out of composite, GIC and amalgam, which has the best strength and durability?
amalgam is very high and durable
composite is good but less resistant to heavy forces
GIC is moderate but weaker in high-stress areas
Out of composite, GIC and amalgam, which has the best occlusal load resistance?
amalgam is high
composite is moderate
GIC is low
Out of composite, GIC and amalgam, which has the best longevity?
amalgam is 10-15+ years
composite is 5-10+ years
GIC is 5-7 years
Out of composite, GIC and amalgam, which has the best fluoride release?
GIC does, helps prevent caries
amalgam and composite - no
Out of composite, GIC and amalgam, which has the best ease of placement?
GIC is quick and easy
amalgam is quick but requires condensation
composite is technique sensitive, requires layering
Out of composite, GIC and amalgam, which has the best cost?
amalgam and GIC are low
composite is moderate
Out of composite, GIC and amalgam, which has the best bonding to tooth?
composite has strong bond with adhesive
GIC has chemical bond to dentine and enamel
amalgam requires mechanical retention
Out of composite, GIC and amalgam, which has the best biocompatability?
GIC is excellent
composite is good but some concerns with resin components
amalgam has some concerns over mercury content
Out of composite, GIC and amalgam, which has the best aesthetics?
composite (tooth-coloured)
GIC (fair - opaque, limited shades)
amalgam (metallic appearance)
How should all cavities be modified?
ability to clean margins
strength for material and tooth
remove weak or unsupported enamel
retention
resistance
What are the advantages of composites?
aesthetics
conservation of tooth structure
bonding to tooth structure
low thermal conductivity
What are the disadvantages of composites?
technique sensitivity
polymerisation shrinkage
marginal leakage
secondary caries
postoperative sensitivity
What are the advantages of amalgam?
strong
hard-wearing
cheap
longevity
less technique sensitive than amalgams
