Management of Gross Caries

Question 1

What is the difference between D1 and D3 caries class?

Answer 1

D1 = only in enamel
D3 = extends in dentine

Question 2

What is the definition of D3 caries?

Answer 2

clinically detectable lesions in dentine

Question 3

What is the ethos behind dealing with caries?

Answer 3

preserve healthy and remineralisable tissue

achieving a restorative seal (kill bacteria that can’t get nutrients)

maximise restoration success

carious tissue is removed to create conditions for long- lasting restorations

Question 4

What are the steps to dealing with caries?

Answer 4

1. Assess reason for caries
2. Address oral environment
3. Restore if necessary
   * Tissue removal
   * Restoration placement

Question 5

What are the steps to partial caries removal?

Answer 5

1. Access cavity (you need to see)
2. Remove caries at periphery and ADJ
3. Remove infected dentine (if you can)
4. Maximise cavity for longevity with permanent restoration

Question 6

What are the steps of the stepwise technique?

Answer 6

1. Access cavity (you need to see)
2. Remove caries at periphery and ADJ
3. Remove infected dentine (if you can)
4. Maximise cavity for longevity (temporary restoration then 6 months later, re-enter, remove hardened dentine, and restore)

Question 7

What should you do if you expose the pulp and it is vital, not painful and not hyperemic?

Answer 7

direct pulp cap

Question 8

What materials are used for a direct pulp cap?

Answer 8

• MTA
• RMGI
• CaOH

Question 9

If the pulp is inflammed, what may be indicated?

Answer 9

pulpotomy (not so proven for closed apices (adult teeth))

Question 10

What is RMGI used for?

Answer 10

step 1 in stepwise (less irritation)

Question 11

What is more successful PCR or stepwise?

Answer 11

PCR