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Operative > Midterm 1: Cariology II Approximal Caries > Flashcards

Midterm 1: Cariology II Approximal Caries Flashcards

1
Q

Where are approximal caries?

A

between teeth
enamel - enamel contact

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1
Q

Class I caries are best prevented by what?

A

Fissure sealants

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2
Q

Posterior approximal caries begin ____________ to contact area.

A

gingival

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3
Q

Is there plaque retention between the posterior teeth?

A

YES

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4
Q

Demineralization can be inhibited by _________.

A

fluoride

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5
Q

How do posterior approximal caries form?

A
  1. undisturbed plaque on smooth surface
  2. plaque fed by carbohydrates
  3. mineral loss at center of lesion
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6
Q

What forms on the clean tooth surface to get caries?

A

pellicle
biofilm

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7
Q

There is a state of equilibrium between _______________ and the oral environment/plaque.

A

Hydroxyapatite
Ca10(PO4)6(OH)2 —> Ca2+ + PO43-

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8
Q

What is the critical pH for dentin?

A

6.2

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8
Q

What causes the pH to decrease?

A

sugar
increases [H+]
sugar increase H+ level which pulls the phosphate out of the tooth

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9
Q

What does bicarbonate do in saliva?

A

Bind with H+ to leave the equilibrium balance of calcium and phosphate untouched

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10
Q

Bicarbonate in saliva serves as a ________.

A

Buffer
distractor

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10
Q

What is saliva for and what does it provide for the mouth?

A

Natural rinsing (clearing bacteria/carbohydrates)
Bicarbonate (buffering capacity)
Calcium and phosphate
Fluoride

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11
Q

What is a Stephan Curve?

A

Shows the balance of remineralization/demineralization throughout time

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12
Q

What is the critical pH for enamel?

A

5.5

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13
Q

For a _____ mouth, it takes longer for pH to return to neutral

A

dry

14
Q

What is the benefit of remineralization into fluorapatite?

A

fluroapatite has a critical pH of 4.5
better able to resist acid demineralization compared to hydroxyapatite

15
Q

With fluoride, the critical pH is now 4.5, which means what?

A

It takes a stronger acid challenge to start demineralization

16
Q

What are some characteristics of remineralization?

A

remineralization is a surface phernomenon
outer layer of enamel will remineralize
deeper enamel/affected dentin will not re-mineralize
will become shiner
radiolucency remains

17
Q

Posterior approximal caries have little ________ evidence and no __________ evidence.

A

visual
tactile

18
Q

How are posterior approximal caries diagnosed?

A

With X-rays

18
Q

What are approximal caries (E2)?

A

acids begin to affect underlying dentin
loss of mineral subjacent to demineralized enamel
some discoloration from stains
NO spread of demineralization along DEJ

19
Q

What are the categories of approximal caries?

A

E1
E2
D1
D2
D3

19
Q

What are approximal caries (E1)?

A

Superficial deminirelization of enamel
No changes in dentin

20
Q

What are approximal caries (D1)?

A

Cavitation of enamel
destruction of outer dentin
SUBSTANTIAL staining in dentin
enamel will begin to break down
spread in oval shape
stain all the way to the pulp even if the damage is to the dentin only

21
Q

What are approximal caries (D2)?

A

Circumferential and axial destruction of dentin
possible pulp involvement
chalkiness
shadowing of occlusal
unsupported enamel broken away revealing dentin
demineralization extending into middle third of dentin

22
Q

What are approximal caries (D3)?

A

Infection of pulp tissue
circumferential destruction of dentin and undermining of enamel is extensive
making repair with filling is UNRELIABLE

23
Q

What is the progression of caries?

A
  1. enamel demineralization
  2. dentin demineralization
  3. enamel cavitation
  4. dentin cavitation
24
Q

What are the pros and cons of panoramic radiographic diagnosis?

A

big picture
NOT SENSITIVE ENOUGH for approximal caries
if approximal caries are visible, TOO ADVANCED

25
Q

What are the pros and cons of periapical radiographic diagnosis?

A

angle of x-ray beam is usually to low/high to highlight horizontal oval lesion

26
Q

What should be used for radiographic diagnosis?

A

BITEWINGS

27
Q

Why are bitewings used to diagnose approximal caries?

A

designed to show approximal lesions
show bone level

28
Q

How to prevent approximal caries?

A

Reduce fermentable carbohydrates
Ex. sucrose, glucose, fructose, lactose

tooth brushing

flossing

fluoride

29
Q

What is the worst fermentable carbohydrate?

A

sucrose

30
Q

Why is sucrose so bad?

A

The oxygen that binds glucose and fructorse
Step mutans can use energy in that bond to link flucose with insoluble polymer: glucan
this linkage causes strep mutans to bind to tooth structure quickly and strong

31
Q

What is surgical treatment for approximal caries?

A

remove defective tooth structure that is surrounded by solid tooth structure
access through marginal ridge
SIGNIFICAN weakening of tooth structure

32
Q

Posterior approximal lesions require access through which sound tooth structure?

A

marginal ridge

33
Q

__________ defects are easier to detect than _________ defects.

(enamel or dentin?)

A

enamel
dentin

34
Q

Proper flossing and fluoride application are effective in preventing lesions unless they are __________.

A

cavitated

Operative (8 decks)

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