Midterms Flashcards by Alex Ko Kam

Is the likelihood of the patient having new caries lesions in the near future

Caries risk

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Cavitated ot non-cavitated dental lesions caused by dental caries process

Caries lesion

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Are environmental factors, biological or chemical therapy that help to swim the caries balance to caries lesion prevention or reversal

Protective factors

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Are environmental or biological factors that contribute to the initiation or progression of carious lesion

Risk factors

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Are clinically observed results of previous and/or ongoing dental caries destruction of the tooth mineral

Disease indicators

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A scientific, evidence-based solutions for prevention and treatment of caries before they have reached the cavitated stage

Caries management by risk assessment

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Dental cares is a ___ medical condition, not a mechanical problem

Manageable

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Caries Classification according to anatomical site

Pits and fissure caries
Smooth surface caries
Root caries

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Classification according to new lesion or recurrent lesion

Primary caries
Recurrent caries
Residual

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Lesion on unrestored surface

Primary caries

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Aka “secondary caries”
Lesion developing adjacent to restoration

Recurrent caries

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Caries that remains in the prepared tooth surface even after placing restorations

Residual carries

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Pathway of caries spread

Forward and backward caries

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Caries cone in enamel is larger or equal to that in the dentin

Forward carioes

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Spread of caries along the DEJ exceeds that in the contagious enamel

Backward caries

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Classification based on number of tooth surface involved

Simple caries
Compound caries
Complex caries

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One tooth surface is involved: buccal, mesial

Simple caries

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Connected surface involved:mesiobuccal or distobuccal

Compound caries

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three surface involved: connected or separated

Complex caries

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Time of progression of caries

18 (+/- 6months) on smooth surface caries

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Peak progession of caries

3 years

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Progression is __ in healthy individuals

Slower

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First clinical evidence of demineralization

White spots

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Reason why white spots occur

Poor oral hygiene

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Enamel caries follow the direction of???

Enamel prism or rods

White spots can only be seen if the oral cavity is

Dessicated

Initial lesion of smooth surface caries

On proximal surfaces

Smooth suface caries can be reminaralized by

Salivary fluoride

In pits and fissure caries,initial caries starts at the?

Lateral walls of fissre

Zones of enamel caries

Translucent zone Dark zone Body of lesion Surface zone

Zone of enamel caries which is the deepest zone layer: near dentin

Translucent zone

Zone of enamel caries that represent the advancing front of the lesion

Translucent zone

Zone of enamel caries that is referred to as positive zone

Dark zone

Zone of enamel caries that does not transmit polarized light

Dark zone

Larges portion of zone of enamel caries

Body of lesion

Zone of enamel caries that is the area of greatest demineralization

Body of lesion

One of enamel caries that is not or least affected by caries

Surface zone

Why is the surface zone of enamel caries has a greater resistance

Because they are accessible by the sailva which helps with the mineralization

Zones f dentinal caries

Zone of fatty degeneration Zone of dentinal sclerosis Zone of decalcification of dentin Zone of bacterial invasion Zone of decomposed dentin

Types of explorer

Interproximal Straight Shepherd’s hook

criteria of visual to detect caries

Clean and dried teeth Under adequate light

An explorer is used to detect softened tooth structure, and when it sticks, it indicates presence of caries

Tactile

There is an evident hole caused by demineralization

Cavitation

Checked with an explorer or probe

Surface roughness

May appear opaque when wet with saliva or dried

Opacification

Color of teeth when the caries are active

Yellow

color of teeth when the caries are arrested

Black

Radiographic method that entirely seen the tooth and bone

Intraoral periapical

Radiographic method which seesthe crown of the maxilla and mandible Occlusion

Bitewing

Radiographic method where it is seen as a bird’s eye view of the dentition

Panoramic

Uses visible light instead of ionizing radiation

Digital Imaging Fiber Optic Transillumination

uses fluorescence for the detection of caries

Quantitative Light/Laser induced fluorescence

Variant of QLF system that is introduced in 1998 as adjunct to diagnosis of occlusal carries

DIAGNODENT - Laser autofluorescence

Sound tooth is a good electrical insulator due to its highinorganic content

Electrical conductance measurement

Electrical conductivity: Electrical resistance:

C - amountof demineralization R - measuring the electrical conductivity through these pores

ECM in surface specific

Measures the entire occlusal surface

ECM in site specific

Applies probe as electrode into fissures and the electrical conductance of that site is measured Can only measure a small occlusal area at one time

HZ of ECM - caries meter and vanguard electronic caries detector

CM - 400hz Vang - 25Hz

Aka as electrical caries monitor

Electrical impedance measurement

a measure of degree at which an electric circuit resist electric current flow when a voltage is aplied across two electrodes

Electrical impedance measurement or aka electric caries monitor

Limitations of caries detection technology

They are only use on unrestored pits and fissures

Conical beam with a flat sensor travels 360 around the object

Cone-beam computer technology or Digital volume tomography

3D representation of the object is constructed by a computer program from the 2D image and a metal sphere used as a reference

Tuned-aperture computer tomography

Radiograph methods

Intraoral periapical Bitewing Panoramic

A radiopaque line representing the tooth socket

Lamina dura

appears as a narrow radiolucent line around the root surface

PDL

Sees as radiolucent lines wthin the tooth

Pulp cavity

An explorer that is used for interproximal surfaces

Interproximal/briault/back action explorer

Explorer that is used for examining occlusal surfaces

Straight explorer

An explorer used for caries and calculus detection

Shepherds hook explorer

Primum non cere

Do no harm

4 types of visual

Cavitation Surface roughness Opacification Discoloration

Advantage of visual

Preferred over probing because of its harmful effects

Disadvantage of visual

Cannot assess levels of caries penetrated in pits and fissure Normal discoloration of tooth can be seen as caries

When an explorer sticks on the tooth surface it indicates?

Presence of caries

If the explorer does not stick on the tooth surface, it indicates what?

No caries present

Disadvantage of tactile

Sharp edges of explorer may fracture demineralized tooth, if left alone could have remineralized Sharp explorer tip on pits and fissure can cavitate the enamel Cariogenic bacteria on the tip of the probe can be seeded onto the pits and fissure of an unaffected tooth

What initiates enamel caries

Deposition of dental plaque on tooth surface, usually areas of plaque stagnation

Initial lesion of proximal surface

Smooth surface caries

What is the spread of pits and fissure caries

Spread laterally to DEJ

Initial lesion can usually be seen on what tooth surface

Facial and lingual

Enamel loses their translucency

Initial lesion

Affected les by drying and wetting Des not represent a clinical problem (except esthetics)

Developmental white spot hypocalcifications

Zone of enamel caries begins from the?

Dentinal side

Dental caries occur when?

Enamel cares reached the DEJ

What is the spread of the dental caries

Spreads laterally and follow the direction of dentinal tubules

Why does dental caries appears brown?

1. Due to pigment producing microorganism 2. Chemical breakdown of protein on the presence of sugar 3. Exogenous stains

Initial penetration in early dentinal changes

Dentinal sclerosis

Calcification of dentinal tubules - prevent further penetration of microorganism

Dentinal sclerosis

Microorganism of dentinal sclerosis

PIONEER BACTERIA

When dentinal tubules are completely occluded; section of the tooth gives a transparent appearance

Transparent dentin

Intertubular dentin is demineralized, lumen is filled by calcified material

Transparent dentin

Proteolytic microorganisms take over as caries becomes father to the carbohydrates (source ofcaries initiation)

Initial decalcification of dentinal tubules

What sheath shows sweling when there is a decalcification of the walls of individual tubules

Sheath of neumann

Coalesing and breakdown of dentinal tubules

Liquefaction foci

Shape of lesion in advanced dentinal changes

Triangular with apex towards the pulp

Xray diagnosis of puts and fissure is diffult in earlier stage Detection is often possible when decay is more advanced in the dentin

Caries of occlusal surface

Small lesions are difficult to detect Lesion may not be evident until 30-40% demineralization has occurred

Caries of proximal surface

Noncarious root surface may appear carious

“Cervical burnout” root surface caries

Diffuse radiolucent areas will ill-defined borders on proximal aspects of teeth in the cervical area

Root surface caries

Appears aswell-defined radiolucency surrounded by a uniform, noncarious region of enamel

Caries of buccal and lingual surface

Lesions next to restorations may be obscured by the radiopaque restorations

Secondary caries