Minimally Invasive Dentistry Flashcards
1
Q
Restorative Renovation - The 5 R’s
A
- Review.
- Refurbish.
- Re-seal.
- Repair.
- Replace.
2
Q
Review
A
- Monitor the tooth and review it later on.
- Can be monitored with radiographs and photographs.
3
Q
Refurbish
A
- Removal of excess.
- Reshaping.
- Polishing.
4
Q
Re-seal
A
The application of a sealant in a non-carious marginal gap.
5
Q
Repair
A
- Removal of part of the restoration.
- Removal of the localised defect.
- Restoration of the defect.
6
Q
Replace
A
- Removal of the entire restoration.
- Restoration of the tooth.
7
Q
Detection definition
A
Determining whether or not disease is present.
8
Q
How to diagnose
A
- Visual examination - very important for monitoring occlusal surfaces and early diagnosis.
- Pain or sensitivity to hot/cold/sweet often occurs later once the lesion has cavitated, because insulation has been lost.
9
Q
Clinicians role
A
- Assess patients caries risk.
- Employ non-operative preventative care protocols.
- Master early detection and diagnostic methods.
- Choose a minimally invasive adhesive restoration carefully.
10
Q
Pits and fissures anatomy
A
- Lined with aprismatic or amorphous enamel.
- Enamel prisms.
- Difficult to clean so promotes the adherence of bacterial plaque biofilm.
- Penetration and adhesion of sealant materials difficult.
11
Q
Pathology of occlusal carious lesions
A
- Pits and fissures acquire a pellicle, which is formed by the absorption of salivary proteins.
- This creates a base substrate for further bacterial attachment and the formation of plaque biofilm.
- Remains undisturbed by toothbrushing in pits and fissures.
- Unrefined carbohydrates infuse for bacterial nutrition.
- Demineralisation occurs on base or walls of fissure.
- Clinically undetectable from visual examination alone.
- May be arrested by biochemical remineralisation.
- If lesion progresses into dentine, it spreads laterally, underneath the EDJ and towards the pulp.
12
Q
Visible changes
A
- White spot lesion detectable when air drying.
- Matte.
13
Q
Fluoride and occlusal caries
A
- Reduces the rate of demineralisation on tooth surfaces, but is least effective in pits and fissures.
- Strong, well-fluoridated enamel is more resistant to fractures.
- This can allow lesions to extend into dentine and towards the pulp without symptoms (hidden caries).
14
Q
Risk assessment
A
- Verbal history.
- Examination.
- High medium or low.
- Patients must be informed of their risk and their need for co-operation.
15
Q
Risk assessment factors
A
- Social history.
- Medical history.
- Caries history.
- Restorative history.
- Dietary habits.
- Plaque control.
- Saliva (flow rate, buffering capacity, composition).
- Detection of existing carious lesions,
16
Q
ICDAS visual assessment protocol
A
- Remove appliances.
- Remove plaque.
- Remove stain with prophylaxis.
- Isolate with cotton wool rolls.
- Remove excess saliva.
- Examine visually.
- Air dry for 5 seconds.
- Examine visually again.
17
Q
High risk category
A
- New lesions or progression of an existing one will put the patient in the high-risk category.
18
Q
What should be noted before removal?
A
- Plaque biofilm.
- Because it is the primary risk factor for the development and progression of carious lesions.
19
Q
Radiography for detection
A
- Important for the early detection of class ll carious lesions.
- Occlusal caries rarely visible until there is significant dentine demineralisation.
- Lesions that are visible, but undetectable on a radiograph are better treated with MI techniques.
- Radiographically obvious dentine lesions are considered to be active.
20
Q
Routine bitewings
A
- 2 yearly, or determined for individual patient risk.
- Reduces the risk of undiagnosed active dentine lesions.
