Paeds: Radiographic Caries Diagnosis And Staging Flashcards
Primary tooth: occlusal caries (outer 1/3 dentine)
Initial occlusal caries
Primary tooth: occlusal caries (inner 1/3 dentine)
Advanced occlusal caries
What is selective CR?
Drill till achieved sound cavity margin to allow seal.
May leave soft carious dentine.
Non-restorable cavity control approach?
Reducing cariogenic potential of the lesion by altering the environment of the plaque biofilm overlying the carious lesion through brushing and dietary advice.
Primary tooth: proximal caries (invading only the enamel)
Initial proximal caries
Primary tooth: proximal caries (invading into the dentine)
Permanent tooth: occlusal caries (confined to enamel)
initial occlusal caries
Stepwise caries removal?
Two-steps
- Soft dentine —> coloured temp rest (GI)
6-12 months
- Hard dentine —> restore
Permanent tooth: occlusal caries (middle 1/3 dentine)
Moderate occlusal caries
Permanent tooth: occlusal caries (inner 1/3 dentine)
Extensive occlusal caries
Permanent tooth: proximal caries (outer 1/3 dentine)
Initial proximal caries
Permanent tooth: proximal caries (middle 1/3 dentine)
Moderate proximal caries
Permanent tooth: proximal caries (inner 1/3 dentine)
extensive proximal caries
Radiographic interpretation: Permanent tooth with caries proximally extending into the inner third of dentine?
PERMANENT TOOTH advanced proximal carious lesion
Management: Stepwise caries removal, temporise with an obviously temporary material and restore with a permanent restoration after 6-12 months.
With or without clear band of normal dentine present?
With
Right or left?
Tooth angled towards the right —> right
Right or left?
Tooth angled towards the left = left
Pain that occurs spontaneously but if provoked by a stimulus is typically not relieved when the stimulus is removed —> worse with heat, relieved by cold.
Irreversible pulpitis:
1. Gently remove gross debris from cavity
2. Place Corticosteroid antibiotic past under a temporary dressing (ideally open up pulp chamber and apply directly onto pulp).
3. Carry out Pulpotomy or extract
No clear band of dentine seen radiographically on primary tooth?
Consider sealing using the Hall technique
Pulpotomy
Fluoride varnish amount for 2-5 years old patient?
0.25ml
Fluoride varnish amount for 5-7 and above years old patient?
0.4ml
ART: atraumatic restorative technique
No drilling/LA - just sharp hand pieces (excavator/chisel etc) remove caries & achieve clear cavity margins - restore high viscosity GI.
Reversible pulpitis from a proximal carious lesion
Temporary dressing for 3-7 days
Symptoms resolved = hall technique
Unresolved = treat as irreversible pulpitis
Reversible pulpitis from occlusal carious lesion
Temporary dressing 3-7 days
Symptoms resolved = Selective CR & restore
Symptoms unresolved = treat as irreversible pulpitis
Irreversible pulpitis from a carious lesion treatment
If child can tolerate
—> straight to extract/pulpotomy
If child can’t initially tolerate
—> dress with sub lining of corticosteroid antibiotic paste & pain relief
—> then extract/pulpotomy
What kind of clinical findings would suggest low risk caries but still requires bitewings to be taken?
good dentition, however crowding, high surface area contacts (i.e. multiple areas for hidden interproximal caries)
Triangle radiolucencies on the mesial cusp of molars are likely to be?
Cusp of carabelli
