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Clinical oral radiology > Radiographic Interpretation of Dental Caries > Flashcards

Radiographic Interpretation of Dental Caries Flashcards

1
Q

Dental caries is a common __ disease

A

chronic

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2
Q

90% of adults experience dental caries before __ years of age

A

30

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3
Q

Percentage of dental caries among youth aged 2-19 years

A

50%

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4
Q

Multifunctional disease involving many complex risk and protective factors

A

Dental Caries

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5
Q

Carious lesions are characterized by __ destruction of teeth by __

A

localized
microorganisms (acid demineralization)

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6
Q

Caries is a dynamic process, explain -

A

Balance between demineralization and remineralization

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7
Q

Metabolic microbial organic acids
- Decrease in pH
- shift toward demineralization
- dissolution of Ca and PO4

A

Demineralization

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8
Q

Teeth are very __ and absorb __ x-rays

A

dense
more
(gums, cheeks, pulp are less dense - x-rays pass through more easily)

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9
Q

Demineralization results in __

A

less tissue density (less absorbed x-ray photons)

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10
Q

5 possible sites of carious lesions

A

Occlusal / pits and fissures
Recurrent / secondary
Smooth surface / facial/lingual
Root / radicular
Inter-proximal

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11
Q

Are occlusal caries detectable on radiographs

A

No

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12
Q

Initial stage of occlusal caries are incipient lesion (enamel only), and not

A

detected radiographically

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13
Q

When can we detect occlusal caries radiographically

A

When lesions are most likely in to dentin

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14
Q

How can you tell that occlusal caries are into dentin

A

Diffuse radiolucency below enamel occlusal surface
(As lesions progress, disruption of enamel may become evident)
(Advanced lesions may show direct pulp involvement)

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15
Q

Radiographs __ lesions

A

underestimate

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16
Q

Caries adjacent to margins of restorations

A

Secondary lesions / recurrent carries

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17
Q

Diffuse radiolucency below restorations

A

recurrent carries

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18
Q

Usually found close to gingival margin facial or lingual

A

Smooth surface carries

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19
Q

When looking at recurrent carries
Ill defined =
Well defined =

A

Carries
Liner

20
Q

Sharply defined round or oval radiolucency

A

smooth surface caries (facial or lingual caries)
(Correlation with clinical examination is important - could also be erosion)

21
Q

Below the CEJ, with gingival recession - not involving enamel

A

Radicular caries (root surface caries)

22
Q

Radicular caries involve __ which is thin and not as __ as enamel

A

cementum
dense

23
Q

Most smooth surface caries are buccal or lingual ?

A

Buccal

24
Q

Collar-shaped or wedge-shaped radiolucent artifact between the CEJ and alveolar bone

A

Cervical burnout
(These are no carious lesions!)

25
Q

2 reasons we can get cervical burnout

A

Cervical area not covered by bone or enamel
Anatomy of cervical area in posterior teeth (PIC)

26
Q

Arise at or slightly below the contact point of two adjacent teeth

A

Interproximal caries

27
Q

Always between enamel and alveolar bone

A

Cervical burnout

28
Q

Clinically direct visualization usually not possible

A

Interproximal caries

29
Q

With interproximal caries, as lesion progresses and dentin is affected, what do we see

A

translucent enamel may show gray discolored dentin on marginal ridges

30
Q

Where is the radiolucency (trianglar) with base of an enamel vs dentin interproximal cary

A

Enamel - base at proximal surface near contact point
Dentin- base at DEJ

31
Q

What is the best radiographic exam to detect carious lesions

A

Good set of bitewings (posterior teeth)
PAs (anterior teeth)

32
Q

On this type of radiograph, carries are usually only seen when large enough to be clinically apparent

A

Panoramic

33
Q

Extraoral vs intraoral bitewings

A

Extraoral - results are controversial (ghost images, noise, configuration of arches)
Intraoral - better detailing

34
Q

When is it okay to use a pan for carries

A

Pt unable to cooperate
Severe gag reflex
Severe anatomic limitations

35
Q

Correct __ angulation matters!

A

horizontal
(vertical angulation also matters)

36
Q

Always look at __ bitewings

A

Both! (premolars and molars)

37
Q

Bitewing is better than PA for detecting carious lesion due to

A

vertical angulation ( able to be more parallel with crowns)

38
Q

Approx. 1/2 of __ cannot be seen clinically

A

proximal surface caries

39
Q

__ can show carious lesion in early stages

A

Bitewings

40
Q

How much demineralization is required before visualization

A

25-50%

41
Q

With a radiograph we can see if a lesion is active or inactive, true or false

A

False
HOWEVER - activity may be monitored radiographically (Second image taken at another time point)

42
Q

E0
E1
E2
D1
D2
D3

A

E0- no radiolucency
E1- outer 1/2 of enamel
E2 - inner 1/2 of enamel
D1 - outer 1/3 of dentin
D2 - Middle 1/3 of dentin
D3 - inner 1/3 of dentin

43
Q

Not cavitated, may present a triangular shape or diffuse radiolucency

A

E1
E2

44
Q

33% to 85% cavitated. Spreads along the DEJ

A

D1

45
Q

Most likely cavitated (>halfway to the pulp)

A

D2

46
Q

Cavitated. MAy directly involve pulp

A

D3

47
Q

Well defined radiolucencies on interproximal surfaces (anterior teeth) may be

A

older radiolucent restorative material

Clinical oral radiology (7 decks)

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