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operative consideration in cariology
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what are the traditional methods of caries detection and diagnosis?
visual
radiography
tactile
Describe the "iceberg of dental caries".
base
: caries just started. consiered as "caries free" . Caries is in enamel.
water line and emerged
: detection in dentin now
tip
: lesion has moved into pulp
Early diagnosis is the key. What is the oral condition needed to examine?
teeth needs to be clean and dry.
good light
magnification
an explorer "catch" in a pit or fissure is an appropriate or not diagnostic criteria? and why?
inappropriate because it report too many false positives
an explorere can destroy remineralizable enamel matrix -> preventing remineralization possibilities
Describe the treatment of dental caries surgically vs. non-surgically.
non-surgical model
: treating the disease as an infection. goal - prevent the advance of reversing the lesions w/o cutting.
surgical model
: ;cutting the tooth to remove the disease, then restoring. goal - to stop the advance of the lesion at that site.
what are the steps in caries treatment decision making?
prevention procedures
remineralization/ reversal procedures
operative intervention
maintenance procedures
Smooth surface diagnosis...
easy to diagnose
easy to treat if supragingival
On occlusal surfaces, fissure sealant is used for:
active enamel lesion
sound fissure in a high caries risk patient
recall and reassessment
cavitated occlusal surfaces requires...
restorations
to diagnose approximal surfaces, what is needed?
bitewing radiographs
what is this?
approximal cavitation
What are the keys to prep design?
preservation of tooth structure
access for adequate caries removal
supporting remaining enamel
clean edges
appropriate to the restorative material
what is stepwise excavation?
2 step caries removal technique for "deep carious lesions"
clear out caries on dentin near pulp and leave caries. seal it well. allow for tooth to react and build tertiary dentin.
Why is it done in 2 steps for the stepwise excavation?
changes the cariogenic environment
promotes tubules sclerosis
creates proper environment for reparative dentin formation
what is the rationale for leaving caries behind?
inner lesion has no bacteria which has potential to remineralize after bacteria has been taken from the outer lesion
how to choose the tooth that is right for this stepwise excavation?
young pulp
evaluate restorability
deep active lesions - more than 75% of dentin
no sign of irreversible pulpitis or pulp necrosis
no swelling or react negatively to percussion
positive pulp vitality
x ray with no peripapical pathosis
operative intervention is performed to do what?
control plaque
restore function
avoid progression of the lesion
pulp exposure in teeth through stepwise are much less than conventional methods. T or F
True
False
T
Author
nhi
ID
63836
Card Set
operative consideration in cariology
Description
operative consideration in cariology
Updated
2011-02-03T08:32:47Z
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