operative consideration in cariology

  1. what are the traditional methods of caries detection and diagnosis?
    • visual
    • radiography
    • tactile
  2. 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
  3. Early diagnosis is the key. What is the oral condition needed to examine?
    • teeth needs to be clean and dry.
    • good light
    • magnification
  4. 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
  5. 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.
  6. what are the steps in caries treatment decision making?
    • prevention procedures
    • remineralization/ reversal procedures
    • operative intervention
    • maintenance procedures
  7. Smooth surface diagnosis...
    • easy to diagnose
    • easy to treat if supragingival
  8. On occlusal surfaces, fissure sealant is used for:
    • active enamel lesion
    • sound fissure in a high caries risk patient
    • recall and reassessment
  9. cavitated occlusal surfaces requires...
    Image Upload 1
  10. to diagnose approximal surfaces, what is needed?
    bitewing radiographs
  11. what is this?
    Image Upload 2
    approximal cavitation
  12. 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
  13. 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.
  14. 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
  15. 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
    • Image Upload 3
  16. 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
  17. operative intervention is performed to do what?
    • control plaque
    • restore function
    • avoid progression of the lesion
  18. pulp exposure in teeth through stepwise are much less than conventional methods. T or F
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operative consideration in cariology
operative consideration in cariology