DH244 interpretation of dental caries
what type of caries is described? extends into the DEJ and into the dentin but does NOT extend through the dentin more than half the distance toward the pulp chamber, involves BOTH enamel and dentin
advanced interproximal caries
when do occlusal caries become apparent radiographically?
after the DEJ is involved
what can cervical burnout appear as due to anatomic root concavities?
as ill defined wedge shaped radiolucencies on the mesial and distal surfaces near the CEJ on posterior teeth
how do interproximal caries spread?
as it progresses toward into the DEJ it spreads laterally and continues into the dentin
why are early occlusal caries difficult to see clinically?
because of the superimposition of the dense buccal and lingual enamel cusps
what are the radiographs of choice for the evaluation of dental caries and early bone loss?
bitewing radiographs
what type of caries is described? best seen clinically, appears as a small circular radiolucency, difficult to view radiographically due to the superimposition of the densities of normal tooth structures
buccal and lingual caries (hard to distinguish from each other
what is abrasion caused by? how does it appear clinically?
caused by excessive occlusal forces on teeth, looks like abrasion
what class lesions are incipient interproximal caries?
class 1
what class lesions are moderate interproximal caries?
class 2
what type of lesion class are advanced interproximal caries?
class 3 lesion
what lesion class is severe interproximal caries?
class 4
how do you distinguish attrition from caries?
clinical examination
how are occlusal caries best seen?
clinically
how must incipient occlusal caries be detected?
clinically, they cannot be seen radiographically
what is the radiographic difference between restorative materials and decay?
composites, acrylics and silicates have well defined borders and decay has undefined borders
what is described? overlap area (closed contacts that appear white or radiopaque on the film), darkened areas just outside the edge of the overlap, doesn't appear as caries but can mask the presence of caries on a film
contrast band effect
what is cervical burnout?
crown of tooth is covered on the lingual and facial surfaces w/ enamel (double coating) and the root is covered on the lingual and facial surface w/bone (double thickness)
what is the definition of caries?
demineralization and destruction of hard tooth structures result in a loss of tooth density in the area of the lesion
what is peripheral burnout?
edges or interproximal spaces between teeth seem wider apart than they really are, edges are burned out at the periphery of the teeth, this is why one can open a contact
how does abrasion appear clinically?
hard and highly polished and should not be confused w/root caries
what are the causes of recurrent caries?
inadequate cavity preparation, defective margins, incomplete removal of caries before the placement of the restoration
what type of caries is described? involves enamel only, is less than half of the way through the enamel, a tiny radiolucent notch interproximally
incipient interproximal caries
which type of caries are between 2 adjacent surfaces and are apical to the contact of the teeth?
interproximal caries
what are the 5 radiographic locations of caries?
interproximal, occlusal, buccal, lingual and root
what is described? radiolucent area just below the tooth/amalgam junction, parallel to the restoration margin, the junction of 2 different densities
mach band effect
what teeth is cervical burnout most often seen on?
mandibular incisors and molars
what is attrition?
mechanical wearing down on the incisal or occlusal surface of the teeth, shallow concavities in the dentin appear as occlusal caries
what type of caries is described? extends more than half way through the enamel but does not extend into the DEJ
moderate interproximal caries
what type of caries are described? may be seen as a very thin line in the dentin, a thin radiolucency is located under the enamel of the occlusal surface of the tooth
moderate occlusal caries
what is the difference in newer composites versus older composites?
newer composites generally have radiopaque fillers added to the material to make it easier to detect radiographically
is caries parallel to the restorative border?
no, and is usually wider
do radiographs give you an accurate representation of the progression of dental caries?
no, caries is always farther advanced clinically
where are root surface caries located?
on root surfaces that exposed to the oral cavity
what are some optical illusions that can be mistaken for caries?
peripheral burnout, cervical burnout, mach band effect and contrast band effect
how are interproximal caries classified?
according to the depth and penetration the lesion exhibits through the enamel and dentin
how do caries appear on a radiograph?
radiolucent, due to less density of structures
how to acrylic restorations appear on a radiograph?
radiolucent, the most radiolucent composite
what type of caries is described? spreading unchecked, refers to advanced/severe caries that effects numerous teeth in the dentition, may be seen in children w/poor dietary habits or in adults w/decreased salivary flow
rampant caries
what type of caries are described? observed adjacent to preexisting restoration, appear radiolucent just beneath the restoration
recurrent caries
what type of caries is described? bone loss and recession precede root caries, involves CEMENTUM and DENTIN, NOT enamel, usually rapid penetration of caries to the pulp
root surface caries
what type of caries is described? extends through enamel and dentin and MORE than half the distance toward the pulp chamber, involves BOTH enamel and dentin, radiographically seen as a large radiolucency from the interproximal region into crown of the tooth
severe interproximal caries
what type of caries is described? seen as a large radiolucency in the dentin, clinically seen as a large hole or cavity in the tooth
severe occlusal caries
what is the cervical or neck part of a tooth?
the area not covered by bone or enamel, this will appear as a radiolucent band at the neck of the tooth, "cervical burnout"
how does caries spread once the DEJ becomes involved in moderate occlusal caries?
the caries spreads laterally and then extends downwards toward the pulp
what causes cervical burnout?
the difference of densities of surrounding structures, generally seen on films w/no alveolar bone loss
what is the most frequent cause of abrasion?
the most frequent type of abrasion is caused by tooth brushing and is seen at the cervical margin of teeth
what is abrasion?
the wearing away of tooth structures from the friction of a foreign object
what kind of configuration do interproximal caries have?
triangular, with apex of the triangle located toward the DEJ
how do root surface caries appear visually? radiographically?
visually its saucer shaped and brown with a leathery texture, radiographically it appears as a crater shaped radiolucency just apical to the CEJ
what happens as interproximal caries continues to develop?
w/in the dentin the decay continues forming another triangle w/ the base of the triangle at the DEJ and the apex pointed toward the pulp chamber
how does abrasion appear on a radiograph?
well defined, horizontal radiolucency along the cervical region of the tooth
