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Dent Y3 > Caries Curriculum > Flashcards

Caries Curriculum Flashcards

1
Q

What are the four D’s to follow when planning a caries treatment plan?

A

Determine, Detect, Decide, Do

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2
Q

What should you do during the ‘Determine’ stage of CariesCare 4D?

A

determine the patients caries risk via medical, dental and social history

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3
Q

What should you do during the ‘Detect’ stage of CariesCare 4D?

A

detect caries by clinical examination using good lighting and clean, dry teeth. Stage the lesion severity using ICDAS and assess the lesion activity

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4
Q

What should you do during the ‘Decide’ stage of CariesCare 4D?

A

decide on a personalised treatment plan based on information from determine and detect

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5
Q

What should you do during the ‘Do’ stage of CariesCare 4D?

A

Do the treatment plan you decided upon whether that is prevention (NOC) or intervention (TPOC)

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6
Q

Why is vital pulp preservation important?

A

the preservation of pulp vitality underpins the successful practice of endodontics

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7
Q

What are the two routes of pulp treatment modalities?

A

vital pulp therapy and nonvital pulp therapy

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8
Q

What are the requirements of an ideal pulp capping agent?

A

maintain pulp vitality, stimulate reparative dentine, be bacteriocidal or bacteriostatic, provide a bacterial seal, adhere well to dentine and restorative materials, resist forces under the restoration, be sterile, radio-opaque

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9
Q

Which three materials are currently recommended as pulp capping agents?

A

Calcium Hydroxide, Mineral Trioxide Aggregate (MTA), Biodentine

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10
Q

What is vital pulp therapy?

A

the treatment initiated on an exposed pulp to repair and maintain the pulp vitality

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11
Q

Which vital pulp therapy is used in cases of deep carious lesions?

A

indirect pulp capping

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12
Q

Which vital pulp therapy is used in cases of pulp exposure?

A

direct pulp capping or pulpotomy

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13
Q

Why is calcium hydroxide used for vital pulp therapy?

A

it acts as a protective barrier for pulpal tissues by blocking dentinal tubules and by neutralising the attack of inorganic acids from certain cements and filling materials

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14
Q

What are the four zones of healing when treating with calcium hydroxide?

A

Zone of obliteration, zone of coagulation necrosis, zone of dentine bridge formation, line of demarcation

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15
Q

What occurs in the zone of obliteration?

A

the pulp tissue immediately in contact with the calcium hydroxide is usually completely deranged and distorted

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16
Q

What occurs in the zone of coagulation necrosis?

A

the tissue together with its plasma proteins within the zone of obliteration takes the brunt of the calcium hydroxide chemical thrust

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17
Q

What occurs in the zone of dentin bridge formation?

A

Mineralisation is initiated by calcium hydroxide and there is no distinct structural configuration

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18
Q

What occurs in the line of demarcation?

A

this develops between the deepest level and the subadjacent vital pulp tissue

19
Q

What are some advantages of using MTA over Calcium Hydroxide?

A

it produces more dentinal bridging with superior structural integrity, less inflammation, antimicrobial properties, highly biocompatible, hydrophilic, when set it is alkaline, presence of blood has little impact on the degree of leakage

20
Q

Why does MTA work so well as a pulp capping agent?

A

hydration is needed for it’s setting process

21
Q

What is biodentine?

A

a calcium-silicate based material that preserves pulp vitality and promotes its healing process

22
Q

What is a negative of biodentine?

A

it takes approx 10 mins to set and there should be no salivary contamination in that time

23
Q

What are some advantages of biodentine?

A

does not stain tooth, excellent radiopacity, no need for surface preparation, higher compressive strength than dentine, absence of shrinkage

24
Q

What is infected dentine?

A

soft and demineralised dentine with lots of bacteria

25
Q

What are some features of infected dentine?

A

collagen is irreversibly damaged, cannot remineralise, soft necrotic tissue is followed by dry leathery dentine which flakes away with an intrument

26
Q

What is affected dentine?

A

demineralised dentine not yet invaded by bacteria

27
Q

What are some features of affected dentine?

A

collagen cross-linking remains, can act as a template for remineralisation, discoloured and softer than normal dentine but does not flake easily

28
Q

What is indirect pulp capping?

A

a procedure in which the deepest layer of the remaining affected carious dentine is covered with a thin layer of bio-compatible material in order to prevent pulpal exposure

29
Q

What is the desirable results of indirect pulp capping?

A

disinfection of the residual affected dentine is easier, arrests the carious process, patient comfort is immediate, rampant dental decay is stopped

30
Q

What symptoms may a patient feel if they need indirect pulp capping?

A

tolerable, dull pain, mild discomfort when eating, no history of spontaneous excruciating pain

31
Q

What may be seen in the clinical examination of a patient needed indirect pulp capping?

A

large carious lesion with positive response to sensitivity tests and normal response to percussion

32
Q

What may be seen in the radiograph of a patient needing indirect pulp capping?

A

large carious lesion with possible pulp exposure, lamina dura appears normal

33
Q

What procedure is used for indirect pulp capping?

A

stepwise caries excavation

34
Q

What thickness of dentine should be left during indirect pulp capping?

A

0.5-2mm of dentine

35
Q

When should you review the patient after vital pulp therapy?

A

within 6-12 months, then annually for the next three years

36
Q

What are the options a clinician has if the pulp becomes exposed?

A

direct pulp capping, partial pulpotomy, full pulpotomy, pulpectomy

37
Q

What are four variables that make the outcome of pulpal exposure favourable?

A

the pulpal exposure is due to trauma rather than caries, bleeding is controlled within 10 mins, exposure site is less than 1mm, treatment is done within 48 hours of exposure

38
Q

What is the thickness of enamel in primary molars?

A

1mm

39
Q

Is the enamel in primary molars uniform in thickness?

A

yes

40
Q

Do primary molars have contact points or areas?

A

broad contact areas

41
Q

What are some of the characteristics of the pulp of primary molars?

A

large pulp, large mesio-buccal pulp horn, thin pulpal floor, early radicular pulpal involvement

42
Q

Is the enamel in permanent molars uniform in thickness?

A

no

43
Q

How can the anatomy of primary molars make things difficult for restorative dentistry?

A

rapid caries progression, short clinical crown makes matrix bands difficult, broad contact points to restore, thin enamel, less tooth structure protecting the pulp, long flared roots

Dent Y3 (23 decks)

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