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Flashcards in Basic Restorative Deck (120):
0

What is the of caries?

A process affecting the mineralised tissues of the teeth which is causes the action of microorganism on fermentable carbohydrates to produce acids

1

Which acids are mainly produced by the bacterias?

Lactic
Propionic
Acetic

2

Which acid is the most damaging?

Lactic acid

3

Which sugar is the most carigigenic?

Sucrose

4

Which bacteria are found in health?

Mainly gram pos facultative bacteria

S sanguis
S gordonii

5

Which bacteria are mainly found in fissure caries?

S sanguis and mitis

6

What are the common sites to develop caries?

Pits and fissures
Approximate surfaces
Root surface

7

What are rh four requisites to caries?

Bacterial plaque
Bacterial substrate
Susceptible tooth surface
Time

8

Which bacteria are involved in caries mainly?

Strep mutans

Lactobacillus sp.deep lesions

Acrinomycosis for root caries

9

How do primary enamel caries appear?

White spot lesion
Brown spot

10

What are the microscopic appearance of primary enamel caries?

IEBS

Initiation
Enamel destruction
Bacterial invasion
Secondary enamel caries

11

What is in the initiation phase of enamel and how porous are they?

TDBS

Normal enamel: 0.1%
Translucent zone: 1%
Dark zone : 2-4%
Periphery : 5%
Body zone: 25%
Surface zone : 1%

12

What is Sedondary enamel caries?

Enamel adjacent to dentine is less resistant to caries possibly due to the branching of dentinal tubules

13

WHat are the zones of dentine caries?

SCZA
Superficial area : just beneath breached enamel
Central area: necrosis and destruction
Zone of penetration : tubules penetrated by bacteria
Advancing front : demineralised but not infected

14

What are the types of dentine?

Primary: bulk of dentine around pulp and also known as cicrumpulpal dentine
Sedondary dentine: develops after root formation and is continuos wit primary but slower rate of formation. Less regular than primary

Tertiary dentine: reactive to stimuli . Deposited either odontoblasts or replacement cells from pulp. Tubular pattern very irregular

15

T/F cementum rapidly decaclfies?

T

16

What are the risk factors for caries?

SES
age
Diet
Local factors
Fluoride
Saliva pH

17

How can we assess the activity of a carious lesions?

Matt or shiny
Colour
Consistency

18

What would caries that felt matt more likely indicate?

More active and indicated amount of pores

19

What does colour indicate?

Poor indicator but may indicate arresting

20

What does the consistent indicate?

Soft and leathery are more active

21

What are the defence mechanisms of the pulp dentine complex?

Tubular scleorsis: this is when the tubules become complety filled with calcified material and increases with age
Reactionary dentine

Inflammation of pulp and pulpits

22

Where does the pulp come from?

Dental papilla

23

Which caries has seen the biggest reduction on orevelance?

Smooth

24

How much do fissure caries account for new lesions?

84%

25

How does fissure caries start?

Bilaterally along walls as inverted cone shape

26

What does tooth brushing prevent?

Smooth surface caries

27

What is the reasonnfor change in caries?

Improved awareness
Use of fluorides

28

When does fissure caries occur?

Two school of thought
1. Occlusal caries incidence peaks during and immediately after eruption
2. Occlusal caries incidence remains high and unremitting

29

Which ways can we diagnose caries?

Invasive and non invasive

30

What are the invasive caries diagnosis techniques?

Diagnostic cavity
Enamel biopsy

31

What are the non invasive caries detection?

Probe
Visual inspection
Magnification
Radiographs
Trans illumination
Electronic methods

32

What is the problem with using a probe in fissure caries?

False positives as probe may stick in fissure due to normal anatomy
Misses dentinal caries
Possibility of breaking the soft surface zone and introduce cariogenic bacteria

Unreliable

33

How does visual inspection work?

Clean dry tooth
Must see staining and se calcification around the fissure

34

How does magnicficationwork?

Fissure caries detection improves and times 4 is thought to be the best

35

What magnification does an intrs oral camera use?

X40

36

What magnification does an operating microscope use?

X16

37

How helpful is radiographs in fissure caries ?

Only useful for occult lesions but otherwise not great since
1. Superimposition or buccal and Palatal enamel
2. Often only seen when caries into dentine
3. Small changes in X-ray tube head can make small lesions disappear

38

How effective is trans illumination?

Good for interproximal caries on ANTERIOR teeth

But POOR in POSTERIOR teeth

39

What must the ambient light be for trans illumination?

Low

40

How will a caries free tooth appear compared to a caries tooth within trans illumination?

Caries free will glow

41

What is an example of trans illumination?

FOTI

42

Compared to x ray how good is FOTI ?

17% enamel lesions detected

48% of dentine

Low sensitivity

43

What are the electronic methods for caries detection based on?

Carious teeth contain pores of enamel which saliva can pass through and this conduct small electrical currents

44

How effective are the electronic methods for caries detection?

HIGH SENSITIVITY !!!!! Can be used to monitor progress

45

What is the diode laser fluoresce?

Uses a laser of 680nm
Carious tooth structure is diff to normal
Fluorescence changes are measured and converted to an analogue scale
Low reading: sound
High reason: caries
80% sens and spec

But no diagnostic threshold and mainly used for occlusal lesions in conjunction with other technique

46

How does vista proof work?

High energery violet light used

47

Hat wave,length of light is used in vista proof?

405nm

48

What does vista proof show?

Porphyrin metabolites show red
Natrual tooth is green

49

What is th best way for carious detection using non invasive ways?

Clean dry tooth
Visual inspection
Light

50

When would invasive methods for caries detection be used?

High risk population or STRONG suspicion of caries in that tooth

51

What are the treatment options for fissure caries?

Observe
Laser therapy
Ozone
Sealane t
Amalgam
Composite
Inlay

52

When would you observe for fissure caries?

You don't since cannot see it well

53

How does laser therapy work for fissure caries?

CO2 laser
Causes carbonate and mg depletion
Reorganises apatite structure

Raises pulp temp by not more than 1 degrees

54

What materials can you use for a sealant restoration?

GIC
Composte
Fissure sealants
Compomer
Dentine adhesive

55

How does a sealants restoration work?and how much surface does it occupy?

Treatment of the enamel and dentine caries in a discrete part of the fissure pattern

Occupies 5%
Amalgam occupies 25%

56

What are the advantages of sealant restoration?

Minimal cavity prep
Tooth not weakened
Aesthetic
Simulatanous prevention

57

What do we polish restrorstions?

For aesthetics,minimise plaque retention, and gingival irration, remove over hangs,

58

What are the options for increasing amalgam retention?

Slots: no greater than 1mm
Groves
Boxes
Dovetails
Steps
Circumfrential slots
Dentine pins
Bonded amalgams
Amalgapins

59

How effective is the Circumfrential slot?

Very
Same resistance as 4 pins but more sensitive to displacement during matrix band removal

60

What are amalgam pins?

Amalgam is used for the retention and similar placement to cone tonal pins

61

How's does the resistance to displacement for the amalgam pins compare to the conventional prins?

Same

62

What are the dimsjonas for amalagmpins?

1.5-2 mm deep
0.8mm diameter

63

How wide and deep do your slopes and steps need to be?

2.0 mm wide
1.oo tall

64

What are bonded amalgams?

Where you use a bonding agent to aid retention of amalgam

65

T/F the bond strength between the amalgam and bonding agent is weaker than that of the tooth and bonding agent?

T

66

T/F there is less stress on the bond between amalgam and bonding agent than compared to composte?

T

67

What type of bonding agents would you use for bonded amalgams?

Autopolymersising agent

68

What to dentine pins provide?

Mechanical retention and resistance

69

How do dentine pins work?

Mechanical interlocking of amalgam into undercuts on the pin

70

What is the pins retention dependant upon?

Resiliency and firmness of dentine

71

What are the three types of dentine pins?

Self threading
Friction locked
Cemented

72

T/F self threading are less retentive than friction locked?

F
Self threading are the most retentive

73

What is the optimum depth of the dentine pins into dentine?

2-3mm

74

What is the optimum length of pin into amalgam?

2mm

75

T/F larger diameter pins are more retentive?

T

76

How many pins per missing cusp should be placed?

1 or marginal ridge/line angle

77

What is the maximum of pins in a tooth?

4

78

How far apart should pins be and what are the other requirement when placing pins?

5mm apart
1mm inside DEJ

1mm inside external Root is apical tonCEJ
2mm into dentine and amalgam
2mm from opposing tooth

79

How much dentine between pin and ADJ?

1mm

80

What angle should you place pins?

90 degree

81

What can you cost the pins in?

MDP Panavia or
4 META

82

How much amalgam is needed ontop of the ion for replacing a cusp?

2.5mm

83

What speed hand piece do you use for pins?

200rpm clockwise

84

What are the problems with pin placement?

Voids around pin
Pins bent
Lose pin
Pin at amalgam surface
Pulp exposure
Root perforation

85

What are the matrix bands available?

Siqveland
Tofflemire
Autommatrix
Copper band

86

How long to extensive amagalsm last?

14.6 years

87

Where do class 2 lesions occur?

Least one of the interproximal surfaces on posterior teeth staters just below contact point

88

How can we classify caries lesions?

E1: outer hand of enamel
E2: inner half of enamel
D1: 0.5mm into dentine
D2: more than 0.5 but not within 0.5mm of pulp
D3: more than 0.5mm within pulp

89

How can you diagnose interproximal caries?

Visual inspection
Radiographs
Laster fluoresce eg diagno dent
Light transmission
Electrical resistance
Temporsry tooth separation

90

How long does it take caries to reach ADJ in adults vs children?

Adults: 6 yrs
Kids: 4 yrs

91

What are the options for class 2?

Class 2 with key
Class 2 with self retentive box
Tunnel prep
MOD
Tunnel prep
Pre fabricated eg inlay

92

What percentage of class 2 amalgams have fractured cusps?

13%

Occur at any age but most frequently affect molars

93

Which types of restorations have the biggest number of cusp fracture?

MOD

94

How does the tunnel prep work?

Intact marginal ridge

95

What was the tunnel prep initially deigned for?

GIC

96

What are the problems with tunnel prep?

Cannot visualise whole lesions
Not sure if cairies free
Cannot assess the strength of remsning tooth
Secondary carie within 3yrs

97

What are thr indications for posterior composite?

Small and moderate sized class 2
Patient allergic to metal s
Unsupported enamel may be strengthened by acid etch technqie
Not possible to obtain retention

98

What are the contr indications to posterior composites?

Patients with high caries risk
Cavities where cannot get isolation
Multiple large restrorstions with cuspal contact
Bruxism
Allergies

99

What are thr problems with large class 2 composites?

Wear
Fracture
Microleakage
Cuspal flexure

100

What is the survival rate for amalgam vs composite?

15 yrs amalgam
6 yrs composite

101

What is blacks classification for caries?

Class 1: pit and fissure
2: mesial and distal premolar and molar
3: mesial and distal incisors and canine
4: involving incisal edge
5: occurring at cervical third

102


What are the contemporary caries classification?

Site
Size

103

What are the caries by site classification?

Site 1: pits fissures and enamel defects on occlusal or other smooth surfaces
Site 2: approximate surfaces for ant and post teeth
Site 3: cervical third of all teeth and any exposed roots

104

What is the classification by size?

0: initial lesion
1: minimal surface cavitation
2: moderate dentine
3: enlarged beyond moderate
4: extensive caries with loss of cusp

105

Why may anterior teeth need restoring?1

Caries
Colour
Fracture
Wear
Developmental disorder

106

Where do class 3 lesions start?

Just at or below the contact point in the mid labial Palatal third

107

T/F the incidence for class 3 is higher than pit and fissure caries?

F
Becaus
1-anterior teeth more accessible for OH
2: narrower contact ares
3: increased use of fluoridated tooth paste

108

Which patients are class 3 more common in?

Mouth breathers
Imbricated teeth

109

How do you diagnose class 3?

Can see once into dentine as a darkness

110

What diagnostic methods can we use for class 3?

Probe
Visual
Radiographs
Trans illumination
Shred floss

111

What probes are used for detecting class 2 and class 2 lesions?

Brialt and Weston

Nee to use a light pressure

112

How can you use trans illumination in class 3 lesions?

Light off dental mirror
FOTI

113

What are the ways of restoring class 3?

Palatal
Labial

114

When would we bevel class 3 cavity?

When the cavity extends to an area that is visible then bevel

Advantages: end on etching of enamel prisms, increases surface ares for bond, blends composte better, reduces micro leakage

BUT: increase cavity size

115

What lining materials can we use in class three?

Dentine bonding agents
Light cured GIC
CaOH

116

What is an alternative to class three prep?

Tunnel prep

117

How can you gain retention for class 4?

Cervical groove in dentine
Enchant
Dentine pins
Bevel

118

Which matrices can you use for class 4?

Polyester : straight or curved of incisal corner
Cellulose acetate

119

What is the dis with cellulose acetate strip?

Reacts with composte
Too thick and bulky
Tear