Flashcards in Gaining Access & Removal of Carious Tissue Deck (22)
What type of disease is dental caries?
Reversible but progressive disease
What tissues are affected by dental caries?
Affecting dental hard tissues
What bacteria initiates dental caries?
Initiated by bacteria in a plaque biofilm
What causes the demineralisation of the inorganic component of the teeth?
Fermenting carbohydrates produced by the carious bacteria produce acid which causes demineralisation
What causes the destruction of the organic component of the teeth?
Proteolytic destruction of organic component
What are some isolation techniques used when removing carious tissue? (4)
- Rubber dam
- Cotton wool roll (children)
- Dry guards
- Aspiration (suction)
What are the ideal conditions when detecting caries on a tooth? (6)
- Good vision with magnification
- Good illumination
- Clean tooth surface
- Examine tooth when both wet and dry
- Use a round explorer (not sharp)
- You need TIME!!!
Where are the 3 main sites of caries development?
- Pits & fissures/cingulum
- Approximal below contact area between teeth
- Smooth surface (near gingival margin)
Explain the histology of each ICDAS score (0-4)
0 - No/Minimal enamel demineralisation
1 - Enamel demineralisation outer 50%
2 - Enamel demineralisation inner 50% through to outer 1/3 dentine
3 - Demineralisation of middle to inner 1/3 dentine
4 - Demineralisation of inner 1/3 dentine towards pulp
What do the scores made from bitewing radiographs mean in regards to radiolucency? (0-4)
0 - Sound on bitewing
1 - Radiolucency confined to enamel
2 - Radiolucency in enamel up to EDJ
3 - Radiolucency in enamel and outer half of dentine
4 - Radiolucency in enamel and reaching inner half of dentine
Explain what site is being referred to in each of Black's Classifications (I-V)
I - Pits and Fissures caries
II - Posterior inter proximal caries
III - Anterior inter proximal caries
IV - Incisal edge caries
V - Smooth surface caries
What is one advantage and one disadvantage of bitewing radiographs?
- Good for inter proximal caries
- Less good for occlusal
Which type of radiograph is good for showing occlusal caries?
Dental Panoramic Tomograph
What radiographs are taken for assessing apical status of a tooth?
What does a sensibility test determine?
Testing the nerve supply
How do you conduct a sensibility test? (3)
- Thermal test (whether or not tooth can feel hot/cold)
- Electronic pulp tester
- Test cavity
Explain the steps of the operative phase of caries management (5)
- Gain access
- Identify sound and carious tissue
- Excavate caries
- Modify cavity for restorative material
What is the importance of enamel preparation when dealing with a carious legion? (3)
- Gain access to full extent of lesion
- Remove demineralised and unsupported enamel
- Create sound peripheral margin to seal with restorative material
What is the sequence of dentine removal?
- Identify caries-infected vs caries affected vs sound dentine with a probe
- Identify peripheral extent of caries to EDJ
- Excavate caries from EDJ (clear periphery of lesion)
- Move towards pulp from periphery
What is the retention property of a cavity?
Property of a cavity to resist displacement of the restoration in the direction of its placement
What is the resistance property of a cavity?
Property of the cavity to resist displacement of the restoration in any other direction