Operative Dentistry: Dental Caries

Front 1

definition of caries

Back 1

infectious microbiological disease that results in localized dissolution and destruction of calcified tissues of the teeth

Front 2

there is a constant balance between demineralization and remineralization, when does demineralization take over?

Back 2

at a pH below 5.5

Front 3

formula for decay process

Back 3

1. bacteria (mutans S.) + CHO (carbohydrate) matrix = bacterial plaque (acidic)
2. acid plaque + susceptible tooth + time = dental caries

Front 4

1) what 3 things do you need to form caries?
2) what other things affect dental caries forming?

Back 4

1. - tooth
- plaque (bacteria)
- diet
2. - topical fluoride
- time
- saliva (important in remineralization)
- immune system
(income, knowledge, attitude, behavior, education, socioeconomic status)

Front 5

types of carious lesions?

Back 5

- pit and fissure lesions
- smooth surface lesions
- root surface lesions
- recurrent lesions

Front 6

what % of the pop. was affected by dental caries in 1987? what % of kids were carries free?

Back 6

95%; 50%

Front 7

why has there recently been a decline in caries ?

Back 7

fluoridation, education, dental insurance

Front 8

Pit and Fissure Lesions

Back 8

common in younger generation (caused by defect - enamel not fused. can be detected w/ magnification and tooth dry):
1. enamel (triangle apex toward occlusion)
a. small site of origin
b. base widens towards DEJ
c. slow to moderate progression (2-4 yrs)
2. dentin (triangle apex towards pulp)
a. wide base at DEJ
b. apex of cone towards pulp

Front 9

saliva is important in what?

Back 9

remineralization

Front 10

smooth surface lesions

Back 10

problem w/ oral hygiene (don't floss). located gingival to contact area. mainly picked up by X-rays. 2 types:
1. enamel (triangle shaped)
a. wide area of origin
b. apex towards DEJ
c. slow initial progression (4 yrs)
d. once reaches DEJ it spreads
2. dentin (triangle shaped)
a. wide base at DEJ
b. apex of cone towards pulp

Front 11

root surface lesions

Back 11

- begin directly on cementum/dentin
- pot hole shaped
- rapid progression

Front 12

caries in enamel:
1. zone 1
2. zone 2
3. zone 3
4. zone 4

Back 12

1. translucent zone (deepest)
2. dark zone (remineralization)
3. body zone (demineralization)
4. surface zone (clinically intact)

Front 13

what are the steps that take place when a cavity is formed in dentin?

Back 13

1. invasion of bacteria into dentin
- mutans S. initiates (enamel, aerobic)
- lactobacillus propagates (dentin)

2. organic acids demineralize dentine
3. collagen is degenerated/dissolved
4. loss of structural integrity (cavity)

Front 14

sclerotic dentin

Back 14

- affected dentin (not infected, but hard and stained)
- deposition of crystalline minerals in dentinal tubules (hypermineralization)
- function: occlude tubules
- slow, long term irration
- hard, shiny, possibly discolored

Front 15

sclerosis

Back 15

hardening

Front 16

reparative dentin (reparative secondary dentin)

Back 16

- formation of tertiary dentin by odontoblast-like cells
- between pulp tissue and dentin (PDJ)
- intermediate level of irritation

Front 17

physiologic secondary dentin

Back 17

layed down as tooth ages, making pulp smaller

Front 18

primary dentin

Back 18

dentin layed down as tooth forms

Front 19

pulpal necrosis

Back 19

- result of severe irritation
- infection, death of pulp, abscess

Front 20

prevention of caries

Back 20

- early detection of caries (demineralized)
- daily oral hygiene
- sealants
- fluoride application
- diet
- immunization

Front 21

sealants

Back 21

most effective in pits and fissures; protective coat of resin

Front 22

control of non-cavitated lesions

Back 22

1. daily oral hygiene
2. remineralization
- fluoride application
- MI paste (recaldent)
3. chewing zylitol gum
4. routine check-ups

Front 23

control of cavitated lesions

Back 23

- surgical removal of decay and weak structures (preparation)
- restored w/ material of choice
- quality of your restorations is a factor for long term health and prevention of recurrent decay and periodontitis

Front 24

what does CAMBRA stand for?

Back 24

caries management by risk assessment

Front 25

1. are E1 and E2 usually cavitated lesions?
2. are D1 and D2 cavitated lesions?

Back 25

1. usually not cavitated, try to remineralize
2. D1 might be cavitated
3. D2 is definitely cavitated

Front 26

Lesions:
1. E1
2. E2
3. D1
4. D2
5. D3

Back 26

1. out 1/2 of enamel
2. inner 1/2 of enamel
3. outer 1/3 of dentin
4. middle 1/3 of dentin
5. inner 1/3 of dentin

Front 27

operative dentistry

Back 27

part of restorative dentistry involving assessment, prevention, and treatment of diseases and defects of the hard tissues of individual teeth to maintain or restore functional, physiologic, and esthetic integrity and health

Front 28

in addition to quadrants the mouth can also be divided into sextants, or sixths. where does this division occur?

Back 28

between the canines and 1st premolars

Front 29

how is each tooth identified?

Back 29

by the arch, side, primary or permanent, and then the individual name. Ex. mandibular left permanent first molar

Front 30

interproximal contact

Back 30

contact between 2 adj. teeth

Front 31

groove

Back 31

linear channel between enamel elevations

Front 32

fissure

Back 32

developmental linear cleft usually found at the base of a groove

Front 33

pit

Back 33

small depression in enamel, usually located in a groove, and often at the junction of 2 or more fissures

Front 34

fossa

Back 34

hollow, rounded, or depressed area in the enamel surface of a tooth

Front 35

1. pulpal wall (floor) of cavity preparation
2. axial wall

Back 35

1. occlusal portion of preparation, wall adj. pulp chamber
2. wall adj. or nearest pulp chamber or pulp canals and is parallel to long axis fo tooth

Front 36

point angle

Back 36

junction of 3 walls

Front 37

line angle

Back 37

junction of 2 walls in a cavity preparation

Front 38

margins

Back 38

formed by junction of a cavity wall and an external tooth surface

Front 39

anatomic crown

Back 39

portion that extends from cementoenamel junction or cervical line

Front 40

clinical crown

Back 40

portion visible to oral cavity

Front 41

class 1 lesions

Back 41

occur in pits and fissures on facial, lingual, and occlusal surfaces of molars and premolars and less often lingual surfaces of max. anterior teeth

Front 42

class 2 lesions

Back 42

proximal surfaces of posterior teeth

Front 43

class 3 lesions

Back 43

proximal surfaces of anterior teeth (do not involve incisal angle)

Front 44

class 4 lesions

Back 44

occur in the proximal surfaces of anterior teeth when incisal angle requires restoration

Front 45

class 5 lesions

Back 45

smooth facial and lingual surfaces in gingival 3rd of teeth

Front 46

class 6 lesions

Back 46

pit or wear defects on incisal edges of anterior teeth or cusp tips of posterior teeth

Front 47

black's steps in cavity preparation

Back 47

1. est. outline form
2. obtain resistance form
3. obtain retention form
4. obtain convenience form
5. remove remaining carious dentin
6. finish enamel walls and cavosurface margins
7. clean preparation

Front 48

excavators

Back 48

cutting instruments, used in shaping tooth preparation