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189 Cards in this Set

  • Front
  • Back

___________ is a localized destruction of teeth by microorganisms.

cavities


________ is an organized matrix of sticky bacteria and polysaccharides (sugar) which demineralize teeth.

plaque

The PH at which demineralization occurs is

less than 5.5

What is the cause of demineralization?

bacteria

3 bacteria that cause caries?

1. strep mutans


2. lactobacillus casei


3. actinomyces viscosus

____________ is known as the primary bacteria to cause smooth surface caries.

strep mutans

____________ is the secondary bacteria that continue the demineralization process.

lactobacillus casei

______________ is one of the bacteria responsible for root caries.

actinomyes viscosus

Name the 3 predisposing factors with caries:

1. bacteria


2. diet


3. saliva

Saliva contains concentrations of salivary _________ & ___________.

glycoproteins (pellicle) & immunoglobulins (antibodies)

3 kinds of demineralization w/ caries (signs and symptoms) :

1. smooth surface


2. pits/fissures of occlusal surfaces


3. proximal surfaces

_________ surfaces are usually at inaccessible areas.

smooth

_____________ surfaces are hard to brush w/ a tooth brush.

pits/fissures of occlusal

___________ surfaces are prevalent in pt's who do not floss.

proximal

Occlusal surfaces may show ________________ in the pits/fissures/grooves.

dark staining

Smooth surfaces may exhibit a _______________________ or opacity indicating demineralization.

chalky white spot

T/F: Some areas may not have color change; therefore clinical examination is not enough to detect caries & will required x-rays.

TRUE

__________ density allows for greater penetration of x-rays in the carious area, so the caries lesion appears more _____________ than normal healthy tissue on a x-ray.

1. decreased


2. radiolucent (dark/black)

2 types of radiographs to detect caries:

1. periapical


2. bitewing

Periapical x-ray uses the ___________ technique.

paralleling

Which angulation is helpful for caries detection if the XCP technique is used to minimize linear distortion (foreshortening/elongation)?

vertical

Which angulation produces open contacts for areas in b/t teeth that would not normally be clinically seen?

horizontal

What is usually the preferred image of choice when detecting cares?

bitewing

Which bitewing (horizontal or vertical) is not as useful because of technique problems from bending the film and difficulty placing film to open contacts?

vertical bitewing

Which bitewing (horizontal or vertical) is the ideal image, producing open contacts and gets more teeth on the x-rays?

horizontal bitewing

Name the factors affecting caries presentation: (9)

1. angulation


2. image receptor placement


3. location of proximal carious lesion


4. degree of hypomineralization


5. exposure factors


6. degree of cavitation


7. ambient light intensity


8. monitor contrast, resolution calibration


9. selection of post processing algorithms on images

T/F: Even with perfect technique, some caries lesions may not be seen depending upon location.

TRUE

T/F: Tooth has to be 60% demineralized before caries can be detected on hard tissue.

FALSE; it has to be 40%!!

What exposure factors can produce radiolucent images that might look like caries?

kVp, mA, and exposure time

Degree of cavitation refers to -

how deep the demineralization occurs

Ambient light intensity refers to -

background lighting

What all has to be calibrated? (4)

1. monitor resolution


2. lighting


3. P.C.


4. software

Name the 5 types of caries:

1. interproximal


2. occlusal


3. buccal/lingual


4. root caries


5. recurrent

On x-ray, where are interproximal caries typically seen at?

just below the level of contact b/t two teeth

As the interproximal caries progress through enamel, it assumes a ___________ configuration/shape w/ apex heading toward the ______.

triangular; DEJ (dentino-enamel junction)

Once the interproximal caries reaches the DEJ, it spreads out ___________ and continues into the _______.

laterally ; dentin

With interproximal caries: Another triangle configuration will be seen in dentin with the apex heading toward the ________________

pulp chamber

Class ___ interproximal caries extend less than halway the thickness of enamel and doesn't involve the DEJ. It is "Beginning to exist/appear" and is known as "incipient interproximal caries".

1

Class __ interproximal caries extends more than halfway the thickness of enamel but doens't involve the DEJ. Known as "moderate interproximal caries".

2

Class __ interproximal caries extends to or through the DEJ and into the dentin but doesn't extend through dentin more than halfway. Known as "advanced interproximal caries".

3

Class __ interproximal caries extends through the enamel, through the dentin and more than halfway the distance of dentin formed toward the pulp. Known as "severe interproximal caries" - appears as a cavitation (hole) in tooth.

4

_____________________ are often confused for interproximal caries lesion, appears radiolucent similar to caries. However thats not the case, it appears because x-ray isn't properly aligned.

interproximal burnouts

What is the optimal detection of occlusal caries done with?

EXD, mirror and light

Why are occlusal caries hard to detect on x-rays?

due to superimposition of b/l enamel cusps.

T/F: Many early occlusal caries go undetected.

TRUE

Name 3 types of occlusal caries:

1. incipient


2. moderate


3. severe

___________ occlusal caries are not normally seen on dental image and have to use an EXD

incipient

___________ occlusal caries extends into the dentin and appears as a very thin radiolucent line underneath enamel. No changes in enamel*

moderate

_____________ occlusal caries appear as cavitation (hole) underneath enamel of occlusal surface, it is a gross loss of tooth structure and appears as large radiolucent body in dentin.

severe

Why are buccal/lingual caries hard to determine on x-rays?

because b/l surfaces of teeth superimpose on one another.

On an x-ray for b/l caries in facial view, how do they appear?

as a small, circular radiolucent area

Root caries involves only the roots of teeth including the ______________ & the _________ located just below the cervical region.

cementum and dentin

What is necessary in order to expose the root surface for caries formation?

bone loss and gingival recession

Clinically, root caries are easy to detect and looks like it is -

saucerized or scooped out

On an x-ray, root caries looks like ________ or _____________ just below the CEJ.

cupped out or crater-shaped radiolucency

Where are root caries most common?

exposed roots of mandibular premolar & molar roots, or on buccal premolar regions followed by lingual & interproximal areas.

Root caries are ___% prevalent on older pt's.

50

___________ caries occurs immediately adjacent to pre-existing restoration due to inadequate cavity preparation, defective margins, or incomplete removal of caries before placement of restoration material.

recurrent (secondary)

For recurrent caries, what may provide a false diagnosis?

faulty angulation

How to recurrent caries appear on an x-ray?

radiolucent area located just beneath a restoration

Requirements of x-rays depend upon what 3 things?

1. past caries incidences


2. suspicions of caries due to clinical examination & health factors


3. oral hygiene

3 types of caries prevention?

1. plaque control


2. coronal protection


3. anti-microbial rinses

Plaque control involves - (2)

1. diet (less carogenic food)


2. mechanical removal (brushing, flossing, office visits)

Coronal protection involves - (3)

1. restorations


2. sealants


3. fluorides (remineralization purposes)

Anti-microbial rinses involves - (2)

1. stannous


2. fluoride

_________ refers to tissues that invest & support teeth, such as gingiva & alveolar bone.

periodontium

_____________ appears as radiopaque line around the roots

lamina dura

_________ appears as radiopaque bone.

alveolar crest

In normal healthy alveolar crest, it is located approximately ___-___ mm apical from the CEJ.

1.5-2.0

Anterior alveolar crest appears -

pointed/sharp and radiopaque

Posterior alveolar crest appears -

flat/smooth, less radiopaque & runs parallel to CEJ of posterior teeth

_______________ appears as a radiolucent line b/t root of tooth & lamina dura.

PDL space

T/F: W/ perio disease, the alveolar crest may no longer appear radiopaque.

TRUE

For perio, on a x-ray you can determine what 3 things?

pattern, distribution, and severity of bone loss

For perio, periapical image is recommended due to its ability to see __________ & __________

bone level & root regions

For perio, paralleling technique also provides accurate representation of the ___________________ in regards to the root

crestal bone height

4 types of changes w/ perio :

1. horizontal bone loss


2. vertical bone loss


3. furcation involvement


4. large crown to root ratio

For perio w/ horizontal bone loss, the anterior dentition becomes -

flat or blunted

For perio w/ horizontal bone loss, the posterior dentition becomes -

flat & parallel to CEJ and moves apically

Vertical bone loss is often referred to as -

angular bone loss

When bone loss falls below the area of furcation (area b/t roots of multirooted teeth) perio has ___________________

furcation involvement

Crown to root ratio means -

crown divided by the length of root

Ideally, the ratio should be less than ___ because you want more than less bone exposed.

1/2

Treatment of perio consist of what 4 things?

1. plaque control


2. antimicrobial flora


3. root planning


4. surgical techniques

What is the primary cause of perio?

plaque

_______________ is the removal of predisposing factors like calculus/plaque.

root planning

Periapical lesions consists of - (3)

1. granuloma


2. abscess


3. cysts

All periapical lesions results from -

pulpitis (pulpal death / necrosis)

All periapical lesions appear as -

round/ovoid radiolucencies at the root

________________ is a localized mass of chronically inflamed granulation tissue at the apex of a nonvital tooth.

periapical granuloma

Periapical granuloma may give rise to -

cysts or abscesses

T/F: Periapical granuloma is asymptomatic - no pain unless acute exacerbation.

TRUE

T/F: Periapical granuloma isn't discolored and has no sensitivity.

FALSE ; it is discolored and has hot/cold/pressure sensitivity

1. Where are granulomas seen as?


2. From loss of mineralized tissue it is replaced with?

1. widened PDL space at root apex


2. fibrous CT

Granuloma is rarely ___________ and is less than __ mm in diameter.

corticated ; 25 mm

What all do periapical granulomas contain? (4)

1. collagen


2. inflammatory cells


3. lymphocytes


4. multi-nucleated phagocytic giant cells (macrophages)

______________ is a localized accumulation of pus in the PA region.

PA abscess

PA abscess is sensitive to -

pressure

PA abscess may develop into a _________ and occasionally have blurred ________

fistula ; margins

PA abscesses may be _______ or __________

acute or chronic

Acute PA abscess is -

constant painful throbbing

Acute PA abscess is when the tooth is ___________ and sensitive to pressure, percussion and heat.

non-vital

Chronic PA abscess is _____________ because the pus from the abscess drains through the bone or the PDL space.

asymptomatic

For PA chronic abscess, at the site of drainage what may develop at the apical site of tooth?

a parulis or gum boil

_____________ is a lesion that develops over a prolonged period of time ; degeneration takes place within a granuloma.

PA cyst

For PA cysts, the growth of ERM causes more _________ at the center of cysts.

necrosis

T/F: PA cysts are typically asymptomatic - mild to no pain.

TRUE

For PA cysts, has loss of lamina dura and radiolucency adjacent to the -

necrotic pulp

PA cyst are usually __________ (still has bone) and is greater than ___ mm in diameter.

corticated ; 16 mm

T/F: Condensing osteitis has severe inflammation.

FALSE ; has NO INFLAMMATION

Condensing osteitis:


1. Is asymptomatic or symptomatic?


2. Is it sensitive to pressure?


3. Is it a vital or non-vital tooth?

1. asymptomatic


2. yes


3. non-vital

Condensing osteitis primarily occurs where?


It does not appear to be attaching to the tooth _____.

mandibular molar/premolar regions ; root

Condensing osteitis appears as a -

radiopacity

_____________- is the shedding of teeth by physiologic processes (natural) or pathological processes (disease ridden).

root resorption

What other names is Idiopathic osteosclerosis known as? (4)

1. dense bone island


2. bone whorl


3. enostosis


4. eburnation

Idiopathic osteosclerosis:


1. is asymptomatic or symptomatic?


2. Is it vital or non-vital?


3. Radiopaque or radiolucent?

1. asymptomatic


2. vital


3. radiopaque

Where does Idiopathic osteosclerosis occur at?

mandibular premolars/molars

What is the film base made from?

2 mm polyester plastic

What does the adhesive layer do?

attaches emulsion to the base

What are the 2 parts of emulsion layer?

gelatin and halide crystals

Which part of emulsion layer is more sensitive to xray?

halide crystals

Most energized areas will be what color?

black

Least energized areas will be what color?

white areas

What do halide crystals turn into?

silver

What is the benefit from having emulsion on both sides of the film?

less radiation

What is the purpose of the protective layer?

manipulation / mechanical processing damage

What is the moisture and light proof film packet made of?

soft vinyl paper

What side will you find the foil sheet located on the tube head side?

tube side (behind it)

What does the black paper film wrapper do?

protect against sunlight

Where is the lead foil sheet located?

behind film wrapper

What does the lead foil sheet do?

keep backscatter radiation from hitting the film

What does backscatter do to the film?

film fog

When you expose the film backwards what are you exposing?

foil

What is the plate size 1 used for?

pedi and PA anterior

Plate size 2 is for?

posterior PA

Plate size 3 is for?

bitewing

Plate size 4 is for?

occlusal (4x larger than 2)

Better name for film speed is-

sensitivity

What is film speed determined by? (3)

1. size of silver halide crystals


2. thickness of emulsion


3. special radiosensitive dyes

What does film speed determine?

how much / how long

What makes a film speed faster?

bigger halide crystals

D speed =

ultraspeed

E speed =

ekstraspeed (no longer used)

F speed =

insight

Which speed is recommended?

F speed

What is a charged coupled device? (4)

- solid state detector


- silican chip w/ electric circut embedded


- silican is sensitive to x-ray/light


- electrons inside are arranged into blocks and translate it into electric message

What is a photostimuable phospher plate?

coated w/ phospher plate, and reusable

What does developing do to the halide crystals?

reduces exposed energized silver halide crystals chemically into black metallic silver

What does developing do to emulsion?

softens film emulsion

If the plates are not developed long enough they will be-

too light (crystals didnt form)

If the plates are developed too long the image will be -

too dark

If the temp of the developer is too hot it will be -

too dark

If the temp of the developer is too cold it will be -

too light

If the developer is not rinsed off correctly the image will be too -

dark

What do fixers do?

unexposes, unenergizes silver halide crystals from film emulsion

What does the fixer leave behind?

black metallic silver

Fixers will also ___________ emulsion

harden

Too long in a fixer =

too light

Too short in a fixer =

too dark

What temp are the films dried at?

room temp

If you are using an autonomic scanner, what step does it leave out?

no rinse step

Advantages of an autonomic procesor? (5)

1. fast


2. time/temp are controlled


3. less equipment


4. less space required


5. convient

Disadvantage of an autonomic processor? (2)

1. inferior quality


2. lot of maintenance

Color of universal safe light?

red

Intraoral safe light is what color?

yellow

_________ refers to a method of capturing a radiographic image using a sensor, breaking the image down into electronic pieces and storing it using a computer instead of film emulsion.

digital imaging

_____ is an array of picture elements

pixels

_________ is used to store the images electronically

software

Digital imaging requires less radiation than conventional radiography by ___-___%.

50-90%

The normal sensor is typically MORE/LESS sensitive than conventional film?

more

3 types of digital radiography?

1. indirect


2. semidirect


3. direct

Which type of digital radiography requires a scanner, digitizes/converts image then sends it to the computer?

indirect

What is one problem w/ indirect digital radiography?

loss/alteration of info due to partial volume averaging so the pixels are not accurate shade of grey.

Which digital radiography requires a scanner to read the image?

semidirect

PSPP stands for -

photostimulable phosphor plate system

In the PSPP, what is used to record/store diagnostic data onto the plate?

reusable imaging plate coated w/ phophors

After the exposure, the PSPP is placed into a -

high speed scanner

Which type of digital radiography doesn't require a scanner the foes from sensor straight to ADC (analog image to digital converter) to a computer?

direct

_________________ is a solid-state detector that contains a silicon chip w/ an electronic circuit embedded into it.


CCD (charge-coupled device)

The electrons inside the CCD are arranged into _______________ & translate light into electronic message.

blocks/pixels

How does CMOS (complementary metal oxide semiconductor) differ from the DDC detector?

the way the pixels are read from the sensor

Name some edge enhancements - (3)

1. low frequency


2. contrast difference


3. sharpening filter

Ways to reduce noise (3) -

1. soften filter


2. remove high-frequency noise


3. remove important diagnostic info which takes away contrast

__________ is overall darkness/blackness of film

density

_______ refers to how sharply dark/light segements are

contrast

What does inversion of gray scale do?

switches black/white areas for a diff view

What does emboss function do?

applies 3D effect on image, has no diagnostic effects

What all does automated image measurement do? (2)

1. gives exact measurement of length of root canal


2. has ruler function in computer to measure

3D image reconstruction requires -

CT scan