Nbde - Operative Dentistry

Front 1

What is the etiology of dental caries?

Back 1

Mass of bacteria adheres to tooth surface -> plaque bacteria feast on refined carbs -> metabolize sugars and produce acidic byproducts -> acid lowers pH of the plaque adherent to the tooth -> critical pH is reached at which demineralization of adjacent tooth takes place

Front 2

What is the "critical pH" of tooth structure?

Back 2

pH = 5.5

Front 3

What is the pH of some sodas?

Back 3

3.5

Front 4

Describe the NON-SPECIFIC PLAQUE HYPOTHESIS:

Back 4

All plaque cause caries

Front 5

Describe SPECIFIC PLAQUE HYPOTHESIS:

Back 5

only ones that cause caries are pathogenic

Front 6

What is the current accepted theory on the production of pain secondary to carious or other insults to the tooth?

Back 6

HYDRODYNAMIC THEORY:
- when tooth subjected to insult, fluid movement through the tubules increases and the greater flow deforms the nerve endings in the pulp leading to pain response

Front 7

What are the CARIOGENIC BACTERIA?

Back 7

SALIVA:
S. mutans, sanguis, mitis, salivarius
A. viscus
Lactobacilli
Veillonella
A. naeslundi

Front 8

What are the most common cariogenic bacteria in coronal caries?

Back 8

Streptococcus mutans and Lactobacilli

Front 9

What is the most common cariogenic bacteria in root surface/smooth surface caries/

Back 9

Actinomyces viscus

Front 10

What organism is the earliest found in dental plaque?

Back 10

Streptococcus sanguis

Front 11

Define INCIPIENT CARIES:

Back 11

caries that have not progressed farther than enamel, they are reversible or able to remineralize

Front 12

Define FRANK CARIES:

Back 12

caries that have progressed just into the DEJ

Front 13

What is the most prevalent type of caries?

Back 13

pit and fissure

Front 14

What is generally the shape of pit and fissure caries?

Back 14

- inverted V
- narrow at enamel and spreads wide at DEJ

Front 15

Where is the LEAST resistance to caries?

Back 15

DEJ

Front 16

What is the 2nd most prevalent caries type?

Back 16

Interproximal / cervical
- found just gingival to proximal contact

Front 17

What are the zones of carious enamel?

Back 17

TRANSLUCENT ZONE -> deepest zone, absent/composition less appearance seen under polarized light

DARK ZONE -> represenets re-mineralization and is termed due to its inability to transmit polarized light

BODY ZONE -> largest zone, demineralizing phase

SURFACE ZONE -> outermost zone, seems unaffected by the caries

Front 18

What factors of the dentin allow for faster spread of acidogenic destruction?

Back 18

- tubular structures
- less mineralized tissue

Front 19

Define AFFECTED DENTIN:

Back 19

bacteria present but in smaller amounts. Demineralization occurs but still can be reversed if favourable environment assumes and infected layer is removed

Front 20

Define INFECTED DENTIN:

Back 20

tubules infected with many acid-producing bacteria, and acidogenic and proteolytic activity results in degradation

Front 21

Which "zones of affected dentin" are capable of remineralization?

Back 21

First three zones (Normal, subtransparent, transparent)

Front 22

Which "zones of carious dentin" are termed AFFECTED?

Back 22

TWO (subtransparent) and THREE (Transparent)

Front 23

Which "zones of carious dentin" are termed INFECTED?

Back 23

FOUR (turbid) and FIVE (infected)

Front 24

What are the five zones of carious dentin?

Back 24

1) NORMAL: no bacteria / byproducts present in this deepest unaffected area

2) SUBTRANSPARENT: demineralization from acidogenesis, but no bacteria found in dentinal tubules

3) TRANSPARENT: softer than normal, further demineralization - yet still no bacteria present

4) TURBID: zone of bacterial invasion, bacteria present in tubules, must remove this zone!!!

5) many bacteria found in this outermost zone, must remove to treat successfully

Front 25

The pathway of initial demineralization is along which path with root surface caries?

Back 25

Sharpey's fibers of the cementum

Front 26

What factors increase likelihood of root surface caries?

Back 26

- root exposed to oral environment
- contaminated root surface with plaque
- decreased salivary flow
- elderly population
- decrease hygeine

Front 27

Define RESIDUAL CARIES:

Back 27

infected or cavitated tooth structure remaining after attempted removal in a completed cavity preparation
- can be intentional such as in indirect pulp capping procedures

Front 28

RAMPANT CARIES is often the result of what factors?

Back 28

- histological disadvantages
- poor hygeine
- drug abuse
- radiation
- high-sugar diets
- decreased salivary conditions

Front 29

What is hte most common etiology of decreased salivary function?

Back 29

- side effect to medications

Front 30

What are some MODERATE caries risk factors?

Back 30

- exposed roots
- deep pit / fissures
- interproximal enamel lesions
- other white spots / discolorations
- recreational drug use

Front 31

What are some HIGH caries risk factors?

Back 31

- visible cavitation
- restoration in past 3 years
- visible plaque
- frequent between meals snack (>3/day)
- inadequate saliva
- appliances (ortho, retainer, RPD)

Front 32

What are some COMMON DRUGS THAT REDUCE SALIVARY FUNCTION?

Back 32

ANTICHOLINERGICS: atropine, glycopyrolate, scoplomine
DIURETICS: hydrochlorothiazide
LOCAL ANAESTHETICS: lidocaine
ANTIPSYCHOTICS: chlorpromazine
BETA-BLOCKERS: atenolol
BENZOS: alprazolam
ANTIHISTAMINES: chlorpheniramine

Front 33

What is the criteria for diagnosis of pit and fissure caries?

Back 33

FLOSS
Flakiness of enamel
Loss of translucency
Opacity
Stickiness
Softening of base of pit and fissure

Front 34

TRUE or FALSE: Caries can be diagnosed by radiographs alone.

Back 34

FALSE: need to be diagnosed in conjunction with clinical examination

Front 35

Cavity preparation should extend at least ___ mm into _____ .

Back 35

At least 0.5mm into dentin

Front 36

What is the minimum width of the marginal ridge of a Class I preparation before it must be converted to a Class II?

Back 36

1.6mm