opd quiz #1

restorative dentistry

is a branch of dentistry which deals with the restoration of teeth destroyed by the dental caries & other causes to prevent destruction of the tooth tissue & intercept the progress of disease

diagnosis, treatment and prognosis

restorative dentistry is the ______ defects of teeth that DO NOT require full coverage restorations for correction

1. restoration of proper tooth form

2. restoration of function

3. restoration of esthetics

4. maintenance of physiologic integrity of the teeth in harmonious relationship with the adjacent hard and soft tissues

restorative dentistry treatment results in?

1. caries

2. malformed, discolored, nonesthetic or fractured

3. restoration replacement or repair

restorative dentistry is categorized into three primary treatment needs (indications)

dental caries

is an infectious microbiologic disease of the teeth that results in localized dissolution and destruction of the calcified tissues

dental caries

irreversible biochemical process characterized by demineralization of inorganic substances & disintegration, dissolution of organic substances

cavity

a defect in enamel or in enamel and dentin resulting from a pathologic process which is dental caries

biofilm (plaque)

- soft, translucent, and tenaciously adherent material accumulating on the surface of the teeth

- a gelatinous mass of bacteria adhering to the tooth surface

1. non specific plaque hypothesis

2. specific plaque hypothesis

2 theories of pathogenicity of plaque

non specific - assumes that all plaque is pathogenic

specific - recognizes that plaque is pathogenic only when signs of associated disease are present

differentiate non specific and specific plaque hypothesis

non specific plaque hypothesis

assumes that all plaque is pathogenic

specific plaque hypothesis

recognizes that plaque is pathogenic only when signs of associated disease are present

high frequency sucrose exposure

may be the single most important factor in producing a cariogenic plaque

host + bacteria + diet = caries

general mechanisms of dental caries

a. tooth

b. saliva

c. muscular activity

d. habits

e. group susceptibility

f. age

g. environment

factors under host

fluoride & calcium content

caries susceptibility of tooth is inversely proportional to its ? & ? content

less prone to caries

high salivary phosphate content = ?

5.5 - 5.7

critical pH

below 5.5 -5.7 → demineralization ; higher than 5.7 → remineralization

pH for demineralization? remineralization?

SEROUS - (low viscosity) – less decay

MUCINOUS - (thick and ropy, more viscous) - more prone to caries

2 types of viscosity? explain

parasite

microorganisms brought into contact w/ the tooth surface via a bacterial plaque, creating a classic parasitic relationship

1. s. mutans

2. lactobacillus acidophilus

3. actinomyces viscosus

bacterias/parasites found in dental caries

s. mutans

the principal bacterial agent involved in the carious agent = enamel (coronal)

lactobacillus acidophilus

bacteria grows/found in dentin

actinomyces viscosus

bacteria grows/found in root surface

carbohydrates

is the most cariogenic of all food materials

1. protective factor deleted from food materials during processing, storage & preparation

2. cariogenic factor added

3. frequency of meals

three detrimental changes in diet

1. recesses of developmental pits and fissure

2. smooth enamel surfaces that shelter plaque

3. root surface

clinical sites for caries initiation

enamel rods

- the basic unit of the enamel structure

- run perpendicularly from the surface of the tooth to the dentin

dentinal tubules

the structure of dentin is an arrangement of microscopic channels, which radiate outward from the pulp chamber to the exterior cementum or enamel border

the pulp chamber to the exterior cementum or enamel border

dentinal tubules is the structure of dentin is an arrangement of microscopic channels, which radiate outward from ? to the ?

false, it always follows the direction of enamel rods

demineralization of enamel by caries does not generally follows the direction of the enamel rods

T or F

the orientation of enamel rods are different in the two areas of the tooth

the different triangles of decay patterns between pit and fissure and smooth-surface caries develop in the enamel because ?

1. primary caries

2. secondary caries

classification of dental caries: according to location

primary caries

refers to a new, initial dental caries (tooth decay) that develops on a surface of the tooth that has never been affected by decay before

secondary recurrent caries

occurs at the junction of the restoration and the tooth and may progress under the restoration

microleakage

primary cause of secondary caries

→ inadequate cavity fillings or adaptation of the filling material to the margin of the restoration

→ may be due to soft infected dentin which is not completely eradicated during the first treatment

→ due to ineffective sterilization of the prepared cavity

other possible causes of secondary caries

1. acute rampant caries

2. chronic (slow or arrested) caries

classification of dental caries: according to rapidity of process

acute rampant caries

- disease is rapid in damaging the tooth; involves several teeth

- usually in the form of many soft, light-colored lesions in the mouth

- has less time for extrinsic pigmentation hence the light color

- common in children and young adults

chronic (slow or arrested) caries

- may be slow or may be arrested following several active phases

- slow rate resulting from episodic demineralization and remineralization due to changes

in the oral environment

- lesion is discolored/dark and hard

1. simple - 1 surface

2. compound - 2 surfaces

3. complex - 3 or more

classification of dental caries: according to no. of surfaces involved - explain

1. shallow cavity depth - more than 2.0 mm remaining dentin

2. moderate cavity depth - less than 2.0 mm, greater than 1.0 mm remaining dentin

3. deep cavity depth - less than 1.0 mm remaining dentin

classification of dental caries: according to depth - explain

1. incipient caries (reversible)

2. cavitated caries (irreversible)

classification of dental caries: according to severity

incipient caries

- it is the first evidence of caries activity in the enamel

- enamel surface hard and still intact

- lesion can be remineralized through plaque removal and control and fluoridization

cavitated caries

- enamel surface is broken

- lesion has advanced into dentin

- remineralization NOT POSSIBLE

backward caries

it is a condition when the spread of caries along the DEJ exceeds the caries in the contiguous enamel

forward caries

when the caries cone in the enamel is larger or at least the same size as that in dentin

residual caries

caries that remain in a completed tooth preparation, whether by intention or by accident

1. infected dentin

2. affected dentin

carious dentin consists of 2 layers

affected dentin

→ has no bacteria

→ can be remineralized

→ should be preserved

infected dentin

→ has bacteria

→ cannot be remineralized

→ should be removed