2.3 Radiographic caries detection

Caries are always (more/less) advanced than the radiograph indicates

more
Because the bacterial penetration of the dentinal tubules and early demineralization do not produce significant changes in density to affect the penetration pattern.

Caries appear _______ because the demineralized area of the tooth does not absorb as many x-ray _______ as the unaffected portion

radiolucent
photons

Lesions confined to enamel may not be evident radiographically until ______ demineralization occurs

30-40%

Typically, it takes _______ for a white spot lesion to progress to cavitation

12-18 months

What is the most accurate x-ray to diagnose interproximal caries in posterior and anterior teeth

Periapical for anterior

Bite wings for posterior (do not diagnose on periapical)

Distal of canine should be on what x-ray

Premolar Bitewing

Beam of bitewing x-ray should be _______ to the long axis of the tooth

perpendicular

Purpose of radiographic examination

Detect carious lesions not readily apparent by clinical examination
Evaluate the extent or size of a lesion that has been detected
Monitor lesion behavior

Intraoral radiography

Extraoral radiograpy

Bitewings and PA

Pano

Digital radiograph senseors

Thicker, non-flexible digital sensors require some modification of intraoral technique

Degree of severity of radiographic lesion

Incipient

Moderate

Advanced

Severe

Incipient: Less ½ of enamel

Moderate: More ½ of enamel

Advanced: Less than ½ of dentin

Severe: More ½ of dentin

When performing a DR, it is important to use _____ ambient lighting and a quality ______

subdued
monitor

For detection of posterior caries _______, for anterior ______

bitewing
PA

E1, E2 and D1 caries are ______. D2 and D3 are ______

microinvasive
invasive

In posterior teeth, teeth may be ________ demineralized before proximal caries appear radiographically.

Approximately ______ of proximally caries do not appear on a radiograph

30-40%
50%

Dentinal lesions are typically (narrower/wider) than enamel lesions

wider

Most proximal caries occur (above/below) the contact.

below

Cavitation is more likely in patients with (high/low) caries risk; however ______ of D1 lesions are not cavitated and can be treated using _____

high
40-60%
fluoride

Occlusal caries are most common in _____

children and adolescents

O1 caries

O2 caries

O3 caries

O4 caries

O5 caries

White or discolored enamel, no cavitation, no radiographic signs of caries

Small cavitation clinically, no radiographic evidence

Moderately sized cavity, radiolucency in outer third of dentin

Large cavity, radiolucency in middle third of dentin

Extensive cavity, radiolucency in inner third of dentin

Facial/lingual caries begin ____ and develop _____

round
eliptical/semilunar

Is making treatment recommendations based purely on scientific evidence practicing Evidence Based Dentistry

No

Facial/lingual or occlusal caries have more defined border radiographically? Which displays image shift relative to the crown?

facial/lingual
facial/lingual

Root caries are associated with

gingival recession

______ ______ appears as a radiolucent band or notches at the neck of the tooth in the area of the cementoenamel junction (CEJ).

cervical burnout
It is contrasted because the part of the tooth apical to it is covered by bone and hence is more radiopaque, whereas the area of the tooth occlusal to it is covered by enamel and is also radiopaque.

cervical burnout occurs most frequently in ______

mandibular incisor and molar areas

Cervical burnout appears more _____ while root caries are more ______

angular
rounded

Do radiation directly cause caries?

No, it cause loss of salivary gland function which leads to decay

Secondary caries are _____ and typically ____ to the restoration whereas radiolucent restoration materials are more ______

diffuse
gingivally
angular

image sharpening

an effect applied to digital images to give them a sharper appearance. Can create generalized, uniform radiolucent bands next to restorations

Mach bands

Exaggerates the contrast between edges of the slightly differing shades of gray, as soon as they contact one another

Optical illusion

In overlap of x-ray