5. caries progression + removal (DONE)

parts of the cavity

caries progression patterns

INFILTRATION

caries progression **KNOW THIS CHART WELL

for D2 and D3 combine with liners and bases

Selective caries removal

Extensive caries

Remove infected dentin; Leave affected dentin

What instruments to use? CARBIDE BUR IN LOW SPEED / DENTIN SPOON

Infected Dentin

Necrotic dentin zone

Superficial demineralized dentin zone

Affected Dentin

Deep demineralized dentin zone

Hypermineralized dentin zone
✓ Dentinal sclerosis
✓ Reactionary dentin

Clinical Caries Detection and Activity Assessment: tactile

Conventional explorer

Rounded-tip explorer

Clinical Caries Detection and Activity Assessment: visual

1. radiographs

• Conventional radiography

• Digital radiography

2. fluorescence

• QLF-D (Quantitative Light-Induced Fluorescence, Inspector Research Systems BV, Amsterdam, Netherlands)

• DIAGNOdent (KaVo Dental, Lake Zurich, IL)
  

3. transillumination

• FOTI (Fiber-optic transillumination)

• DIFOTI (Digital imaging fiber-optic transillumination)

Dental Transillumination

When a high-intensity light is applied to the tooth structure, it passes through the structure and illuminates it.

When affected by a carious lesion, the refractive indexes of the decayed enamel and dentin are modified, causing the light to be scattered instead of transmitted, creating a darker appearance in the affected area.

Fiber-Optic Transillumination Using a Camera (DIFOTI)

Uses a harmless white light to transilluminate each tooth and
instantaneously generate a high-resolution digital image on the computer monitor, allowing the clinician to capture the desired image using simple software and a foot pedal activation.

Clinical Caries Detection and Activity Assessment: visual-tactile

ICDAS International Caries Detection and Assessment System

clinical examination of free surfaces

Visual clinical examination

Do not use the explorer with pressure

Generally does not require other diagnostic methods

clinical examination of Interproximal surfaces

Clinical examination (visual + dental floss)

Tooth separation

Interproximal radiography

Transillumination

clinical examination of occlusal surface

Visual

Tactile (no pressure/blunt tip)

X-ray

Dye or Fluorescence

caries detector dyes

Dyes are capable of increasing the contrast between normal and decay-altered tissues, thus increasing the accuracy in diagnosing carious lesions.

However, dyes do not differentiate infected from affected dentin, leading to unnecessary removal of dental tissue.

have also been linked to toxicity reactions and the creation of stains in dental tissues.

ICON resin infiltration

a minimally invasive technique used to treat early enamel caries (white spot lesions) without drilling

A low-viscosity resin infiltrates the porous, demineralized enamel, blocking acid diffusion and arresting lesion progression.

indicated for non-cavitated enamel lesions and supports a preventive, tooth-preserving approach to caries management

dental tx based on caries