Session 4: caries and radiographic interpretation

• toothbrush 2x/day w a F toothpaste (≥1100 ppm F)

• follows dental exam instructions based on comprehensive risk: F rinse/gel, interproximal cleaning, oral health behaviors, nutrition and diet, etc

low-moderate risk home care H₁

• additionally brush teeth 2x/day w 5000 ppm F toothpaste (or as recommended by dentist)

home care for high-extreme ris pt

what are the most significant factors in determining management strategies?

cavitation, activity, and cleansibility

(pt caries risk, contributing then chart caries odontogram or pg 13)

general of home care instructions

Dietary and habits counseling; Brush twice daily with 1100 ppm fluoride; Floss twice daily; rinse with water after every meal

general office care

6- Month Recare and Prophy

Full mouth Fluoride varnish application (for moderate and high-risk patients)

describe ICDAS and radiographic presentation of approximal surfaces

preferred radiograph for caries detection?

bitewings - intraoral

when are caries visible on panoramic radiograph?

when they are large enough to be clincially apparent

which has lower resolution introral or extraoral bw?

extraoral

caries lesion is the manifestation of net (?) loss subsequent to an imbalance in demin-remin over time

mineral

is air radiolucent or raiopaque?

radiolucent

rank enamel, dentin, air, cancellous bone, cortical bone, restorations on scale from radiolucent to radiopaque

what is caries detection?

detection of radiolucency in relative density of enamel and/or dentin

ASA CCS

what are the radiographic classifications of caries?

• proximal caries

• occlusal caries

• F/B and L caries

• root surface caries

• recurrent caries

• rampant caries

• radiation caries

what are some presentations of proximal lesions?

classic cone shape; band, notch, dot, thin line

caries in outer half of enamel? inner half? outer third of dentin?

RA1 RA2 RA3

caries within middle third of dentin

RB4

caries within inner third of dentin? in contact with pulp?

RC5 RC6

classification for occlusal caries

• incipient - difficult to detect

• moderate - thin radiolucent line

• severe - large cavitation

root surface caries involve what structures?

C and D, associated w gingival recession

define recurrent caries

caries at margin of existing restoration

what are some examples of caries imitators"?

• cervical burnout

  • conical root forms

  • rotated teeth

• mach bands

• composite restorations

• attrition

• tooth brush abrasion

• Burnout: Sharp edges on X-ray. Smooth surface. No pain.

• Caries: Fuzzy edges on X-ray. Soft surface. Pain or sensitivity.

composite restorations

hypoplastic enamel: defect in enamel thickness, not density, and radiographs primarily detect changes in density; clinical visual inspection with a dental explorer is required for diagnosis.