Podcast
Questions and Answers
What are Class V caries lesions?
What are Class V caries lesions?
Lesions or defects involving gingival 1/3 of facial or lingual surfaces of anterior or posterior teeth.
What are the types of Class V caries?
What are the types of Class V caries?
- Only non-carious lesions
- Only carious lesions
- Caries (correct)
- Non carious cervical lesions (NCCLs) (correct)
Why do caries lesions occur?
Why do caries lesions occur?
Inadequate oral hygiene, reduced salivary flow, frequent sugar intake, lack of regular dental care, existing dental work leading to plaque accumulation, xerostomia.
Why do Class V caries affect the gingival 1/3rd surface?
Why do Class V caries affect the gingival 1/3rd surface?
Why do non-carious cervical lesions occur?
Why do non-carious cervical lesions occur?
Enamel and dentin have different tensile strengths.
Enamel and dentin have different tensile strengths.
What leads to stress concentration in the cervical area?
What leads to stress concentration in the cervical area?
What is the abfraction theory?
What is the abfraction theory?
What is erosion?
What is erosion?
What are some factors of erosion?
What are some factors of erosion?
Which causes more dissolution?
Which causes more dissolution?
What is abrasion?
What is abrasion?
What should be assessed in deciding a treatment plan?
What should be assessed in deciding a treatment plan?
What is the appearance of an early lesion?
What is the appearance of an early lesion?
What is the appearance of an active lesion?
What is the appearance of an active lesion?
What is the consistency of an active lesion?
What is the consistency of an active lesion?
What is the appearance of slowly progressing lesions?
What is the appearance of slowly progressing lesions?
What is the consistency of slowly progressing lesions?
What is the consistency of slowly progressing lesions?
What is the appearance of an inactive lesion?
What is the appearance of an inactive lesion?
What does the treatment of NCCLs include?
What does the treatment of NCCLs include?
The majority of NCCLs do not require restoration.
The majority of NCCLs do not require restoration.
When should NCCLs be restored?
When should NCCLs be restored?
When is no treatment necessary?
When is no treatment necessary?
How action should be taken by the dentist for shallow, non-sensitive, non-carious lesions?
How action should be taken by the dentist for shallow, non-sensitive, non-carious lesions?
What does the treatment protocol for carious lesions depend on?
What does the treatment protocol for carious lesions depend on?
What should be considered when treating carious lesions?
What should be considered when treating carious lesions?
When should the medical model treatment be used?
When should the medical model treatment be used?
For non-cavitated lesions, when in doubt, _______ is preferred.
For non-cavitated lesions, when in doubt, _______ is preferred.
In non-cavitated lesions, the spread of lesion in dentin is limited to the area of demineralized enamel rods.
In non-cavitated lesions, the spread of lesion in dentin is limited to the area of demineralized enamel rods.
What are some treatment options for the medical model?
What are some treatment options for the medical model?
What is the main challenge of restorations?
What is the main challenge of restorations?
How can isolation be achieved?
How can isolation be achieved?
When should coverage be used in periodontal therapy?
When should coverage be used in periodontal therapy?
What are the soft tissue grafting procedures?
What are the soft tissue grafting procedures?
What are the restorative material options?
What are the restorative material options?
When should amalgam be used?
When should amalgam be used?
What are some contraindications for amalgam?
What are some contraindications for amalgam?
What are the basic steps of the amalgam procedure?
What are the basic steps of the amalgam procedure?
What are the main features to keep in mind during amalgam preparations?
What are the main features to keep in mind during amalgam preparations?
What are the features to optimize the strength of the restoration?
What are the features to optimize the strength of the restoration?
What are features to protect the remaining tooth tissue?
What are features to protect the remaining tooth tissue?
What are the features to help retain the restorative material in the cavity?
What are the features to help retain the restorative material in the cavity?
What is needed for amalgam restorations?
What is needed for amalgam restorations?
What is the 330 bur used for?
What is the 330 bur used for?
What are the steps of amalgam preparation?
What are the steps of amalgam preparation?
What should be avoided when performing amalgam restorations?
What should be avoided when performing amalgam restorations?
How deep should the retentive groove be?
How deep should the retentive groove be?
How deep should the preparation be?
How deep should the preparation be?
What are the steps of the amalgam restoration?
What are the steps of the amalgam restoration?
Which instruments are used for amalgam restorations?
Which instruments are used for amalgam restorations?
What are the basic steps of composite preparation?
What are the basic steps of composite preparation?
If it is an NCCL, no prep is required.
If it is an NCCL, no prep is required.
What are some rules for placing an enamel bevel?
What are some rules for placing an enamel bevel?
What are some rules for packing the cord?
What are some rules for packing the cord?
What are RMGI restorations indicated for?
What are RMGI restorations indicated for?
What are RMGI restorations non-indicated for?
What are RMGI restorations non-indicated for?
RMGI's have good wear resistance.
RMGI's have good wear resistance.
What is a sandwich restoration?
What is a sandwich restoration?
What is an open sandwich restoration?
What is an open sandwich restoration?
What is a closed sandwich restoration?
What is a closed sandwich restoration?
When should a sandwich restoration be used?
When should a sandwich restoration be used?
Study Notes
Class V Caries Overview
- Class V caries lesions occur in the gingival third of the facial or lingual surfaces of both anterior and posterior teeth.
Types of Class V Caries
- Two main types: Carious (root caries) and Non-carious cervical lesions (NCCLs).
Causes of Caries Lesions
- Inadequate oral hygiene and reduced salivary flow contribute to caries development.
- Frequent sugar intake and lack of dental care increase risk.
- Existing dental work can trap plaque, exacerbating the issue.
- Xerostomia (dry mouth) also plays a significant role.
Specifics of Class V Caries
- The gingival one-third surfaces are more affected due to increased surface roughness and organic content.
- Lower pH levels required for demineralization of cementum compared to enamel make these areas more susceptible to decay.
Non-Carious Cervical Lesions
- Causes include abrasion, erosion from acidic foods, and abfraction due to uneven occlusal forces.
- Non-carious lesions can be multifactorial in origin.
Assessment and Treatment Considerations
- Comprehensive examination is crucial; do not rely on singular findings.
- Treatment plans should consider caries risk, progression stage, sensitivity, and aesthetics.
- Early lesions may appear as well-defined, discolored areas at the cementoenamel junction (CEJ).
Lesion Appearances
- Active lesions are soft, yellowish to brown, often covered with microbial deposits.
- Slowly progressing lesions exhibit a brown to black color and have a leathery consistency.
- Inactive lesions are shiny, smooth, and predominantly dark brown or black.
Treatment Protocol for Various Lesions
- Reduction of factors causing NCCLs includes changing brushing habits and reducing oral acid exposure.
- NCCLs do not typically require restoration unless sensitized, aesthetically undesirable, or structurally compromised.
- Restoration decisions for carious lesions depend on the stage of progression and the treatment model (surgical vs. medical).
Remineralization Preference
- For non-cavitated lesions, remineralization is preferred when in doubt.
Medical Model Treatment Options
- Potential options include fluoride varnish, RX fluoride toothpaste, Theragum, Mi paste, and the Icon treatment.
Restoration Challenges
- Isolation during the restoration process is critical.
- Techniques for achieving isolation include using cotton rolls, retraction cords, or rubber dams.
Amalgam and Composite Restorations
- Amalgam is suitable for lesions with significant gingival cementum exposure and when moisture control is challenging.
- Contraindications for amalgam include aesthetic concerns and safety issues.
- Amalgam procedures involve specific steps to ensure proper cavity preparation and retention.
Restoration Techniques
- Crowning features of amalgam preparation focus on optimizing restoration strength, protecting remaining tooth tissue, and retaining the restorative material.
- For composites, thorough plaque removal and shade selection precede isolation and cavity preparation.
RMGI Restorations
- Glass ionomer restorations are preferred for moderate to high caries risk but are not effective for NCCLs.
- Sandwich restorations combine RMGI with composite materials for enhanced aesthetic appeal and caries prevention.
Sandwich Restoration Types
- Closed sandwiches have all RMGI covered, while open sandwiches expose some RMGI at the restoration surface.
General Principles
- Avoid excessive tooth removal during restoration procedures to minimize trauma and preserve remaining structure.
- Retentive grooves in preparations should have a depth of approximately 0.25 mm.
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Test your knowledge on Class V caries with these flashcards. Learn about the lesions, their types, and the reasons behind their occurrence. Perfect for dental students or anyone interested in oral health!
