Dental Caries and Mineralization Quiz

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Questions and Answers

What is the primary mineral that constitutes the enamel and dentin?

Hydroxyapatite (correct)

Fluorapatite

Apatite

Carbonate-substituted apatite

What is the critical pH level at which demineralization occurs for enamel?

4.5

5.5 (correct)

6.5

6.0

Which type of apatite is more resistant to acid challenges due to fluoride substitution?

Carbonate-substituted apatite

Calcium phosphate

Fluorapatite (correct)

Hydroxyapatite

What is the first stage in the progression of caries as defined in the lesion characteristic stages?

E0: No caries or radiolucency Signup and view all the answers

How does saliva contribute to the remineralization process?

Through bicarbonate that buffers the acid Signup and view all the answers

In the context of caries progression, which stage indicates that caries has penetrated into the first third of dentin?

D1 Signup and view all the answers

What structural formation do enamel rods create?

Crystal lattice structure Signup and view all the answers

What form does infected dentin typically exhibit?

Wet, soft, and mushy Signup and view all the answers

What phenomenon explains the shift in the demineralization equation when sugar is introduced?

LeChatelier’s principle Signup and view all the answers

What does the cavosurface margin refer to in cavity preparation?

The junction where the cavity preparation meets the natural tooth Signup and view all the answers

What describes the shape of a pit and fissure lesion in dental caries?

Inverted V shape Signup and view all the answers

In the context of the GV Black classification, which class corresponds to interproximal anterior cavities with no incisal edge involvement?

Class III Signup and view all the answers

What is primarily removed during the outline form stage of tooth preparation?

Friable and unsupported enamel Signup and view all the answers

Which internal wall of the cavity may be referred to as the pulpal floor?

The wall that is closest to the pulp chamber Signup and view all the answers

In terms of tooth preparation, which angle is defined as the junction between two walls?

Line angle Signup and view all the answers

Class V cavities affect which part of the tooth?

Buccal or lingual surface at the cervical third Signup and view all the answers

What is an external wall in cavity preparation?

The wall that forms the cavosurface margin Signup and view all the answers

What defines Class I cavities according to the GV Black classification?

Pits and fissures on the occlusal surface Signup and view all the answers

What is a required characteristic of the walls in an onlay preparation?

Walls should be divergent Signup and view all the answers

What should be done to enhance adhesion to the veneer?

Apply hydrofluoric acid for cleaning and etching Signup and view all the answers

Which of the following is NOT a characteristic of an onlay preparation?

Preparation should be deep and narrow Signup and view all the answers

What is the purpose of applying silane to the etched veneer surface?

To prepare for resin cement adhesion Signup and view all the answers

Which of the following conditions may lead to inadequate bonding of enamel?

Amelogenesis imperfecta Signup and view all the answers

What type of dentin is characterized by being demineralized but free of bacteria?

Affected dentin Signup and view all the answers

Which type of caries is irreversible and typically affects the dentin?

Cavitated lesion Signup and view all the answers

Which lesion appears opaque when air dried but disappears when wet?

Incipient lesion Signup and view all the answers

What best describes arrested caries?

Discolored but not progressing Signup and view all the answers

Which term refers to caries that develop at the junction of a tooth and a previous restoration?

Secondary/recurrent caries Signup and view all the answers

Which of the following implies a chemical loss of tooth structure without bacterial involvement?

Erosion Signup and view all the answers

What is the cause of abrasion in dental terms?

Mechanical wear from toothbrushes Signup and view all the answers

What distinguishes acute/rampant caries from chronic caries?

Color and infection rate Signup and view all the answers

What is the role of the coupling agent in composite resin?

To promote adhesion between resin and fillers Signup and view all the answers

What happens when enamel is overdried during the bonding process?

It can cause desiccation, affecting bonding quality Signup and view all the answers

Which type of filler has the highest wear resistance?

Nanofill Signup and view all the answers

What is a characteristic of self-cure composites?

They use an initiator and activator system Signup and view all the answers

Which of the following statements about phosphoric acid is true?

It is used to etch enamel prior to bonding. Signup and view all the answers

Which polymerization method is best suited for large build-ups where light cannot penetrate?

Dual-cure Signup and view all the answers

What effect do smaller filler sizes have on composite properties?

Provides a smoother surface finish Signup and view all the answers

What is the primary disadvantage of using macrofill composites?

Lowest wear resistance Signup and view all the answers

What type of reaction can contact dermatitis from certain dental materials cause?

Type IV hypersensitivity reaction Signup and view all the answers

Which curing method typically uses camphorquinone as a photoinitiator?

Light-cure Signup and view all the answers

What is one advantage of using glass ionomer in dental restorations?

It releases fluoride to the tooth structure. Signup and view all the answers

Which of the following is NOT a disadvantage of glass ionomer materials?

Requires multiple appointments for placement. Signup and view all the answers

What characterizes a high caries risk according to the American Dental Association’s assessment?

Presence of caries in the last 6 months. Signup and view all the answers

What indicates a moderate caries risk?

Regular dental care with sugary food exposure only at mealtimes. Signup and view all the answers

Which of these conditions is considered low risk for caries?

Regular dental care is practiced. Signup and view all the answers

What is the primary use of luting cements in dentistry?

Placing temporary restorations or liners. Signup and view all the answers

What is a characteristic of resin-modified glass ionomer (RMGI)?

It features properties from both resin and glass ionomer. Signup and view all the answers

Which of the following health conditions poses a high risk for caries?

Presence of special health care needs in individuals aged over 14. Signup and view all the answers

How does the presence of xerostomia affect caries risk?

It is associated with moderate risk for caries. Signup and view all the answers

What happens if a glass ionomer mixture is desiccated?

It causes it to crack or develop craze lines. Signup and view all the answers

Which of the following factors contributes to a low caries risk assessment?

Frequent dental visits and preventive care. Signup and view all the answers

What is a primary indication for veneers in dentistry?

For staining and diastemas between teeth. Signup and view all the answers

Which option is not a condition associated with high caries risk?

Presence of fluoride exposure. Signup and view all the answers

What is a potential reason for the presence of open margins in restorations?

Poor adherence of the restorative material. Signup and view all the answers

Study Notes

Composition of Teeth

Teeth are primarily composed of inorganic calcium phosphate minerals, mainly apatite.
Hydroxyapatite is the major component, a carbonate-substituted apatite with a hexagonal structure forming enamel rods.
Fluorapatite is a fluoride-substituted apatite, more resistant to demineralization.

Stephan Curve

The Stephan curve depicts the pH changes in the oral cavity after acid introduction.
Critical pH levels exist for different tooth components: dentin/cementum (6.2-6.7), enamel (5.5), and fluorapatite (4.5).
Demineralization occurs when salivary pH falls below the critical pH.
Demineralization is a process where calcium and phosphate ions are removed from the tooth.
Hydroxyapatite (Ca10(PO4)6(OH)2) dissolves in acid.
Bicarbonate (HCO3-) in saliva can buffer acids, shifting the reaction to remineralization.

Progression of Caries

Caries progression is categorized into stages (E0-E3 and D1-D3).
E0: No caries or radiolucency
E1: Caries in outer half of the enamel.
E2: Caries in inner half of enamel but not dentin.
D1: Caries into the first third of the dentin.
D2: Caries into the middle third of the dentin.
D3: Caries into the inner third of the dentin.

Terminology of Tooth Lesions

Infected dentin: Soft, mushy, and infiltrated by bacteria.
Affected dentin: Demineralized but bacteria-free dentin.
Incipient lesion: Appear opaque when dry, but disappears when wet, can remineralize.
Cavitated lesion: Enamel is no longer intact.
Acute/rampant caries: Light colored, soft, and highly infectious.
Chronic caries: Brown/black, not progressing, dentin almost remineralized.
Arrested caries: Appears brown/black, not actively progressing.
Erosion: Chemical loss of tooth structure without bacteria.
Attrition: Heavy occlusal forces on tooth (like bruxism).
Abrasion: Pathologic, mechanical wear (e.g. toothbrush).
Abfraction: Loss of tooth structure in cervical areas due to tooth flexure.

Cavity Preparation

Cavity preparation procedures are outlined for different tooth classes (I-V).
Tooth preparation should be divergent, withstand masticatory pressure, and have rounded pulpal floors.
Different factors in preparing the tooth will depend on the specific class of tooth.
Cavity preparation considerations depend on whether there's caries present, and if not the extent of the caries.

Amalgam

Amalgam comprises mercury and metallic alloy.
Proper amalgam procedures, including trituration, are crucial for its properties.
Handling is an important consideration when dealing with amalgam, as well as resistance, which protects the amalgam in case of stress or breakage during mastication.

Composite Resin

Composite resins are tooth-colored materials.
For successful composite bonding, isolation from water/saliva is vital.
Composite restorative materials are better suited for bonding with enamel than dentin.
Beveling the preparation is advantageous for class IV/V restorations.

Acid Etching

Acid etching (37% phosphoric acid) is used to roughen tooth surfaces.
It creates micromechanical retention for bonding composite materials by removing smear layers and exposing dentin tubules.

Veneers and Onlays

Veneers are thin coverings for teeth.
Onlays are indirect restorations for tooth.
Hypocalcified enamel will not allow adequate bond strength.
Factors to consider when deciding between veneers and onlays will depend on existing tooth structure, and caries.
Hydrofluoric acid (HF acid) can be used to clean off a veneer prior to application of bonding agent.

Glass Ionomer

Glass ionomers are restorative material for anterior teeth (class III & V) and root caries lesions.
Releases fluoride to the tooth structure.
Does not require perfect moisture control.

Caries Risk

American Dental Association's Caries Risk Assessment categorizes risk levels: low risk, moderate risk, high risk.
The assessment considers factors like fluoride exposure, dietary habits, etc, to determine caries risk.

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Description

Test your knowledge on dental caries, enamel, and dentin mineralization in this quiz. Explore the critical pH levels for demineralization, the role of saliva in remineralization, and the stages of caries progression. Perfect for dental students and professionals looking to refresh their understanding of key concepts.