Histopathology of Enamel and Dentine Caries Quiz (ODS Learning Outcomes)

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What indicates a Code 1 IDAS score for enamel caries?

Distinct cavity in enamel

Localized breakdown of enamel integrity

Visual signs of demineralisation such as white spots or brown discoloration (correct)

Dry tooth with no visible changes

Which zone of destruction in enamel caries has the largest area of demineralisation?

Body of the lesion (correct)

Surface zone

Dark zone

Translucent zone

What happens in the dark zone associated with enamel caries?

It is the advancing edge with active demineralisation

It has some remineralization but appears dark under light microscopy (correct)

It shows high porosity and extensive demineralisation

It is a visible cavity in enamel with dentine exposure

How does the clinical appearance of the body of an enamel caries lesion manifest?

Translucent appearance with prominent striae of Retzius Signup and view all the answers

Which of the following changes in enamel caries is most clearly visible when the tooth is dry?

White spots from demineralisation Signup and view all the answers

What does a Code 4 IDAS score for dentine caries indicate?

Moderate shadow from dentine with possible enamel breakdown Signup and view all the answers

What is the pore volume characteristic of the translucent zone in enamel caries?

1% as it represents early demineralisation Signup and view all the answers

In pit and fissure caries, where does the wedge-shaped lesion progress towards?

The enamel surface Signup and view all the answers

What will cause the staining associated with the colour change in enamel caries?

Absorption of substances over time Signup and view all the answers

What part of the tooth does not show significant damage due to the presence of saliva in enamel caries?

Surface zone Signup and view all the answers

What is the clinical appearance of dentine caries?

Grey shadowing under enamel with broken crown integrity Signup and view all the answers

Which zone of dentine caries shows a high bacterial load and destruction?

Zone of destruction Signup and view all the answers

In which zone does dentine maintain its tubule structure without liquefaction?

Zone of penetration Signup and view all the answers

Which of the following is NOT a characteristic of the zone of demineralisation?

Presence of bacteria Signup and view all the answers

What is the appearance of the zone of demineralisation?

Very small and pale brown Signup and view all the answers

Which type of dentine is produced when the pulp is mildly irritated by acids?

Reactionary dentine Signup and view all the answers

What is the role of translucent (sclerotic) dentine?

To slow acid and toxin penetration Signup and view all the answers

What is the main characteristic of zone four, translucent dentine?

Hypermineralisation visible radiographically Signup and view all the answers

Which zone is described as clinically dark brown and infected?

Zone of destruction Signup and view all the answers

Which structure is created in response to strong irritants affecting the pulp?

Reparative dentine Signup and view all the answers

Study Notes

Enamel Caries: Histopathology and Clinical Appearance

IDAS Scores (Enamel):
- Code 0: Clinically sound enamel.
- Code 1: Visual signs (white spots/brown discoloration) on dry tooth.
- Code 2: Distinct visual changes (demineralization) when wet and dry.
- Code 3: Localized breakdown of enamel integrity, visible wet and dry.
Clinical Appearance:
- White spots: Demineralization, increased porosity, easier to see when dry. Recent, fast progression.
- Color change: Increased porosity can lead to staining. Slower progression as more time for staining.
Histology:
- Wedge-shaped lesion, towards dentin in smooth surface caries, towards enamel surface in pits and fissures. Enamel surface lesion smaller compared to size towards dentine.
Zones of Destruction (Enamel):
- Surface zone: Surface of the tooth, least affected, can remineralize due to saliva.
- Body of the lesion: Largest area of demineralization.
- Dark zone: Low porosity, remineralization and demineralization.
- Translucent zone: Advancing edge of the lesion, early demineralization.
Clinical Appearance vs. Histopathology (Enamel):
- Surface zone: Pore volume below 5%.
- Body of lesion: Pore volume 5-25%, translucent with visible striae of Retzius.
- Dark zone: Pore volume 2-4%. Dark under microscopy, some remineralization.
- Translucent zone: Pore volume 1%, early demineralization.

Dentine Caries: Histopathology and Clinical Appearance

IDAS Scores (Dentin):
- Code 4: Moderate, dark shadow, possible enamel breakdown.
- Code 5: Extensive, distinct cavity, visible demineralization.
- Code 6: Extensive cavity into dentin, visible.
Clinical Appearance:
- Grey shadowing: Under enamel, breaking down crown integrity.
Histology:
- Zone of Destruction: Dissociated mineral content, denatured collagen, high bacterial load, destroyed dentin tubules. Liquefaction foci, transverse cracks.
- Zone of Penetration: Dentin tubules intact, bacteria decalcify and dissolve proteins. Requires removal with bur and sealing.
- Zone of Demineralization: Acid spreads to unoccluded tubules, demineralization. No bacteria present.
- Zone of Translucent Dentin: Initial acid penetration, hypermineralization, visible radiographically.
Zones of Destruction (Dentin):
- Zone of destruction: Dark brown, soft, infected, cannot be repaired.
- Zone of penetration: Affected by acid toxins, no bacteria
- Zone of demineralization: Small, less than 1mm, softer, pale brown, repairable.
- Zone of translucent dentin: Bacteria causing destruction.
Dentin's Protective Mechanisms:
- Translucent (Sclerotic) Dentin: Odontoblasts lay down calcification, plugging tubules. Slows acid and toxin penetration, protects pulp.
- Tertiary Dentin: Produced when pulp inflames. Two types:
  - Reactionary: Mild irritant.
  - Reparative: Strong irritant.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Explore the histopathology and clinical features of enamel caries through this comprehensive quiz. Learn to identify IDAS scores and the significance of visual and histological changes in tooth enamel. This quiz will enhance your understanding of the zones of destruction and the clinical appearance of carious lesions.