Podcast
Questions and Answers
What happens when the organic plug fails in the fissure?
What happens when the organic plug fails in the fissure?
- Bacteria have limited access to the depths of the fissure
- Bacteria have no access to the depths of the fissure
- The fissure walls move further apart
- Bacteria have full access to the depths of the fissure (correct)
Which part of the fissure may not be decalcified and thus undetectable by a probe?
Which part of the fissure may not be decalcified and thus undetectable by a probe?
- The enamel defects in the fissure wall (correct)
- The area near the organic plug
- The decalcified enamel
- The dentin under the decalcified enamel
What is the purpose of intraoral examination in the context of fixed prosthodontics considerations?
What is the purpose of intraoral examination in the context of fixed prosthodontics considerations?
- To examine the arch curvature and crown root ratio (correct)
- To identify caries and defective restorations
- To assess occlusion and root configuration
- To analyze pulp vitality and percussion
Which traditional technique for examining proximal smooth surface caries involves using a curved explorer?
Which traditional technique for examining proximal smooth surface caries involves using a curved explorer?
Which of the following abnormalities may be detected during intraoral examination for fixed prosthodontics?
Which of the following abnormalities may be detected during intraoral examination for fixed prosthodontics?
What is the purpose of using transillumination to examine proximal caries?
What is the purpose of using transillumination to examine proximal caries?
What type of radiographic examination is NOT typically used in fixed prosthodontics diagnosis?
What type of radiographic examination is NOT typically used in fixed prosthodontics diagnosis?
Which traditional technique for examining proximal smooth surface caries involves the use of a bitewing x-ray?
Which traditional technique for examining proximal smooth surface caries involves the use of a bitewing x-ray?
During the clinical examination of teeth, which type of caries may tend to occur bilaterally and on adjacent proximal surfaces?
During the clinical examination of teeth, which type of caries may tend to occur bilaterally and on adjacent proximal surfaces?
Which traditional technique for examining proximal smooth surface caries can detect a shadow under the marginal ridge?
Which traditional technique for examining proximal smooth surface caries can detect a shadow under the marginal ridge?
What adjunctive diagnostic aid is used to assess the vitality of the pulp in fixed prosthodontics?
What adjunctive diagnostic aid is used to assess the vitality of the pulp in fixed prosthodontics?
Which type of defect is NOT included in the category of non-carious defects detectable during intraoral examination?
Which type of defect is NOT included in the category of non-carious defects detectable during intraoral examination?
What is the purpose of the Cariogram?
What is the purpose of the Cariogram?
Which sector of the Cariogram represents the patient's diet?
Which sector of the Cariogram represents the patient's diet?
What does a larger green sector in the Cariogram indicate?
What does a larger green sector in the Cariogram indicate?
Which of the following factors is NOT considered in the 'Susceptibility' sector of the Cariogram?
Which of the following factors is NOT considered in the 'Susceptibility' sector of the Cariogram?
What is the relationship between the 'Chance to avoid caries' and caries risk?
What is the relationship between the 'Chance to avoid caries' and caries risk?
Which sector of the Cariogram is based on a combination of past caries experience and related diseases?
Which sector of the Cariogram is based on a combination of past caries experience and related diseases?
Which of the following statements about radiographic examination of caries is correct?
Which of the following statements about radiographic examination of caries is correct?
According to the digitally created Caries Classification, what does the letter 'M' represent?
According to the digitally created Caries Classification, what does the letter 'M' represent?
Which of the following statements about incipient interproximal caries is correct?
Which of the following statements about incipient interproximal caries is correct?
What does the term 'moderate' refer to in the context of interproximal caries?
What does the term 'moderate' refer to in the context of interproximal caries?
Which of the following statements about bitewing radiographs is correct?
Which of the following statements about bitewing radiographs is correct?
Which of the following statements is correct regarding the radiographic detection of caries?
Which of the following statements is correct regarding the radiographic detection of caries?
What is the recommended treatment for mild cases of tooth misalignment?
What is the recommended treatment for mild cases of tooth misalignment?
Which of the following is a common problem associated with the second molar abutment?
Which of the following is a common problem associated with the second molar abutment?
What is a potential solution for a tilted or malaligned abutment tooth?
What is a potential solution for a tilted or malaligned abutment tooth?
What is a potential issue with short abutment teeth?
What is a potential issue with short abutment teeth?
What is a potential solution for an overerupted abutment tooth?
What is a potential solution for an overerupted abutment tooth?
What is a potential issue with an overerupted abutment tooth?
What is a potential issue with an overerupted abutment tooth?
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Study Notes
Fissure Caries
- Decalcification occurs when the organic plug fails, allowing bacteria to access the depths of the fissure.
- The fissure walls are in close proximity, making it difficult for a probe to detect caries.
Modern Fissure Caries Model (Coke Bottle Shape Fissure)
- The model consists of:
- Organic plug
- Area that may not be decalcified, making it difficult for a probe to detect
- Enamel defects in the fissure wall
- Decalcified enamel (caries in this zone is undetectable by probe)
- De-mineralized dentin
Traditional Techniques of Examination of Proximal Smooth Surface Caries
- Visual Method:
- A white chalky appearance or a shadow under the marginal ridge
- Visual with temporary tooth separation
- Tactile examination:
- Probing with a curved explorer may detect cavitation occlusal or cervical to the contact area
- Radiograph:
- Bitewing x-ray is usually used to diagnose proximal caries
- Transillumination:
- Placing a light source on the lingual side of the anterior teeth and directing the light through the teeth
Intra Oral Examination
- Includes any abnormality in the mucosa, tongue, cheeks, palate, and teeth
- Should be performed under good operatory light
Clinical Examination of Teeth
- May reveal:
- Caries:
- Pit & fissure
- Smooth surface (proximal or facial and lingual)
- Defective Restorations:
- Amalgam
- Cast restoration
- Tooth-colored restoration
- Non-carious defects:
- Hypo calcification
- Abrasion
- Abfraction
- Erosion
- Attrition
- Fracture lines
- Hypersensitivity
- Caries:
Radiographic Examination
- Includes:
- Periapical radiographic
- Bitewing
- Panoramic
- Digital radiography
Adjunctive Diagnostic Aids
- Percussion
- Palpation
- Pulp vitality
Fixed Prosthodontics Department
- Intraoral Examination
- Lecturer: Dr. Sherif Samir
- Lecturer of Fixed Prosthodontics
- MSA University
Lecture Outline
- Cause of discoloration
- Abnormal Coronal form and size
- Occlusion
- Spam length
- Arch curvature
- Crown root ratio
- Root configuration
- Diagnostic Wax-up
Case Analysis
- Mild cases may be adjusted by enameloplasty
- Severe cases may require elective root canal treatment or full coverage high-strength material
Diagnostic Wax-up
- Identify the relative information required for proper diagnosis
- Analyze the collected data and recognize the relative information to determine patients' diagnosis
Problems Encountered in the Abutment Teeth
- Malaligned teeth
- Solutions:
- Orthodontic up-righting
- Restoring or recontouring mesial surface of third molar
- Proximal half crown as a retainer on tilted abutment
- Telescopic crown on the tilted molar to modify the path of insertion
- Non-rigid connector used on the anterior abutment
- Crowning of abutments to compensate for the narrow space without constructing a pontic
- Short teeth
- Overerupted teeth
- Solutions:
- Orthodontic intrusion
- Simple contouring of plunger cusp and topical application of fluoride
- Onlay preparation
- Crowning of over-erupted tooth
- Endodontic treatment and crowning of over-erupted tooth
Caries Risk Assessment
- Cariogram:
- A unique PC software that draws a pie circle-diagram
- Shows if the patient is at high, intermediate, or low risk for caries
- Used for clinical purposes, educational, and preventive
- The Cariogram is divided into five sectors:
- Diet (dark blue)
- Bacteria (red)
- Susceptibility (light blue)
- Circumstances (yellow)
- Actual chance to avoid new cavities (green)
Traditional Method of Examination of Caries
- Radiographic Examination:
- Caries is regularly found beneath a seemingly intact enamel surface
- Frequently, the diagnosis of occlusal caries cannot be done by radiograph unless it reaches a considerable size
- Radiograph is not reliable for detecting early stages of caries
Caries Classification
- Digitally created Caries Classification:
- I: Incipient (Stage I)
- M: Moderate (Stage II)
- A: Advanced (Stage III)
- S: Severe (Stage IV)
Interproximal Caries
- Incipient (Stage I):
- Up to half the thickness of enamel
- Usually not restored unless the patient has a high level of caries activity (high risk)
- Treated with fluoride and oral hygiene measures
- Moderate (Stage II):
- More than halfway through the enamel (up to DEJ)
- The bottom arrow points to a moderate lesion on the distal of #20
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