Proximal Surface Caries Diagnosis Quiz

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Questions and Answers

Where does Class V smooth surface caries occur?

  • On the occlusal surface of molars
  • At the gingival 1/3 of facial and lingual surfaces of all teeth (correct)
  • At the middle third of facial surfaces
  • At the incisal edges of anterior teeth

What is a characteristic feature of non-cavitated enamel carious lesions?

  • Visible holes on the tooth surface
  • Yellow discoloration
  • Chalky white, opaque areas (correct)
  • Gingival bleeding upon probing

How can you detect a non-cavitated lesion in enamel?

  • By tactile examination
  • By observing yellow spots
  • By using a dental explorer
  • By visual inspection (correct)

What can be observed about the surface texture of a non-cavitated lesion?

<p>It is undetectable by tactile examination (B)</p> Signup and view all the answers

What does a rough surface on an advanced lesion indicate?

<p>Active caries (B)</p> Signup and view all the answers

Why are chipped areas of advanced lesions difficult to remineralize?

<p>They have extensive sub-surface porosity (C)</p> Signup and view all the answers

What is the primary function of the etched crystallites in the enamel rods during remineralization?

<p>To act as nucleating agents for remineralization (C)</p> Signup and view all the answers

Which type of carious lesion is often seen in older patients with low caries activity?

<p>Arrested caries (D)</p> Signup and view all the answers

What is the primary limitation of using radiographs for caries diagnosis?

<p>Radiographs provide a two-dimensional representation of a three-dimensional object (C)</p> Signup and view all the answers

When is restorative treatment not indicated for arrested caries lesions?

<p>When the lesion interferes with esthetics (B)</p> Signup and view all the answers

What is the purpose of using bitewing radiographs for the diagnosis of proximal lesions?

<p>To avoid horizontal overlapping of adjacent teeth (A)</p> Signup and view all the answers

What is the primary function of the crystalline framework of the enamel rods during remineralization?

<p>To provide a template for the deposition of new minerals (D)</p> Signup and view all the answers

What is the normal width of the periodontal membrane space?

<p>0.18-0.25 mm (B)</p> Signup and view all the answers

Which of the following is not a factor affecting the crown-root ratio?

<p>Reduction in tooth length due to orthodontic treatment (B)</p> Signup and view all the answers

According to Ante's law, the total periodontal membrane area of abutments should be:

<p>Greater than the tooth or teeth to be replaced (D)</p> Signup and view all the answers

Which type of occlusal bite may dictate the choice of retainer type, material, and bridge?

<p>Deep bite (A)</p> Signup and view all the answers

In a cross-bite, the functional cusps are:

<p>Reversed, with the bevel placed on the buccal cusp of maxillary teeth and the lingual cusps of mandibular teeth (C)</p> Signup and view all the answers

What is the implication of a wide periodontal membrane space?

<p>Occlusal trauma, prematurity, and looseness (A)</p> Signup and view all the answers

What is the earliest clinical evidence of incipient caries on smooth surfaces?

<p>A white spot that disappears when wet and reappears when dried (A)</p> Signup and view all the answers

Which traditional technique is used to examine proximal smooth surface caries?

<p>All of the above (D)</p> Signup and view all the answers

What is the appearance of proximal surface caries on the marginal ridge?

<p>A dark discoloration due to the carious lesion absorbing more light (C)</p> Signup and view all the answers

What is the main limitation of radiographs mentioned in the text?

<p>They are susceptible to processing errors and human variables. (B)</p> Signup and view all the answers

What is the significance of frayed or threaded unwaxed dental floss when passed interproximally?

<p>It indicates the presence of proximal surface caries (D)</p> Signup and view all the answers

Based on the analogy, what does an 80% risk for strong winds represent in terms of caries risk assessment?

<p>The risk of the patient developing caries is high, but not absolute. (D)</p> Signup and view all the answers

Which type of film should be used for diagnosing proximal lesions?

<p>Bitewing film (B)</p> Signup and view all the answers

Which of the following factors is NOT mentioned as being important for producing an accurate weather forecast in the analogy provided?

<p>Barometric pressure (B)</p> Signup and view all the answers

What is the appearance of proximal surface caries on the marginal ridge?

<p>A dark discoloration due to the carious lesion absorbing more light (A)</p> Signup and view all the answers

What is the comparison made in the text regarding caries risk assessment?

<p>It is compared to predicting the weather. (A)</p> Signup and view all the answers

What is the significance of the color of acute (rapid) caries lesions?

<p>They are typically lighter in color (D)</p> Signup and view all the answers

What is the purpose of the analogy provided in the text?

<p>To demonstrate the complexity of caries risk assessment. (D)</p> Signup and view all the answers

Flashcards

Class V Caries Location

Class V caries occurs on the gingival 1/3 of facial and lingual surfaces, excluding the palatal of upper anteriors.

Appearance of Early Class V Caries

Early Class V caries may look chalky white when demineralized or discolored and soft.

Visual Detection of Cervical Caries

Visual signs include cavitation and chalky white areas appearing when the tooth surface is dry.

White Spot Lesions

These appear as chalky white, opaque spots when the tooth surface is dried.

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Loss of Enamel Translucency

Loss of translucency indicates extensive subsurface porosity from demineralization.

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Remineralization

Non-cavitated lesions can regain minerals and become sound again.

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Characteristics of Advanced Caries

Advanced lesions feel rough, are softer, and are easily chipped away with an explorer.

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Dental Floss Detection of Caries

Floss shreds or frays when passing between teeth with rough carious margins.

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Visual Signs of Proximal Caries

Chalky white or dark discoloration or cavitation on the marginal ridge.

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Limitation of Radiographs

Radiographs are 2D images of a 3D structure, and interpretation requires care.

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Radiographic Distortion

Changes in cone angulation can result in elongation or shortening of structures on a radiograph.

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Best Radiograph for Caries Detection

Bitewing radiographs display posterior teeth to avoid horizontal overlapping of adjacent teeth.

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Factors Affecting Crown Root Ratio

Crown-root ratio is altered by attrition, bone resorption, periapical pathosis, or root reduction.

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Normal Periodontal Membrane Space Width

Normal range is typically 0.18-0.25 mm.

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Narrow Periodontal Membrane Space

Narrow periodontal membrane space on the functionless side.

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Wide Periodontal Membrane Space

Wide periodontal membrane space is associated with occlusal trauma, prematurity, and looseness.

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Deep Bite Definition

Increased vertical overlap of the incisors.

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Open Bite Definition

Lack of vertical overlap between the incisors.

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Posterior Crossbite

Maxillary teeth are positioned lingual to mandibular teeth.

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Crossbite and Functional Cusps

Crossbite affects the placement of functional cusp bevel.

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Ante's Law

The total periodontal membrane area of abutments should equal or exceed that of teeth being replaced.

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Purpose of Caries Risk Assessment

Caries risk assessment uses multiple factors to predict future caries development.

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Accuracy of Caries Risk Assessment

Risk forecasts need data to be accurate

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Attrition

Attrition is the wearing away of tooth structure due to tooth-to-tooth contact.

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Bone Resorption Impact

Alveolar bone resorption contributes to a less favorable crown-root ratio.

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Apexectomy & Crown-Root Ratio

Apex-ectomy reduces the root length, influencing crown-root ratio.

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Root Fracture Impact

Tooth fracture reduces the root length.

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Drifting

When teeth move into new positions, they can worsen the crown root ratio

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Normal Bite

Normal bite is a proper alignment of teeth

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Limitation Factors Radiographs

Radiographs film are susceptible to human variations, therefore, can introduce problems.

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Study Notes

Traditional Methods of Examination

  • Tactile examination:
    • Class V occurs at the gingival 1/3 of the facial and lingual surfaces of all teeth except the palatal surface of upper anterior teeth
    • May appear as chalky white demineralized areas or discolored soft carious lesions that can be penetrated by the explorer

Examination of Smooth Cervical Surface Caries

  • Visual examination:
    • Cavitation
    • Chalky white area that appears with dryness
    • Sensitivity with probing
  • Tactile examination:
    • White spots lesions: chalky white, opaque areas that are revealed only when the tooth surface is desiccated
    • Loss of translucency due to extensive sub-surface porosity caused by demineralization
    • Progression of caries in enamel: gradual increase in pore volume over time
    • Non-cavitated lesions can remineralize
    • Advanced lesions develop a rough surface that is softer than normal and can be chipped away with an explorer

Examination of Proximal Smooth Surface Caries

  • Dental floss method:
    • Pass unwaxed dental floss interproximally
    • If one or two adjacent teeth are carious, the floss will be threaded or frayed due to rough margin of the carious cavity
  • Visual examination:
    • Chalky white discoloration of marginal ridge
    • Dark discoloration of marginal ridge
    • Cavitation

Diagnosis of Dental Caries

  • Limitations of radiographs:
    • Radiographic image is a 2D representation of a 3D object
    • Care must be taken during interpretation
    • Elongation or shortening may result from changing vertical angulations of the cone
    • Processing of the film is susceptible to human variables and problems
    • Bitewing film should be used to avoid horizontal overlapping of adjacent teeth at this area

Factors Affecting Crown Root Ratio

  • Attrition, wear of the occlusal surface
  • Alveolar bone resorption
  • Periapical pathosis
  • Reduction of the root length due to apex–ectomy, root fracture
  • Root fracture
  • Drifting

Periodontal Membrane Space

  • Normal width: 0.18-0.25 mm
  • Narrow: functionless side
  • Wide: occlusal trauma, prematurity, and looseness

Occlusion

  • Deep bite
  • Open bite
  • Posterior crossbite
  • Normal bite
  • Crossbite: affects the place of functional cusp bevel
  • Ante's law: total periodontal membrane area of abutments should be equal to or exceed that of the tooth or teeth to be replaced

Caries Risk Assessment

  • Compared to weather forecast
  • Requires information on several factors
  • Produces an accurate risk report, but not absolutely certain

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