30 Questions
Where does Class V smooth surface caries occur?
At the gingival 1/3 of facial and lingual surfaces of all teeth
What is a characteristic feature of non-cavitated enamel carious lesions?
Chalky white, opaque areas
How can you detect a non-cavitated lesion in enamel?
By visual inspection
What can be observed about the surface texture of a non-cavitated lesion?
It is undetectable by tactile examination
What does a rough surface on an advanced lesion indicate?
Active caries
Why are chipped areas of advanced lesions difficult to remineralize?
They have extensive sub-surface porosity
What is the primary function of the etched crystallites in the enamel rods during remineralization?
To act as nucleating agents for remineralization
Which type of carious lesion is often seen in older patients with low caries activity?
Arrested caries
What is the primary limitation of using radiographs for caries diagnosis?
Radiographs provide a two-dimensional representation of a three-dimensional object
When is restorative treatment not indicated for arrested caries lesions?
When the lesion interferes with esthetics
What is the purpose of using bitewing radiographs for the diagnosis of proximal lesions?
To avoid horizontal overlapping of adjacent teeth
What is the primary function of the crystalline framework of the enamel rods during remineralization?
To provide a template for the deposition of new minerals
What is the normal width of the periodontal membrane space?
0.18-0.25 mm
Which of the following is not a factor affecting the crown-root ratio?
Reduction in tooth length due to orthodontic treatment
According to Ante's law, the total periodontal membrane area of abutments should be:
Greater than the tooth or teeth to be replaced
Which type of occlusal bite may dictate the choice of retainer type, material, and bridge?
Deep bite
In a cross-bite, the functional cusps are:
Reversed, with the bevel placed on the buccal cusp of maxillary teeth and the lingual cusps of mandibular teeth
What is the implication of a wide periodontal membrane space?
Occlusal trauma, prematurity, and looseness
What is the earliest clinical evidence of incipient caries on smooth surfaces?
A white spot that disappears when wet and reappears when dried
Which traditional technique is used to examine proximal smooth surface caries?
All of the above
What is the appearance of proximal surface caries on the marginal ridge?
A dark discoloration due to the carious lesion absorbing more light
What is the main limitation of radiographs mentioned in the text?
They are susceptible to processing errors and human variables.
What is the significance of frayed or threaded unwaxed dental floss when passed interproximally?
It indicates the presence of proximal surface caries
Based on the analogy, what does an 80% risk for strong winds represent in terms of caries risk assessment?
The risk of the patient developing caries is high, but not absolute.
Which type of film should be used for diagnosing proximal lesions?
Bitewing film
Which of the following factors is NOT mentioned as being important for producing an accurate weather forecast in the analogy provided?
Barometric pressure
What is the appearance of proximal surface caries on the marginal ridge?
A dark discoloration due to the carious lesion absorbing more light
What is the comparison made in the text regarding caries risk assessment?
It is compared to predicting the weather.
What is the significance of the color of acute (rapid) caries lesions?
They are typically lighter in color
What is the purpose of the analogy provided in the text?
To demonstrate the complexity of caries risk assessment.
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
Test your knowledge on diagnosing proximal surface caries in dentistry. Learn about the traditional techniques used to identify carious lesions, such as the dental floss method. Understand how the appearance of dark areas along the marginal ridge can indicate caries.
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