Podcast
Questions and Answers
Where does Class V smooth surface caries occur?
Where does Class V smooth surface caries occur?
What is a characteristic feature of non-cavitated enamel carious lesions?
What is a characteristic feature of non-cavitated enamel carious lesions?
How can you detect a non-cavitated lesion in enamel?
How can you detect a non-cavitated lesion in enamel?
What can be observed about the surface texture of a non-cavitated lesion?
What can be observed about the surface texture of a non-cavitated lesion?
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What does a rough surface on an advanced lesion indicate?
What does a rough surface on an advanced lesion indicate?
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Why are chipped areas of advanced lesions difficult to remineralize?
Why are chipped areas of advanced lesions difficult to remineralize?
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What is the primary function of the etched crystallites in the enamel rods during remineralization?
What is the primary function of the etched crystallites in the enamel rods during remineralization?
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Which type of carious lesion is often seen in older patients with low caries activity?
Which type of carious lesion is often seen in older patients with low caries activity?
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What is the primary limitation of using radiographs for caries diagnosis?
What is the primary limitation of using radiographs for caries diagnosis?
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When is restorative treatment not indicated for arrested caries lesions?
When is restorative treatment not indicated for arrested caries lesions?
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What is the purpose of using bitewing radiographs for the diagnosis of proximal lesions?
What is the purpose of using bitewing radiographs for the diagnosis of proximal lesions?
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What is the primary function of the crystalline framework of the enamel rods during remineralization?
What is the primary function of the crystalline framework of the enamel rods during remineralization?
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What is the normal width of the periodontal membrane space?
What is the normal width of the periodontal membrane space?
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Which of the following is not a factor affecting the crown-root ratio?
Which of the following is not a factor affecting the crown-root ratio?
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According to Ante's law, the total periodontal membrane area of abutments should be:
According to Ante's law, the total periodontal membrane area of abutments should be:
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Which type of occlusal bite may dictate the choice of retainer type, material, and bridge?
Which type of occlusal bite may dictate the choice of retainer type, material, and bridge?
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In a cross-bite, the functional cusps are:
In a cross-bite, the functional cusps are:
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What is the implication of a wide periodontal membrane space?
What is the implication of a wide periodontal membrane space?
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What is the earliest clinical evidence of incipient caries on smooth surfaces?
What is the earliest clinical evidence of incipient caries on smooth surfaces?
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Which traditional technique is used to examine proximal smooth surface caries?
Which traditional technique is used to examine proximal smooth surface caries?
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What is the appearance of proximal surface caries on the marginal ridge?
What is the appearance of proximal surface caries on the marginal ridge?
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What is the main limitation of radiographs mentioned in the text?
What is the main limitation of radiographs mentioned in the text?
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What is the significance of frayed or threaded unwaxed dental floss when passed interproximally?
What is the significance of frayed or threaded unwaxed dental floss when passed interproximally?
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Based on the analogy, what does an 80% risk for strong winds represent in terms of caries risk assessment?
Based on the analogy, what does an 80% risk for strong winds represent in terms of caries risk assessment?
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Which type of film should be used for diagnosing proximal lesions?
Which type of film should be used for diagnosing proximal lesions?
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Which of the following factors is NOT mentioned as being important for producing an accurate weather forecast in the analogy provided?
Which of the following factors is NOT mentioned as being important for producing an accurate weather forecast in the analogy provided?
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What is the appearance of proximal surface caries on the marginal ridge?
What is the appearance of proximal surface caries on the marginal ridge?
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What is the comparison made in the text regarding caries risk assessment?
What is the comparison made in the text regarding caries risk assessment?
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What is the significance of the color of acute (rapid) caries lesions?
What is the significance of the color of acute (rapid) caries lesions?
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What is the purpose of the analogy provided in the text?
What is the purpose of the analogy provided in the text?
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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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Description
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.
