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48 Cards in this Set
- Front
- Back
definition of caries
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infectious microbiological disease that results in localized dissolution and destruction of calcified tissues of the teeth
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there is a constant balance between demineralization and remineralization, when does demineralization take over?
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at a pH below 5.5
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formula for decay process
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1. bacteria (mutans S.) + CHO (carbohydrate) matrix = bacterial plaque (acidic)
2. acid plaque + susceptible tooth + time = dental caries |
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1) what 3 things do you need to form caries?
2) what other things affect dental caries forming? |
1. - tooth
- plaque (bacteria) - diet 2. - topical fluoride - time - saliva (important in remineralization) - immune system (income, knowledge, attitude, behavior, education, socioeconomic status) |
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types of carious lesions?
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- pit and fissure lesions
- smooth surface lesions - root surface lesions - recurrent lesions |
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what % of the pop. was affected by dental caries in 1987? what % of kids were carries free?
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95%; 50%
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why has there recently been a decline in caries ?
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fluoridation, education, dental insurance
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Pit and Fissure Lesions
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common in younger generation (caused by defect - enamel not fused. can be detected w/ magnification and tooth dry):
1. enamel (triangle apex toward occlusion) a. small site of origin b. base widens towards DEJ c. slow to moderate progression (2-4 yrs) 2. dentin (triangle apex towards pulp) a. wide base at DEJ b. apex of cone towards pulp |
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saliva is important in what?
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remineralization
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smooth surface lesions
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problem w/ oral hygiene (don't floss). located gingival to contact area. mainly picked up by X-rays. 2 types:
1. enamel (triangle shaped) a. wide area of origin b. apex towards DEJ c. slow initial progression (4 yrs) d. once reaches DEJ it spreads 2. dentin (triangle shaped) a. wide base at DEJ b. apex of cone towards pulp |
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root surface lesions
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- begin directly on cementum/dentin
- pot hole shaped - rapid progression |
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caries in enamel:
1. zone 1 2. zone 2 3. zone 3 4. zone 4 |
1. translucent zone (deepest)
2. dark zone (remineralization) 3. body zone (demineralization) 4. surface zone (clinically intact) |
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what are the steps that take place when a cavity is formed in dentin?
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1. invasion of bacteria into dentin
- mutans S. initiates (enamel, aerobic) - lactobacillus propagates (dentin) 2. organic acids demineralize dentine 3. collagen is degenerated/dissolved 4. loss of structural integrity (cavity) |
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sclerotic dentin
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- affected dentin (not infected, but hard and stained)
- deposition of crystalline minerals in dentinal tubules (hypermineralization) - function: occlude tubules - slow, long term irration - hard, shiny, possibly discolored |
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sclerosis
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hardening
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reparative dentin (reparative secondary dentin)
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- formation of tertiary dentin by odontoblast-like cells
- between pulp tissue and dentin (PDJ) - intermediate level of irritation |
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physiologic secondary dentin
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layed down as tooth ages, making pulp smaller
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primary dentin
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dentin layed down as tooth forms
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pulpal necrosis
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- result of severe irritation
- infection, death of pulp, abscess |
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prevention of caries
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- early detection of caries (demineralized)
- daily oral hygiene - sealants - fluoride application - diet - immunization |
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sealants
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most effective in pits and fissures; protective coat of resin
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control of non-cavitated lesions
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1. daily oral hygiene
2. remineralization - fluoride application - MI paste (recaldent) 3. chewing zylitol gum 4. routine check-ups |
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control of cavitated lesions
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- surgical removal of decay and weak structures (preparation)
- restored w/ material of choice - quality of your restorations is a factor for long term health and prevention of recurrent decay and periodontitis |
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what does CAMBRA stand for?
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caries management by risk assessment
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1. are E1 and E2 usually cavitated lesions?
2. are D1 and D2 cavitated lesions? |
1. usually not cavitated, try to remineralize
2. D1 might be cavitated 3. D2 is definitely cavitated |
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Lesions:
1. E1 2. E2 3. D1 4. D2 5. D3 |
1. out 1/2 of enamel
2. inner 1/2 of enamel 3. outer 1/3 of dentin 4. middle 1/3 of dentin 5. inner 1/3 of dentin |
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operative dentistry
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part of restorative dentistry involving assessment, prevention, and treatment of diseases and defects of the hard tissues of individual teeth to maintain or restore functional, physiologic, and esthetic integrity and health
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in addition to quadrants the mouth can also be divided into sextants, or sixths. where does this division occur?
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between the canines and 1st premolars
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how is each tooth identified?
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by the arch, side, primary or permanent, and then the individual name. Ex. mandibular left permanent first molar
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interproximal contact
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contact between 2 adj. teeth
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groove
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linear channel between enamel elevations
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fissure
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developmental linear cleft usually found at the base of a groove
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pit
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small depression in enamel, usually located in a groove, and often at the junction of 2 or more fissures
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fossa
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hollow, rounded, or depressed area in the enamel surface of a tooth
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1. pulpal wall (floor) of cavity preparation
2. axial wall |
1. occlusal portion of preparation, wall adj. pulp chamber
2. wall adj. or nearest pulp chamber or pulp canals and is parallel to long axis fo tooth |
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point angle
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junction of 3 walls
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line angle
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junction of 2 walls in a cavity preparation
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margins
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formed by junction of a cavity wall and an external tooth surface
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anatomic crown
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portion that extends from cementoenamel junction or cervical line
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clinical crown
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portion visible to oral cavity
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class 1 lesions
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occur in pits and fissures on facial, lingual, and occlusal surfaces of molars and premolars and less often lingual surfaces of max. anterior teeth
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class 2 lesions
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proximal surfaces of posterior teeth
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class 3 lesions
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proximal surfaces of anterior teeth (do not involve incisal angle)
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class 4 lesions
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occur in the proximal surfaces of anterior teeth when incisal angle requires restoration
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class 5 lesions
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smooth facial and lingual surfaces in gingival 3rd of teeth
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class 6 lesions
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pit or wear defects on incisal edges of anterior teeth or cusp tips of posterior teeth
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black's steps in cavity preparation
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1. est. outline form
2. obtain resistance form 3. obtain retention form 4. obtain convenience form 5. remove remaining carious dentin 6. finish enamel walls and cavosurface margins 7. clean preparation |
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excavators
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cutting instruments, used in shaping tooth preparation
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