Radiographic Interp. 5A (Caries) Self-Study

Front 1

What is the range of caries severity on radiographs?

Back 1

R1-R4

Front 2

Which is worse, R1 or R4?

Back 2

R4

Front 3

Enamel caries less than half through enamel

R1, 2, 3 or 4?

Back 3

R1

Front 4

Enamel caries at least half through enamel but NOT involving DEJ

R1, 2, 3 or 4?

Back 4

R2

Front 5

Caries through DEJ but less than half way through dentin?

R1, 2, 3 or 4?

Back 5

R3

Front 6

Caries more than half way through dentin to pulp

R1, 2, 3 or 4?

Back 6

R4

Front 7

What classification (R1, 2, 3 or 4) describes incipient caries?

Back 7

R1

Front 8

What area of the tooth are caries most common?

Back 8

occlusal surface

Front 9

What type of caries are more common in kids and adolescents in posterior teeth?

Back 9

occlusal caries

Front 10

True or False, irregularities of pits and fissures of teeth can make someone more inherently prone to occlusal caries

Back 10

True

Front 11

Occlusal caries have a triangle shape in the enamel. The "base" of the triangle is towards the dentin or the outer surface?

Back 11

towards dentin

Front 12

When are occlusal caries visible on a radiograph?

Back 12

when it reaches DEJ

Front 13

True or False, radiographs are a solid way to diagnose occlusal caries

Back 13

False, you'll catch it too late

Front 14

Why are occlusal caries often invisible on radiographs?

Back 14

they are "hidden" by surrounding enamel that don't allow the carious lesion to be detected due to a lack of contrast

Front 15

Occlusal caries spread along what line?

Back 15

DEJ

Front 16

Occlusal caries are (RO/RL) line between enamel and dentin

Back 16

RL (duh...)

Front 17

When occlusal caries break through the DEJ, what pattern to they create as they spread further towards the pulp

Back 17

spherical (remember, they were triangular shaped in the enamel, but once they pass the DEJ, they spread like a sphere)

Front 18

How can occlusal caries eventually lead to collapse of enamel that was not initially diseased?

Back 18

Caries invades dentin and basically carves out under the enamel, giving it little support. Then, you bite down and collapse the enamel in the area.

Front 19

Radiographs can detect occlusal caries as a fine grey shadow under the ___

Back 19

DEJ

Front 20

Radiographs are only effective for occlusal caries once the caries reach the ___

Back 20

dentin (or DEJ)

Front 21

True or False, R1 occlusal caries are not typically visible on a radiograph

Back 21

True (must hit dentin before they can be seen)

Front 22

True or False, for occlusal caries, the enamel may appear intact even though there is clearly decay in the dentin

Back 22

True! You only need a very small hole for caries to spread and widen into the dentin. Enamel might look normal!

Front 23

For occlusal caries, you'll first notice a (narrow/wide) based RL zone in the dentin

Back 23

wide

Front 24

A band of increased opacity between lesion and pulp chamber in dentin is likely what?

Back 24

reparative dentin

Front 25

True or False, severe occlusal caries can be seen on radiographs only

Back 25

False, radiographs AND visually (duh, they're "severe")

Front 26

Interproximal caries develop (fast/slow)

Back 26

slow

Front 27

It takes __ years for interproximal caries to become clinically apparent

Back 27

3-4years

Front 28

What two areas do interproximal caries typically develop?

Back 28

1. just below contact point
2. on enamel between contact point and height of free gingival margin

Front 29

Interproximal caries will appear chalky-white and rough. Explain both of these findings.

Back 29

chalky-white due to demineralization of enamel, and rough for the same reason. Enamel breaks down and becomes rough and chalky.

Front 30

interproximal caries in the enamel create a triangle shape. The 'base' of this triangle is (towards the dentin/ towards the outer surface)

Back 30

towards the outer surface (this is OPPOSITE of direction in occlusal caries)

Front 31

What % of demineralization is needed before caries are seen on a radiograph?

Back 31

30-40%

Front 32

Why are incipient caries hard to detect on a radiograph?

Back 32

Not much demineralization so there's hardly any (if any at all) contrast for the X-ray to pick up on

Front 33

True or False, incipient caries are like all other caries and must be restored

Back 33

False! They can be reversed and remineralized

Front 34

True or False, once a lesion is more than halfway through the enamel, it is no longer considered incipient

Back 34

True (it's now an R2)

Front 35

R3 caries are when the lesion has invaded what area?

Back 35

dentin or past the DEJ (same thing)

Front 36

Why can caries that spread to dentin still affect the enamel?

Back 36

They can undermine the integrity of the enamel above it and lead to it's collapse

Front 37

Once caries have spread more than half way through the dentin, they are called:

R1, 2, 3 or 4?

Back 37

R4

Front 38

True or False, you can remineralize any lesion as long as it has not reached the DEJ

Back 38

False! Once it gets halfway through the enamel, it's no longer incipient!

Front 39

What type of caries appear as a dark thin RL line running through interproximal enamel into dentin, where the caries then spreads along DEJ?

Back 39

Lamellar caries

Front 40

True or False, because of the antimicrobial properties of the pulp, caries can technically never get all the way through the dentin to the pulp

Back 40

False, I completely made that up. You're welcome.

Front 41

True or False, if caries are severe enough to get into the pulp, you will know it from the radiograph

Back 41

False, caries are always worse clinically than radiographically and if it has just reached the pulp, you may not be able to tell on radiograph alone

Front 42

Occlusal caries are identifiable on a radiograph when they are:

R1
R2
R3
R4

Back 42

R3 and worse (So R3 and R4 only...)

Front 43

Why is it hard to detect caries interproximally of you have overlapping contacts?

Back 43

The contacts may cover up a carious lesion and it won't show up

Front 44

What is commonly misdiagnosed as caries around the gum line?

Back 44

cervical burn out

Front 45

What causes cervical burnout?

Back 45

the area between neck of tooth and root absorb less xrays... not related to disease

Front 46

On (posterior/anterior) teeth, cervical burnout is a RL triangle on proximal cervical neck

Back 46

posterior

Front 47

On (posterior/anterior) teeth, cervical burnout is a RL band across cervical neck of teeth

Back 47

anterior

Front 48

What type of treatment is needed if cervical burnout is detected?

Back 48

Nothing

Front 49

Why will cervical burnout sometimes show up or not show up in the same patient?

Back 49

often depends on horizontal angulation

Front 50

Facial and lingual caries are often seen as "___ ___"

Back 50

black holes (most worthless flashcard ever)

Front 51

The periphery of facial or lingual caries is often (poorly/well) demarcated

Back 51

well

Front 52

Cervical caries on the facial or lingual are often ___ shaped

Back 52

crescent

Front 53

Cemental caries are known by what two other names?

Back 53

1. root caries
2. radicular caries

Front 54

cemental caries start near the ___

Back 54

CEJ

Front 55

Cemental caries are (poorly/well) defined

Back 55

poorly

Front 56

Cementum is relatively (more/less) resistant to caries

Back 56

less

Front 57

What is a common medical cause of root caries in elderly?

Back 57

Xerostomia

Front 58

Cementum can slowly be exposed due to what in elderly people?

Back 58

gingival recession

Front 59

How do cemental caries look radiographically?

Back 59

ill-defined
saucer-shaped
"scooped-out"
discolored

Front 60

(acute/chronic) caries are often seen in childhood and ages 15-25

Back 60

acute

Front 61

People that frequently snack or have poor hygiene often have (acute/chronic) caries

Back 61

acute

Front 62

What spreads faster, acute or chronic caries?

Back 62

acute

Front 63

(acute/chronic) caries are initially small with rapid penetration and spread at DEJ

Back 63

acute

Front 64

What type of caries are described by poor diet, and extensive caries

Back 64

rampant caries

Front 65

sudden and uncontrollable destruction is a sign of ___ caries

Back 65

rampant

Front 66

Who gets rampant caries the most?

Back 66

young kids/teens
adults w/Xerostomia

Front 67

(acute/chronic) have a large surface entrance at initial stages

Back 67

chronic

Front 68

(acute/chronic) caries are more common in adults

Back 68

chronic

Front 69

The slow progress of (acute/chronic) caries allows time for sclerosis of tubules and 2ndary dentin

Back 69

chronic

Front 70

True or False, pain is very common in chronic caries

Back 70

False

Front 71

(primary/secondary) caries are defined as a new lesion with no prior cavity preparation

Back 71

primary

Front 72

What is another name for recurrent caries

Back 72

secondary caries (hmmm go figure...)

Front 73

What type of caries (primary/secondary) develop at margins of existing restorations?

Back 73

secondary

Front 74

If someone gets secondary caries, what might this indicate

Back 74

1. susceptible to caries
2. bad hygiene
3. poor restoration

Front 75

Why are secondary caries often hard to see?

Back 75

The existing restoration can "hide" them

Front 76

Caries are usually (more/less) severe than they look on a radiograph

Back 76

more

Front 77

(over/under) exposure can mask proximal caries

Back 77

over

Front 78

What type of non-carious phenomenon is mistaken for cervical caries?

Back 78

cervical burnout

Front 79

Bad (vertical/horizontal) angulation results in foreshortening or elongation

Back 79

vertical

Front 80

Bad (vertical/horizontal) angulation results in overlap of contacts

Back 80

horizontal

Front 81

List a few types of restorations that appear RL and may mimic caries

Back 81

1. older silicates
2. older Ca(OH)2
3. resins
4. some composites

Front 82

True or False, hypoplastic teeth (or enamel hypoplasia) can mimic caries

Back 82

True

Front 83

True or False, abrasion and attrition are the same thing

Back 83

false, abrasion is mechanical wear, attrition is physiologic wear

Front 84

If you brush too hard, you can get (abrasion/attrition) of the tooth structure

Back 84

abrasion

Front 85

What type of caries are indicated by the red arrow? purple arrow?

Back 85

Red - R3 (mesial)
Purple - R2 (distal)

Front 86

What opaque region is indicated by the green arrow?

Back 86

Reparative dentin

Front 87

What level are all three carious lesions?

Back 87

R1

Front 88

These caries can all be classified as interproximal and what level?

Back 88

R2

Front 89

The orange and blue box are what level of caries? (not the same)

Back 89

orange - R4
blue - R3

Front 90

These caries are at what level?

Back 90

R4

Front 91

What is the likely cause of this little area of radiolucency?

Back 91

cervical burnout

Front 92

What is indicated by the white arrows?

Back 92

Cervical burnout

Front 93

What is wrong with the root of this tooth?

Back 93

cemental caries

Front 94

What is wrong with the root of this tooth?

Back 94

Cemental caries

Front 95

A patient comes in and you take this radiograph. It is an adult with xerostomia and the claim they didn't have cavities like this a year ago. What is your diagnosis?

Back 95

rampant caries

Front 96

A patient comes in and you take this radiograph. You notice that the caries indicated by the black arrow have looked nearly identical on radiographs for this patient for a few years now. What is your diagnosis? (bonus: what does the orange arrow indicate?)

Back 96

Chronic caries, reparative dentin

Front 97

What kind of caries are indicated by the green arrows?

Back 97

Recurrent (aka secondary) caries. Notice that they are UNDER an existing restoration!

Front 98

What is indicated by the red arrow? purple arrow?

Back 98

red - recurrent caries
purple - R1 (incipient) interproximal carious lesion

Front 99

One of these is attrition and one is abrasion. Which is which?

Back 99

green - attrition
blue - abrasion

Front 100

What is indicated by the blue arrow?

Back 100

Gutta percha (root canal material)