Principles of cavity prep/management of Pit/Fissure Caries

• What is GV Blacks Classification of Caries?

  Developed a standard method of classifying dental caries based on surfaces of teeth involved
• What does GV Blacks Classification of caries NOT include?

  1) Root caries2) secondary caries 3) non-carious tooth surface loss
• What is Class I classification?

  
• What is Class II classification?

  
• What is Class III Classification?

  proximal of incisors and canines does not involve incisal angle
• What is Class IV classification?

  
• What is Class V Classification?

  
• Types of classification by process of disease

  1) pit and fissure caries

  2) coronal smooth surface caries - mesial, distal, buccal or lingual

  3) Cervical margin and root surface caries

  4) Secondary caries around restoration margins
• How is caries diagnosed?

  Signs :1) visual 2) tactile 3) radiographic 4) transillumination

  Symptoms: 1) Pain 2) Tactile
• How do we detect pit and fissure caries?

  • Rake debris
  • Remove plaque
  • Confirm frank cavitation
  • Check for dentine involvement
• What does ICDAS stand for?

  International Caries Assessment and Detection System
• How is Pit and Fissure Caries managed?

  1) Preventative measures

  2) Fissure seal 'at risk' teeth

  3) PRR (Preventative Resin Restoration)

  4) Restore minimal cavities with composite

  5) Restore extensive cavities with composite or amalgam
• How can caries be prevented?

  1) Diet 2)Oral Hygiene Routine 3) Fluoride Therapy 4) Regular review 5) Correction of Iatrogenic Plaque Retention Factors 6) Enhancing Saliva production 7) Fissure Sealants
• How are PRR's Preventative and Conservative?

  Preventive, Minimal cavities in part of fissure system, Remaining fissures are sealed for prevention

  Conservative, Adhesive resin will support undermined enamel, Retention is from adhesion
• What are the principles of cavity preparation?

  Gain access to carious lesion Remove peripheral caries Stop, look, think about design Choose restorative material Be prepared to modify decisions
• When using amalgam, what is meant by retention form and resistance form?

  RETENTION FORM – Features of the cavity preparation that will oppose forces which could displace the restoration against the path of insertion e.g the cavity shape RESISTANCE FORM –Features of the cavity preparation that will oppose compressive and oblique displacing forces
• What is placed on the bottom layer of enamel before placing amalgam to protect the pulp?

  Calcium hydroxide cement
• What are the principles of cavity design dependent on?

  - structure & properties of dental tissues- the disease or damage- the individual- properties of restorative material available
• What are examples of Cavity Linings?


  Varnish, Lining, Base ----------------------> increase in thickness
• What are some properties of Calcium Hydroxide cement?

  • Popular
  • Stimulates odontoblasts to increase dentine thickness
  • Less adherent to dentine than glass ionomer or composite
  • Not suitable as bulk material
  • Weak
  • Used in deep cavities where pulp is glowing through
• Glass Ionomer can be used as a cement/base/liner material, it bonds to dentine and can protect calcium hydroxide in deep cavities, true or false?

  True
• What is the purpose of finishing and polishing?

  Prevents food and plaque retention Prevents soft tissue irritation Corrects small defects of contour Composite can be finished immediately inmost cases Amalgam requires at least 24hrs to set