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Caries - Diagnosis

Clinical Examination: Probing of the margins

Radiographic Examination of Teeth and Restorations


 

Proximal caries-susceptible zone. This region extends from the contact point (upper arrow) down to the height of the free gingival margin (lower arrow). It increases with recession of the alveolar bone and gingival tissues.


A. Radiograph of an extracted tooth with a lesion just into dentin in the left side (circle) but no visible lesion in the right side.
B, The same tooth after sectioning assessed under a microscope reveals lesions in both sides; the lesion in the right side is only in enamel. Enamel in the left side has broken off during sectioning

Arrested caries and cervical burnout can deceive diagnosis

Cervical burnout.

  • Presents as a diffuse radiolucent area on the interproximal surfaces of the root apical to the cemento-enamel junction.
  • Created by decreased x-ray attenuation of the cementum as it is very thin and unable to stop x- rays from reaching the image receptor.
  • No visible tooth structure missing in this area.
Radiographic examination


Activity Assessment Factor

Caries Lesion Activity Assessment
DESCRIPTORS Likely to Be Inactive/ArrestedLikely to Be Active
Location of the LesionLesion is not in a plaque stagnation area
Lesion is in a plaque stagnation area (pit/fissure, approximal, gingival)
Plaque Over the LesionNot thick or stickyThick and/or sticky

Surface AppearanceShiny; color: brown-blackMatte/opaque/loss of luster;
color: white-yellowTactile
FeelingSmooth, hard enamel/hard dentin
Rough enamel/soft dentinGingival Status (If the Lesion is Located Near the Gingiva)
No inflammation, no bleeding on probingInflammation, bleeding on probing

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