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100 Cards in this Set
- Front
- Back
What is the range of caries severity on radiographs?
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R1-R4
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Which is worse, R1 or R4?
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R4
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Enamel caries less than half through enamel
R1, 2, 3 or 4? |
R1
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Enamel caries at least half through enamel but NOT involving DEJ
R1, 2, 3 or 4? |
R2
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Caries through DEJ but less than half way through dentin?
R1, 2, 3 or 4? |
R3
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Caries more than half way through dentin to pulp
R1, 2, 3 or 4? |
R4
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What classification (R1, 2, 3 or 4) describes incipient caries?
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R1
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What area of the tooth are caries most common?
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occlusal surface
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What type of caries are more common in kids and adolescents in posterior teeth?
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occlusal caries
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True or False, irregularities of pits and fissures of teeth can make someone more inherently prone to occlusal caries
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True
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Occlusal caries have a triangle shape in the enamel. The "base" of the triangle is towards the dentin or the outer surface?
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towards dentin
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When are occlusal caries visible on a radiograph?
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when it reaches DEJ
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True or False, radiographs are a solid way to diagnose occlusal caries
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False, you'll catch it too late
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Why are occlusal caries often invisible on radiographs?
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they are "hidden" by surrounding enamel that don't allow the carious lesion to be detected due to a lack of contrast
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Occlusal caries spread along what line?
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DEJ
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Occlusal caries are (RO/RL) line between enamel and dentin
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RL (duh...)
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When occlusal caries break through the DEJ, what pattern to they create as they spread further towards the pulp
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spherical (remember, they were triangular shaped in the enamel, but once they pass the DEJ, they spread like a sphere)
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How can occlusal caries eventually lead to collapse of enamel that was not initially diseased?
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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.
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Radiographs can detect occlusal caries as a fine grey shadow under the ___
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DEJ
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Radiographs are only effective for occlusal caries once the caries reach the ___
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dentin (or DEJ)
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True or False, R1 occlusal caries are not typically visible on a radiograph
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True (must hit dentin before they can be seen)
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True or False, for occlusal caries, the enamel may appear intact even though there is clearly decay in the dentin
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True! You only need a very small hole for caries to spread and widen into the dentin. Enamel might look normal!
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For occlusal caries, you'll first notice a (narrow/wide) based RL zone in the dentin
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wide
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A band of increased opacity between lesion and pulp chamber in dentin is likely what?
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reparative dentin
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True or False, severe occlusal caries can be seen on radiographs only
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False, radiographs AND visually (duh, they're "severe")
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Interproximal caries develop (fast/slow)
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slow
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It takes __ years for interproximal caries to become clinically apparent
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3-4years
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What two areas do interproximal caries typically develop?
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1. just below contact point
2. on enamel between contact point and height of free gingival margin |
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Interproximal caries will appear chalky-white and rough. Explain both of these findings.
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chalky-white due to demineralization of enamel, and rough for the same reason. Enamel breaks down and becomes rough and chalky.
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interproximal caries in the enamel create a triangle shape. The 'base' of this triangle is (towards the dentin/ towards the outer surface)
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towards the outer surface (this is OPPOSITE of direction in occlusal caries)
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What % of demineralization is needed before caries are seen on a radiograph?
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30-40%
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Why are incipient caries hard to detect on a radiograph?
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Not much demineralization so there's hardly any (if any at all) contrast for the X-ray to pick up on
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True or False, incipient caries are like all other caries and must be restored
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False! They can be reversed and remineralized
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True or False, once a lesion is more than halfway through the enamel, it is no longer considered incipient
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True (it's now an R2)
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R3 caries are when the lesion has invaded what area?
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dentin or past the DEJ (same thing)
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Why can caries that spread to dentin still affect the enamel?
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They can undermine the integrity of the enamel above it and lead to it's collapse
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Once caries have spread more than half way through the dentin, they are called:
R1, 2, 3 or 4? |
R4
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True or False, you can remineralize any lesion as long as it has not reached the DEJ
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False! Once it gets halfway through the enamel, it's no longer incipient!
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What type of caries appear as a dark thin RL line running through interproximal enamel into dentin, where the caries then spreads along DEJ?
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Lamellar caries
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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
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False, I completely made that up. You're welcome.
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True or False, if caries are severe enough to get into the pulp, you will know it from the radiograph
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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
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Occlusal caries are identifiable on a radiograph when they are:
R1 R2 R3 R4 |
R3 and worse (So R3 and R4 only...)
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Why is it hard to detect caries interproximally of you have overlapping contacts?
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The contacts may cover up a carious lesion and it won't show up
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What is commonly misdiagnosed as caries around the gum line?
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cervical burn out
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What causes cervical burnout?
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the area between neck of tooth and root absorb less xrays... not related to disease
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On (posterior/anterior) teeth, cervical burnout is a RL triangle on proximal cervical neck
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posterior
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On (posterior/anterior) teeth, cervical burnout is a RL band across cervical neck of teeth
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anterior
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What type of treatment is needed if cervical burnout is detected?
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Nothing
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Why will cervical burnout sometimes show up or not show up in the same patient?
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often depends on horizontal angulation
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Facial and lingual caries are often seen as "___ ___"
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black holes (most worthless flashcard ever)
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The periphery of facial or lingual caries is often (poorly/well) demarcated
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well
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Cervical caries on the facial or lingual are often ___ shaped
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crescent
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Cemental caries are known by what two other names?
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1. root caries
2. radicular caries |
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cemental caries start near the ___
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CEJ
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Cemental caries are (poorly/well) defined
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poorly
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Cementum is relatively (more/less) resistant to caries
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less
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What is a common medical cause of root caries in elderly?
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Xerostomia
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Cementum can slowly be exposed due to what in elderly people?
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gingival recession
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How do cemental caries look radiographically?
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ill-defined
saucer-shaped "scooped-out" discolored |
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(acute/chronic) caries are often seen in childhood and ages 15-25
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acute
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People that frequently snack or have poor hygiene often have (acute/chronic) caries
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acute
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What spreads faster, acute or chronic caries?
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acute
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(acute/chronic) caries are initially small with rapid penetration and spread at DEJ
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acute
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What type of caries are described by poor diet, and extensive caries
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rampant caries
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sudden and uncontrollable destruction is a sign of ___ caries
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rampant
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Who gets rampant caries the most?
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young kids/teens
adults w/Xerostomia |
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(acute/chronic) have a large surface entrance at initial stages
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chronic
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(acute/chronic) caries are more common in adults
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chronic
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The slow progress of (acute/chronic) caries allows time for sclerosis of tubules and 2ndary dentin
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chronic
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True or False, pain is very common in chronic caries
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False
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(primary/secondary) caries are defined as a new lesion with no prior cavity preparation
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primary
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What is another name for recurrent caries
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secondary caries (hmmm go figure...)
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What type of caries (primary/secondary) develop at margins of existing restorations?
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secondary
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If someone gets secondary caries, what might this indicate
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1. susceptible to caries
2. bad hygiene 3. poor restoration |
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Why are secondary caries often hard to see?
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The existing restoration can "hide" them
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Caries are usually (more/less) severe than they look on a radiograph
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more
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(over/under) exposure can mask proximal caries
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over
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What type of non-carious phenomenon is mistaken for cervical caries?
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cervical burnout
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Bad (vertical/horizontal) angulation results in foreshortening or elongation
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vertical
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Bad (vertical/horizontal) angulation results in overlap of contacts
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horizontal
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List a few types of restorations that appear RL and may mimic caries
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1. older silicates
2. older Ca(OH)2 3. resins 4. some composites |
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True or False, hypoplastic teeth (or enamel hypoplasia) can mimic caries
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True
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True or False, abrasion and attrition are the same thing
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false, abrasion is mechanical wear, attrition is physiologic wear
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If you brush too hard, you can get (abrasion/attrition) of the tooth structure
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abrasion
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What type of caries are indicated by the red arrow? purple arrow?
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Red - R3 (mesial)
Purple - R2 (distal) |
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What opaque region is indicated by the green arrow?
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Reparative dentin
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What level are all three carious lesions?
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R1
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These caries can all be classified as interproximal and what level?
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R2
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The orange and blue box are what level of caries? (not the same)
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orange - R4
blue - R3 |
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These caries are at what level?
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R4
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What is the likely cause of this little area of radiolucency?
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cervical burnout
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What is indicated by the white arrows?
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Cervical burnout
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What is wrong with the root of this tooth?
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cemental caries
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What is wrong with the root of this tooth?
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Cemental caries
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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?
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rampant caries
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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?)
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Chronic caries, reparative dentin
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What kind of caries are indicated by the green arrows?
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Recurrent (aka secondary) caries. Notice that they are UNDER an existing restoration!
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What is indicated by the red arrow? purple arrow?
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red - recurrent caries
purple - R1 (incipient) interproximal carious lesion |
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One of these is attrition and one is abrasion. Which is which?
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green - attrition
blue - abrasion |
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What is indicated by the blue arrow?
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Gutta percha (root canal material)
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