6. a) Visual-Tactile Examination
b) Conventional radiography
a) Digital Radiography
b) Enhanced Visual Techniques
c) Fluorescent Technique
d) Electric-Based Detection Systems
e) Ultrasound Techniques
f) Chemical Dyes
77. Score Surface Status Score Surface Status
0 Not sealed or restored 5 Stainless Steel Crowns
1 Sealant, partial 6 Porcelain or gold or PFM crown or veneer
2 Sealant, Full 7 Lost or broken restoration
3 Tooth Colored Restoration 8 Temporary restoration
4 Amalgam Restoration
9 Used for missed teeth due to one
of the following conditions:
97
98
99
Tooth extracted because of caries
Tooth extracted for reasons other than caries
Unerupted
80. Score Surface Status Score Surface Status
E Excluded root surfaces (no gingival
recession)
3 Cavitated (greater than 0.5mm in depth)
carious root surface— soft or leathery
0 Sound (no caries or restoration) 4 Cavitated (greater than 0.5mm in depth)
carious root surface—hard and glossy
1 Non-cavitated carious root surface— soft
or leathery
6 Extensive cavity: an extensive cavity
involves at least half of a tooth surface
and possibly reaching the pulp.
2 Non-cavitated carious root surface— hard
and glossy
7 Filled root with no caries
114. A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
129. A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
143. A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
165. A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
178. A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
182. A) DIGITAL RADIOGRAPHY
B) ENHANCED VISUAL TECHNIQUES
C) FLUORESCENT TECHNIQUE
D) ELECTRIC-BASED DETECTION SYSTEMS
E) ULTRASOUND TECHNIQUES
F) CHEMICAL DYES
209. 2 New Developments in Caries Removal and Restoration
rasion
minimal
ion and
surface
r abra-
is light
powder
d vari-
Fig. 2.5 The air abra-
sion handpiece is light
and the flow of powder
has a controlled vari-
able outflow
but they have the disadvantage that they can easily cause iatrogenic dam-
age by removing exposed cementum and root dentin in teeth affected by
gingival recession and periodontal disease. Atkinson et al. (1984) found that
their air-powder abrasive system removed a mean depth of 637µm of root
structure in 30s of exposure time. Further research aimed at identifying less
abrasive powders is ongoing (Petersilka et al. 2003), because softer particles
might be more effective in removing carious dentin more selectively. Lau-
214. Administration approved the erbium:YAG laser for caries removal in the USA.
The Fidelis erbium:YAG laser (Fotona, Ljubljana, Slovenia) is one example of
the commercially available lasers for dental use, but it is a rather large device
(Fig. 2.1), with settings for varying the cutting speed (Fig. 2.2).
Erbium:YAG laser treatment of teeth produces no smear layer, so the adap-
tation of filling materials to the enamel and dentin surfaces should be optimal.
Fig. 2.1 The erbium-YAG laser is commer-
cially available, but many perceive it as
costly and offering few advantages over
conventional methods of cavity prepara-
tion. The machine is large and occupies
considerable space in the dental office
224. Carisolv®
gel multimix
25% faster compared with previous gel
The removal of caries with the new gel takes an average of 5.2 min-
utes, less than 30 per cent of the total treatment time. This develop-
ment of Carisolv®
makes it possible to remove caries as fast as with
the drill but with all the advantages a minimally-invasive method
Minimally-invasive, precise and reliable caries removal
225. Carisolv®
– minimally-invasive method for
caries removal
Minimally-invasive dentistry comprises biologically-
oriented procedures. The teeth are treated with preci-
sion and caution in order to last as long as possible,
avoid post-operative complications and fulfil the de-
mands of present-day patients.
Using the gel-based caries removal method Carisolv®
brings you as close to minimally-invasive procedures
as possible. The method involves the use of a gel that
selectively reacts with denatured collagen, thereby mak-
ing the carious dentine softer. Specially-designed
instruments – hand and power-operated – are used to
remove the softened material. Drill, air abrasion or
similar techniques are used if access to the cavity is
required.
Carisolv®
• Well documented
• Minimally-invasive, selective and precise
• Minimises the need for the drill and anaesthetics
and enhances patient comfort
• Makes it possible to avoid drilling close to the
pulp
• Carisolv®
instruments with sharp yet blunt cutting
angles help to protect healthy tissue
Carisolv®
– the clinical procedure
1. The gel does not affect healthy dentine or soft
226. mands of present-day patients.
Using the gel-based caries removal method Carisolv®
brings you as close to minimally-invasive procedures
as possible. The method involves the use of a gel that
selectively reacts with denatured collagen, thereby mak-
ing the carious dentine softer. Specially-designed
instruments – hand and power-operated – are used to
remove the softened material. Drill, air abrasion or
similar techniques are used if access to the cavity is
required.
Carisolv®
• Well documented
• Minimally-invasive, selective and precise
• Minimises the need for the drill and anaesthetics
and enhances patient comfort
• Makes it possible to avoid drilling close to the
pulp
• Carisolv®
instruments with sharp yet blunt cutting
angles help to protect healthy tissue
Carisolv®
– the clinical procedure
1. The gel does not affect healthy dentine or soft
tissue. Nor does it affect enamel. Consequently
Carisolv™
should be used in combination with the
drill or alternative techniques.
2. Drilling could preferably be used whenever the
cavity needs to be opened up, for adjustment of
cavity periphery or whenever there are large
amounts of caries and when the risk to affect
healthy tissue is minimal.
3. Cover the cavity with gel and wait for 30 seconds
until the carious dentine has been softened.
4. Softened caries can then be scraped away using
the PowerDrive™
and/or the Carisolv®
hand
instruments.
5. Repeat steps three and four without waiting 30
seconds, until the cavity is free from caries.
6. Inspect and fill as usual.
syringe should be sufficient for approximately 10 treat-
ments. Only the amount of gel that is needed for each
individual treatment is extruded.
An opened package can be kept at room temperature
during working hours. At all other times, it should be
kept in a refrigerator. An opened package can be kept
up to one month, for subsequent use.
The gel comprises uncoloured fluid of high viscosity,
which contains three different amino acids, and a trans-
parent fluid consisting of a low concentration of so-
dium hypochlorite. When the fluids are mixed, their