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OCCLUSAL CARIES

Obvious plaque stagnation area
1. difficult to detect as surface can appear fine
2. OCCULT CARIES (hidden)
3. bacteria enters fissure and spreads laterally at ADJ
DIAGNOSIS
1. Radiograph - most reliable
  1. Radiolucent area show infected dentine
  2. Lesions not visible - Fissure seal
  3. BW's at regular intervals
  4. Caries always under estimated on radiograph
TREATMENT
1. If in doubt - leave wait and watch
  1. Apply Fluoride
  2. Chlorohexidine
  3. Fissure Sealants
  4. Sealant Restoration - Preventitive restoration resin
  5. Conventional Restoration
2. Improve OH
WHEN TO RESTORE
1. Obvious cavity
2. Caries into ADJ
3. When dentine is infected
PREVENTIVE RESIN RESTORATION
1. Used when part of fissure system becomes carious
2. restore carious part and FS rest of fissure
3. Prevents secondary caries
4. Resin comp used
SEALANT RESTORATION TECHNIQUE
1. Take occ registration
2. Outline form (minimal)
3. Remove caries and add lining if necessary
4. Etch prime bond and place comp
5. Etch remaining fs and apply sealant
CONVENTIONAL RESTORATION
1. When cavity involves all of fissure system
2. Amalgam previously used - now comp as preserves tooth sub
3. Occ reg and outline form - keep minimal
4. Remove caries - apply lining
5. Etch, prime, bond apply comp in 2mm increments
  1. Oblique layering - comp touches only one wall of cavity
6. CONFIGURATION FACTOR - BONDED OVER UNBONDED SURFACES
As much sound tooth preserved as poss
1. undermined enamel can be supported by adhesive material
2. Place comp and cure at 2mm increments!
3. Occlusion checked and adjusted
4. AMALGAM no longer indicated for occ rest

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OCCLUSAL CARIES

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	Created by aahughes over 10 years ago