Download - Code 4 Icdas
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CODE 4 ICDAS
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FEATURES
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Features• Shows shadow of discolored dentin with
or without localized enamel breakdown• Shadow appearance seen easily when
tooth is wet - Grey, blue or brown.• For pits and fissures, smooth surface
(mesial and distal), and free smooth surface
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DIAGNOSIS
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DIAGNOSISVisual inspection• Teeth must be cleaned (plaque and biofilm), air-
dried and well illuminated.• Teeth must be sufficiently dried so changes can
be seen properly (remove saliva that obscure lesion)
• Fibre optic Trans illumination- lesions appear as dark shadow. Normally used for anterior teeth
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Radiograph • Bite wing radiograph typical method for proximal
smooth surface• Dimineralized dentin shows white chalky
appearance/ shadow under enamel.• To determine the depth of carious lesion.
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bitewing radiograph
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TREATMENT
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TREATMENT• Minimal invasive restoration–Removing carious lesion & infected dentin as
minimally as possible• Aim: to arrest the caries process• Conservative – does not require retention and
resistance features
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TREATMENT• Methods: –Box only preparation – dark shadows in proximal
side–Tunnel preparation – dark shadows under pits
• Materials that can be used:–Flowable composite–GIC
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TREATMENT
Composite GICAdvantages - High strength
- High wear resistance
- Better finishing and esthetics
- Bonds chemically to tooth
- Releases fluoride- Good marginal
seal
Disadvantages - Technique sensitive- High polymerization
shrinkage (light cure)
- Less esthetic - Brittle
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FLOW CHART 1: DECISION TREE FOR PRIMARY CORONAL CARIES
DETECTION
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TUNNEL AND BOX PREPARATION
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GIC RESTORATION
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COMPOSITE RESTORATION