code 4 icdas
DESCRIPTION
Details about Code 4 ICDASTRANSCRIPT
CODE 4 ICDAS
FEATURES
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
DIAGNOSIS
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
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.
bitewing radiograph
TREATMENT
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
TREATMENT• Methods: –Box only preparation – dark shadows in proximal
side–Tunnel preparation – dark shadows under pits
• Materials that can be used:–Flowable composite–GIC
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
FLOW CHART 1: DECISION TREE FOR PRIMARY CORONAL CARIES
DETECTION
TUNNEL AND BOX PREPARATION
GIC RESTORATION
COMPOSITE RESTORATION