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

DIAGNOSIS
Visual inspection
Teeth must be cleaned (plaque and biofilm), airdried 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

GIC
- Bonds
Advantag - High
chemically to
es
strength
tooth
- High wear
- Releases
resistance
fluoride
- Better
- Good marginal
finishing and seal

esthetics

Disadvanta - Technique
sensitive
ges

- High
polymerization
shrinkage (light

- Less esthetic
- Brittle

FLOW CHART 1: DECISION TREE

FOR PRIMARY CORONAL CARIES
DETECTION

TUNNEL AND BOX PREPARATION

GIC RESTORATION

COMPOSITE RESTORATION