Cariology, Operative Dentistry and Endodontics
Cariology
Understand the dynamic demineralisation–remineralisation balance, the Stephan curve (pH falls after sugar exposure and recovers with saliva), the role of fluoride (topical effect, fluorapatite formation, inhibition of demineralisation, enhancement of remineralisation, antibacterial effect), and the caries risk assessment approach. Know ICDAS and caries detection methods (visual-tactile, bitewing radiographs, transillumination, fluorescence). Know minimal intervention principles: sealants, infiltration, fluoride varnish, and the concept of the caries continuum from white spot to cavitation. Know the cavity classification (G.V. Black) and modern adhesive preparation principles - bevelled enamel margins, no unsupported enamel, and the fact that enamel bonding relies on acid etching, while dentine bonding requires removal of the smear layer or its modification.
Operative
Know composite (polymerisation shrinkage, C-factor, layering, light-curing depth), glass ionomer (fluoride release, chemical adhesion to tooth, poor wear resistance), amalgam (creep, corrosion, contraindications), and ceramic materials. Understand pulp protection, matrix and wedge use, and occlusal anatomy restoration.
Endodontics
Know pulp diagnosis (normal, reversible pulpitis, irreversible pulpitis, necrotic, previously treated) and periapical diagnosis (symptomatic/asymptomatic apical periodontitis, acute/chronic apical abscess, condensing osteitis). Know working length determination (electronic apex locator, radiograph), irrigation (sodium hypochlorite concentration and tissue-dissolving action, EDTA for smear layer, chlorhexidine as an alternative), instrumentation (hand vs rotary, crown-down, balanced force, reciprocation), obturation (gutta-percha with sealer, warm vertical compaction), and post-endodontic restoration (cusp coverage, ferrule). Know endodontic emergencies (flare-up, ledge, perforation, separated instrument) and revascularisation concepts in immature teeth.
Traps
- Fluoride works mainly topically, not systemically, in adults.
- Sodium hypochlorite does not remove the smear layer - EDTA does.
- Irreversible pulpitis can be asymptomatic between episodes; the diagnosis is not based on pain intensity alone.
Rule of thumb
If the pulp is vital and symptoms are provoked and transient, it is reversible; if spontaneous or lingering, it is irreversible.