cariology lec

most accepted, wd miller in 1890

diet, bacteria, time, susceptible surface (host)

WHO

Dental caries

acidogenic, proteolytic, proteolysis-chelation

acidogenic

aciduric

pH 5.5 - critical ph, Below pH5.5 – demineralization of the tooth surface, CHO + Microorganism is transformed into Lactic Acid through Degradation Process then attacks tooth tissue and cause dissolution of the Hydroxyapatite components of Enamel and Dentin

Also known as microbial plaque, Important in the beginning of dental caries, Provides the environment for bacteria to produce acid, Demineralization of the hard tissues of teeth

GOTTLIEB 1947, Proteolysis – breakdown of proteins, Breakdown of proteins causes destruction of the organic matrix of the enamel, Inorganic crystals of the enamel became detached from one another and finally cause destruction of the whole structure

SCHUTZ ET AL 1955, Caries is formed by simultaneous events, Proteolysis- dest. of organic portion, Chelation- removal of calcium, Proteolytic breakdown of the organic portion of the enamel forms chelating agent ( agent forms from the combination of proteolytic breakdown products), The chelating agent which is negatively charged releases the calcium ions ( positively charged) from enamel and dentin and results in tooth decay

Caries

Proteolysis

Chelation

Tooth ( Host), Substrate, Microorganisms, Time

hypoplastic enamel

stage of lesion progression, severity of disease, clinical manifestation

depth of defect, location of the lesion, intensively of caries within the dentition

initial form of caries - whitish discoloration, no cavity developed, white spot lesion at the entrance to the fissure on a molar

progression of white spottly lesion, minimally or maximally extended from the tooth surface to inward direction towards pulp

carious lesion is ceased due to cleansing action of toothbrush, mastication, and saliva bcos of wide opening of lesion, affected dentin is burnished and becomes brown hard and polished ( dentin eburtion)

caries on the occlusal surfaces of molars and premolars, occlusal 2/3 of the buccal and lingual surfaces of molars, lingual surfaces of the anterior teeth

esions found on the proximal surfaces of molars and premolars

lesions found on the proximal surfaces of anterior teeth, but do not involve the incisal angle

lesions found on the proximal surfaces of anterior teeth and involving incisal angle

lesions found on the gingival third of the facial and lingual surfaces of anterior and posterior teeth

proposed by WJ Simon in 1956 - lesions on the incisal edge and cusp tips of the teeth

location, extent, rate

location, extent, rate

reversible

irreversible

rampant

slow or arrested

Extends from DEJ towards contiguous enamel, Triangle in shape with base at the DEJ and apex towards the enamel

Proceeds from enamel to dentin, Lesion is triangle with base of triangle at enamel surface and apex towards dentin, Pits and fissure , base is at DEJ and apex at pit

Secondary caries, Occurs immediately adjacent to restorations

Due to nursing bottle containing milk formula, sweetened water, sugar or honey sweetened pacifier

rampant caries, runs a rapid clinical course, children and young individual with large dentinal tubules without sclerosis, faster spread

slowly progression, adult patients, opening of cavity is wide, less retention of plaque, more entry of saliva buffer, dentin sclerosis, repartive dentin formtion, stained deep brown dentin

acid producing bacteria, frequent eating or drinking of fermentable carbs, sub normal saliva flow and function

saliva flow and component, flouride remineralization with calcium and phosphate, antibacterials - chlorhexidine, xylitol

upper and lower first molar

lower anterior teeth

ms and lactobacilli

enamel caries

actinomycetes viscosus

translucent zone, dark zone, body of lesion, surface (intact zone)

translucent zone, advancing front of lesion, 10x more porous than sound enamel, not always present

dark zone, lies adjacent and superficial to translucent zone, usually present, positive zone, calked dark z bcos it doesnt transmit polarized light, formed due to dimineralization

body of the lesion, largest portion of incipient caries, between surface and dark zone, area of greatest demineralization making it more porous

surface zone, not or least affected by caries, greater resistance prolly due to greater degree of mineralization and greater flouride concentration, less than 5% porous, radiolacity is comparable to adjacent enamel

translucent, dark, body of lesion, surface zone

normal dentin, fatty degenertion of tomes fibers, formed by degeneration of odontoblastic process, dentin is normal and produces sharp pain on stimulation

zone of dentinal sclerosis, intertubular dentin - demineralized, deposition of calcium salts in dentinal tubules, damage to odontoblastic zone is apparent, no bacteria; capable pf remineralization

zone of decalcification, further demineralization of intertubular dentin, lead to spfter dentin

zone of bacterial invasion, widening and distortion of dentinal tubule which refilled w bacteria, dentin is not self repairable bcos less mineral content and irreversibly denatured collagen, should be removed during tooth prep

outermost, consist of decomposed dentin filled w bacteria, mjst be removed during tooth prep

fluoride

tooth brush, floss, rinse, pits and fissure sealants

s mutans, s sobrinus

s cricetus

s ferus

acidogenic