It is an irreversible microbial disease of calcified tissue of teeth characterized by demineralization of inorganic portion and destruction of organic substance of the

tooth which often lead to cavitation.

According to location: a) pit and fissure b) Smooth surface c) Root surface

a) b) c)

Acc. to structure of tooth: Enamel Dentine Cementum

Onset and progression: a) Acute b) Chronic c) Incipient

a) b) c)

Acc. To chronology: Infancy Aldosencent Adult Acc. to senile: Rampant Arrested

a) b)

The Early Theories :

The legend of worm. Endogenous theories Chemical theory Parasitic theory

I.
II. III. IV.

It states that caries is caused by ACID produced by microorganisms of the mouth. Dental decay is a CHEMOPARASITIC PROCESS consisting of two stages : Decalcification of enamel and dentine ( preliminary stage ). Dissolution of the softened residue ( subsequent stage ).

I. II.

Acids resulting in primary decalcification is produced by fermentation of starches and sugar from the retaining centers of teeth.

Significance of Millers observation included three factors namely : 1. Oral microorganisms. 2. Carbohydrate substrate. 3. Acid produced by the microorganisms.

 ZONES

First recognizable zone of the lesion. Advancing front of the lesion . Half the lesions demonstrate TZ ,not always present. TZ appears structure less. Pore volume -1% (compared to 0.1% sound enamel)

Zone 1:Translucent zone (TZ):

OF ENAMEL CARIES:

Zone 2: Dark zone:

Lies adjacent and superficial to the TZ . Positive zone. Shows positive birefringence (in contrast to sound enamel) Pore volume of 2%-4% (polarized light )

Presence of small pores,large molecules of quinolone are enable to penetrate. Micropore system gets filled with air and become dark. Medium like water may penetrate.

Zone 3:Body of lesion

Between unaffected surface and dark zone. Area of greatest demineralization . Pore volume -5% in periphery and 25% in centre. Water imbibition- positive birefringence compare to sound enamel. Striae of retzius -prominent

Zone 4: surface zone

Quantitative studies partial demineralization of 110%. Pore volume less than 5% of spaces. Negative birefringence-water imbibition. Positive birefringence-porous subsurface.

Dentinal caries starts from DEJ and involves greater number of dentinal tubules.

1. 2. 3.

It includes following stages namely : Early dentinal changes. Advanced dentinal changes. Secondary dentine involved.

Caries penetrate initial to dentine. Ground section shows TRANSPARENT appearance of tooth surface in transmitted light. Reflected light shows SCLEROTIC dentine, which will appear dark. Fatty degeneration of TOMES fibers. PIONER bacteria in early stages of caries is seen.

Here, decalcification of tubule wall, liquefaction of foci is seen. Globular dentine also shows decalcification. Proteolytic enzyme produced by microorganisms cause further destruction. Lathery consistency of necrotic mass is seen.

Zone 1 : Zone of fatty degeneration of Tomes process. Zone 2 : Zone of dentinal sclerosis. Zone 3 : Zone of decalcification of dentine. Zone 4 : Zone of bacterial invasion of decalcified but intact dentine. Zone 5 : Zone of decomposed dentine.

The caries involvement of secondary dentine is usually slower because the dentinal tubules are fewer in number and more irregular in their course, thus delaying the penetration of the invading microorganisms. Occasionally, caries will spread laterally at the junction of the primary and secondary dentine and produces a separation of two layers.