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23 February 2012
DEFINITION
is
Bacterial-induced tooth
demineralization or cavitation
from imbalance between
risk factors and
protective factors over time
Harris and Christen ( Primary Preventive Dentistry, 1995),
Larsen and Bruun (Clinical Cariology, 1994)
Keyes Diagram
microorganism
carie
s
dental
susceptibl
e
diet
Demineralizati
on
Remineralizatio
n
Saliva is normal
30 minutes
after eating
CARIES CONTROL
DENTAL
CARIES
Tooth
Diet
Age
Frequency
Morphology
Sucrose
Fluoride
Acidic F&B
White spots
Restoration,3 yrs
Enamel lesion
Dentinal lesion
Pulpal lesion
Filling
Dental appliance
Bacteria
Saliva
S. Mutans
Flow rate
Plaque
Viscosity
Brushing
Buffering
Flossing
Restoration
Remineralization
Demineralization
Cavity
Remineralization:
Demineralization:
GV
Pit-and-fissure caries
develop initially in the
fissures of the teeth, but
can spread into the dentine
2. Smooth-surface caries
are most common on
interdental surfaces, but
can occur on any smooth
surface of the tooth
3. Root caries attack the
cementum and dentine,
which becomes exposed as
gums recede
1.
Dental Caries
Enamel Caries
Dentin Caries
Cementum Caries
(Root caries)
DX
ACTIVE
INACTIVE
COLOR
LIGHT
DARK
CONSISTENCY
MUSHY
FIRM
MOISTURE
WET
DRY
SYMPTOM
SENSITIVE
NONE
SHAPE
DEPTH>WIDT
H
WIDTH>DEPT
H
Translucent
zone
Dark zone
Body of the
lesion
Surface
zone
multiple
Goal
elimination of source of
cariogenic organisms by removal of
caries from all deep lesions and
placement of temporary restorations
early in the treatment
This is very important in effecting
reversal of the active caries process
Cavity
Pulpal
response to the
restorative treatment can be
observed and endodontic
treatment instituted if
necessary before planning
definitive restoration.
The
1. CaOH :
- bacteriocidal
- stimulates reparative dentin
2.Reinforced Zinc Oxide-eugenol
- reducing pain and sensitivity
- bacteriocidal to organisms deep in the
cavity
- seals margins for several
months,preventing ingress of nutrients to
the organisms
- fair strength
GI :
bonds to tooth structure for improved
retention
release fluoride reduces organisms
and promotes remineralization
good marginal seal
fair strength
esthetically pleasing
Amalgam
has excellent strength
maintains occlusal and
proximal relationships
fair marginal seal,
best for long term temporary
After
6-8 weeks
- entire restoration removed
- any remaining caries is removed
- definitive restoration is planned