Histopathology of Enamel Caries
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Questions and Answers

What happens to hydroxyapatite when the pH decreases?

  • It remains stable and intact.
  • It demineralizes into component ions. (correct)
  • It becomes less soluble.
  • It is fortified and strengthened.

    • Which of the following is a zone of destruction identified in enamel caries?

  • Zone of mineral accumulation
  • Zone of demineralization (correct)
  • Zone of hypermineralization
  • Zone of remineralization

    • What is the primary aetiological factor in the development of enamel caries?

  • High levels of calcium
  • Plaque bacteria decomposition
  • Fermentable carbohydrates (correct)
  • Excessive fluoride exposure

    • What is the relevance of understanding the histopathology of enamel caries?

    <p>It aids in the identification of caries stages.</p> Signup and view all the answers

    Which clinical sign indicates the presence of enamel caries?

    <p>Translucent white spots</p> Signup and view all the answers

    What does an ICDAS score of 0 indicate?

    <p>No evidence of caries in a sound tooth</p> Signup and view all the answers

    What visual characteristics are associated with an ICDAS score of 1?

    <p>White spot and/or brown discolouration after air drying</p> Signup and view all the answers

    What does an ICDAS score of 3 indicate regarding caries status?

    <p>Localized enamel breakdown without visible dentine exposure</p> Signup and view all the answers

    Which statement is true about the ICDAS scoring system?

    <p>A score of 2 involves distinct visual changes visible when wet and dry</p> Signup and view all the answers

    What issue led to the development of the ICDAS scoring system?

    <p>Inconsistencies in caries diagnosis</p> Signup and view all the answers

    Which statement accurately describes the pore volume of the Surface Zone?

    <p>It possesses a pore volume below 5%.</p> Signup and view all the answers

    What characterizes the Body of the Lesion?

    <p>It has porosities of a large diameter.</p> Signup and view all the answers

    Why does the Dark Zone appear dark under light microscopy?

    <p>Its small porosities prevent the clearing medium from entering.</p> Signup and view all the answers

    What is the pore volume of the Translucent Zone?

    <p>It has a pore volume of 1%.</p> Signup and view all the answers

    What occurs in the Translucent Zone during the carious process?

    <p>Initial dissolution occurs along the rods' gaps.</p> Signup and view all the answers

    What is the initial indicator of the carious process in enamel?

    <p>Slight etching of the enamel surface</p> Signup and view all the answers

    Under cariogenic conditions, where do microporosities typically form in the enamel?

    <p>At prism boundaries</p> Signup and view all the answers

    What causes white spot lesions to appear in enamel?

    <p>Greater scattering of light due to increased porosities</p> Signup and view all the answers

    What might the presence of brown coloration in white spot lesions indicate?

    <p>The lesion has been present for a longer time</p> Signup and view all the answers

    What is a distinct shape of established enamel caries lesions?

    <p>Wedge-shaped</p> Signup and view all the answers

    How are histological zones of established enamel caries identified?

    <p>Using a clearing agent with identical refractive index</p> Signup and view all the answers

    What microscopy technique is commonly used to identify pore size and volume in enamel caries?

    <p>Transmitted light microscopy</p> Signup and view all the answers

    What does the presence of porosities in the enamel correspond to in terms of dental health?

    <p>Early stage of carious activity</p> Signup and view all the answers

    Study Notes

    Histopathology of Enamel and Dentine Caries

    • Topic: Histopathology of enamel and dentine caries, Oral and Dental Science, Josh Hudson
    • Learning Outcomes: Describe oral diseases, their relevance to prevention, diagnosis, and treatment, aetiology and pathogenesis of oral disease, relevant dental, oral, craniofacial, and general anatomy, and their application to patient management.
    • Pre-reading: 'Aetiology of Dental Caries' lecture, 'Histology of enamel and dentine' lectures
    • ICDAS Score: An international caries detection and assessment system

    ICDAS Score Codes

    • Code 0: Sound tooth; no evidence of caries when the tooth surface is wet or dry.
    • Code 1: Initial stage caries; no evidence of caries when the surface is wet, but white or brown spot/discoloration is visible after air drying.
    • Code 2: Initial stage caries; distinct visual changes in enamel that are visible when the tooth surface is wet or dry.
    • Code 3: Moderate stage caries; localized enamel breakdown without visible dentine exposure; visible when wet and dry, further drying reveals loss of enamel integrity.

    Recap of Caries Aetiology

    • As pH lowers, the tooth surface (hydroxyapatite) demineralises and breaks down into its component ions.
    • If pH doesn't neutralize, this process continues leading to caries.

    Enamel Caries Microscopic Appearance

    • Every carious process starts with slight etching of the enamel surface under dental plaque buildup, which is frequent and reversible.
    • Under cariogenic circumstances, the tooth dissolves further, resulting in microporosities at prism boundaries.
    • The first clinical signs are white spots. Their whiteness is due to decreased light scattering compared to surrounding enamel caused by increased porosities as minerals are lost.
    • Air or electrolytes in these porosities have a different refractive index to sound enamel.
    • Exogenous pigmentation can cause lesions to appear brown. Location and appearance suggests lesion duration.
    • Established enamel caries has four distinct zones: surface, dark, translucent, and body of the lesion.

    Established Enamel Caries Histology

    • Surface Zone: Relatively unaffected enamel, able to remineralize, has low pore volume (<5%).
    • Body of Lesion: Largest area, significant demineralization, pore volume 5-25%.
    • Dark Zone: Thin layer with low light transmission, some remineralization, and pore volume 2-4%.
    • Translucent Zone: Advancing edge of the lesion, early demineralization in gaps between enamel rods, pore volume 1% (sound enamel 0.1%).
    • Clearing agents like quinoline are used to distinguish zones as they have similar refractive index to enamel.

    Clinical Applications

    • Clinical assessment is related to the microscopic features for accurate diagnosis.

    • Applying this knowledge helps dentists to diagnose different stages of caries and potentially manage it better.

    • The provided information recommends reviewing a YouTube video (https://www.youtube.com/watch?v=Y_o0ygwA6CI) from timestamp 4:40 for further details.

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