Podcast
Questions and Answers
What is the earliest histological change observed in smooth surface caries?
What is the earliest histological change observed in smooth surface caries?
- Presence of transverse striations of the enamel rods
- Loss of inter-rod substance of enamel (correct)
- Accentuated incremental lines of Retzius
- Loss of enamel structure
In which direction does pit and fissure caries typically progress?
In which direction does pit and fissure caries typically progress?
- Towards the occlusal surface
- Following the contours of the tooth surface
- Outwards towards the oral cavity
- Towards the dentin-enamel junction (DEJ) (correct)
What characterizes the cavitation seen in pit and fissure caries compared to smooth surface caries?
What characterizes the cavitation seen in pit and fissure caries compared to smooth surface caries?
- More cavitation due to greater involvement of dentinal tubules (correct)
- Less cavitation due to thicker enamel
- No cavitation as it only affects enamel
- Cavitation occurs only after the lesion reaches the surface
What is the clinical appearance of early caries often identified as?
What is the clinical appearance of early caries often identified as?
How is the triangular shape of caries lesions described?
How is the triangular shape of caries lesions described?
What is the initial response of dentin to the carious process before the enamel surface breaks down?
What is the initial response of dentin to the carious process before the enamel surface breaks down?
Which characteristic is associated with sclerotic dentin as the carious process progresses?
Which characteristic is associated with sclerotic dentin as the carious process progresses?
What happens to the tubular structure of dentin as the caries develops?
What happens to the tubular structure of dentin as the caries develops?
What is the state of bacteria in dentin before the enamel surface deteriorates?
What is the state of bacteria in dentin before the enamel surface deteriorates?
Which change occurs in dentin after tubular sclerosis begins?
Which change occurs in dentin after tubular sclerosis begins?
Which zone of carious enamel is characterized by a pore volume of approximately 1% and remains intact in early caries attack?
Which zone of carious enamel is characterized by a pore volume of approximately 1% and remains intact in early caries attack?
What is the primary reason for increased porosity in the dark zone of carious enamel?
What is the primary reason for increased porosity in the dark zone of carious enamel?
What differentiates dentin caries from enamel caries?
What differentiates dentin caries from enamel caries?
Which zone is described as clinically and radiologically unrecognizable due to submicroscopic pores?
Which zone is described as clinically and radiologically unrecognizable due to submicroscopic pores?
What factors are responsible for the remineralization of carious enamel?
What factors are responsible for the remineralization of carious enamel?
Flashcards
Incipient Caries
Incipient Caries
The earliest sign of enamel caries, appearing as white spots under plaque due to loss of inter-rod substance and demineralization.
Smooth Surface Caries
Smooth Surface Caries
A type of caries that forms on the smooth surfaces of teeth, often starting as white spots and progressing to a triangular shape with the apex towards the dentin.
Pit and Fissure Caries
Pit and Fissure Caries
A type of caries that forms within pits and fissures, often reaching the dentin quickly due to the deep, narrow grooves.
White Spot Lesion
White Spot Lesion
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DEJ (Dentino-Enamel Junction)
DEJ (Dentino-Enamel Junction)
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Surface Zone in Enamel Caries
Surface Zone in Enamel Caries
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Body of Lesion in Enamel Caries
Body of Lesion in Enamel Caries
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Dark Zone in Enamel Caries
Dark Zone in Enamel Caries
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Translucent Zone in Enamel Caries
Translucent Zone in Enamel Caries
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Defense Reaction in Dentin Caries
Defense Reaction in Dentin Caries
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Tubular Sclerosis
Tubular Sclerosis
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Reactive Dentin
Reactive Dentin
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Sclerotic Dentin
Sclerotic Dentin
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Dead Tracts
Dead Tracts
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Dentin Caries Progression
Dentin Caries Progression
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Study Notes
Histological and Clinical Appearance of Dental Caries
- Clinical appearance of caries is important for diagnosis and treatment.
- Histological study of caries lesions provides understanding of the disease process.
- Early caries, or incipient caries, initially appears as white spots on enamel.
- Early demineralization involves loss of inter-rod substance, with enamel rods becoming more prominent.
- Subsequent loss of mucopolysaccharides in enamel leads to a triangular or cone-shaped lesion.
- These lesions progress from the surface toward the dentinoenamel junction (DEJ).
- Enamel caries eventually leads to a disintegration of enamel prisms.
- Pit and fissure caries starts with decalcification of enamel in pits and grooves.
- These lesions spread along enamel rods, developing a triangular shape with the apex pointed toward the tooth surface.
- These lesions tend to form larger cavities compared to smooth surface caries.
- Early visible lesions are called "white spots."
- These white spots are areas of enamel demineralization.
- White spots can be identified visually when enamel is dry.
- Caries can penetrate the enamel layer before becoming clinically visible.
Histology of Enamel Caries
- Histological analysis of enamel caries reveals four distinct zones: translucent, dark, body of lesion, and surface.
- Translucent zone: characterized by submicroscopic pores and slightly increased porosity compared to healthy enamel.
- Dark zone: shows greater degree of demineralization with increased porosity.
- Body of lesion: shows maximum demineralization, with pore volume increasing from periphery to center.
- Surface zone: Remains relatively intact and heavily mineralized in early stages, containing the lowest porosity.
Histology of Dentin Caries
- Dentin, unlike enamel, is a living tissue with a defense response.
- Initial defense response is formation of reactive/tertiary dentine.
- Dentin caries begins with demineralization.
- Bacterial toxins and acids can reach dentin through the increasingly porous enamel.
- Bacteria first invade the demineralized dentin.
- This invasion forms the "zone of penetration".
- Sclerotic dentin appears as a response to penetration with occluded tubules and thick peritubular layers.
- Progressive demineralization leads to destruction of the dental matrix(soft material).
- This zone of penetration can eventually reach the pulp, causing irreversible pulpal inflammation.
Concept of Infected and Affected Dentin
- Affected dentin: inner layer of demineralized dentin.
- Infected dentin: outer layer of demineralization with bacteria.
- Infected dentin appears yellowish and mushy.
- Affected dentin is hardened, leathery.
Difference in Enamel and Dentin Reaction
- Enamel is a non-cellular tissue reacting via dissolution and precipitation.
- Dentin is a vital tissue with cellular responses (odontoblasts) involved in its reaction.
Root Caries
- Root caries are lesions on the root surface.
- They begin with decalcification of the cementum, causing saucer-shaped carious lesions.
- The carious lesion spreads similar to dentin caries and can eventually involve the pulp.
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