Dental Defects Lecture Notes PDF

Dental Defects (carious and non carious lesions) Dental caries is a preventable, chronic, and biofilm-mediated disease modulated by diet. this multifactorial, oral disease is caused primarily by an imbalance of the oral flora (biofilm) due to the presence of fermentable dietary carbohydrates on the...

Dental Defects (carious and non carious lesions) Dental caries is a preventable, chronic, and biofilm-mediated disease modulated by diet. this multifactorial, oral disease is caused primarily by an imbalance of the oral flora (biofilm) due to the presence of fermentable dietary carbohydrates on the tooth surface over time. Diet Bacteria & plaque Host Time Caries Organic acids for long periods causes lowering in the pH below the critical level 5.5 Enamel 6.2 Dentin With extended periods Shift in microbiome to acidophilic and acidogenic bacteria Further acidification and demineralization When the pH in the biofilm returns to neutral and the concentration of soluble calcium and phosphate is supersaturated relative to that in the tooth, mineral can then be added back to partially demineralized enamel in a process called remineralization. Caries Health Ongoing demineralization in enamel  collapse of surface and cavitation. Severe demineralization in dentin  exposure of collagen matrix denaturation and degradation  cavitation. Rough and dry ? Or smooth and shiny? Active lesions -Tend to be whitish or yellowish in color and opaque (non-glossy). Inactive lesions: -brown/black in color and shiny or glossy. -feel hard and less rough. -feel rough when the tip of the explorer is moved gently across their surface. -Shows progression by time -Shows no progression by time. -Mostly seen on buccal/lingual surface, and beside extracted teeth. -More resistant to develop caries again. According to rate (speed) of caries: Acute: rapidly progressing, lesion is very soft, infected dentin has light color, common in young age. Chronic caries: slow progression, there is time for remineralization, harder and darker in color, common in older ages. Pit-Fissure Caries Smooth Surface Caries Root Caries Page 50 Art and science sixth edition Page 54 Art and science sixth edition Tertiary dentin: forms in response to stimuli eg: caries, attrition, and operative procedures. -known as reparative or reactive dentin. -Usually appears as a localized dentin deposit on the wall of the pulp space immediately subjacent to the area of the tooth that has received the injury. -It is less mineralized than primary and secondary dentin, and contains irregular dentinal tubules. -Clinically, tertiary dentin is not as hard as primary dentin. Sclerotic dentin. forms in response to stimuli such as aging or mild irritation (slow advancing caries). When responding to initial caries demineralization events, crystalline material precipitates in intratubular and intertubular dentin. Sclerotic dentin walls off a lesion by blocking (sealing) the dentinal tubules. -it may not be present in rapidly advancing lesions. Clinically, sclerotic dentin is dark and harder than normal dentin.