Cariology I Source: Fejerskov O., Kidd E., Dental Caries, The Disease and its Clinical Management, Blackwell Munksgaard 2003 0 1 2 3 4 Diagrammatic representations of caries on bitewing radiographs. Sound on bitewing Radiolucency confined to enamel Radiolucency in enamel up to enamel-dentine junction Radiolucency in enamel and outer half of dentine Radiolucency in enamel and reaching to inner half of dentine CS caries superficialis CM caries media CPP I caries pulpae proxima caries in ½ of dentine thickness no changes in the dental pulp no pain CPP II caries pulpae proxima dentin – continuous, but thin microbs present pain on stimuli, no spontaneous Pulp exposure pain – spontaneous Inflammation of the dental pulp (pulpitis) oral cavity S V T sublingual submandibular skin This coronal section shows the directions that may be taken by pus from an apical abscess. Caries of dentine Conical lesion Base-towards the surface of the tooth Apex-towards the dental pulp 7 zones Zone 1 – tertiary dentine formation Zone 2 – dentine is normal-in the dental pulp-changes in odontoblasts(degeneration) Zone 3 – sclerotic dentine (translucent dentine) Zone 4 – dead tracts Zone 5 – demineralized dentine (zone of demineralization) Zone 6 – zone of bacterial invasion Zone 7 – area of totally decomposed dentine Bacterial genera and groups Necrotic dentin Decalcified dentin Streptococcus +++ +to++ Mutans, streptococcii +++ + Anaerobic gram coccii +++ +to++ Actinomyces ++to+++ +to++ Lactobacillus +++ +++ Eubacterium +++ +++ Propionibacterium +++ +++ Arachnia(Propionibacterium) +++ +++ Bifidobacterium +++ +++ Veillonella ++to+++ + Prevotella + + Bacteroides + + Fusobacterium + + Motile gram negative rods + + Composition of the bacterial community in carious dentin Finding Light microscopy –dental pulp Finding Dental pulp – penetration of microbs Finding Brown-Brenn staining Finding TEM- penetration of microbs , defense, obturation of tubules Finding pulpitis Finding Exposed dental pulp – actinomycosis Finding microbes in dentine tubules