Lecture 5

Caries of pit fissures origin

Caries of enamel-smooth surface origin

Root-surface caries

According to their anatomical site

Backward Caries

Forward Caries

Based on Pathway of Caries Speed

Backward Caries

When spread of caries along dentinoenamel junction (DEJ) exceeds the adjacent caries in enamel.

Forward Caries

Caries cone in enamel is larger or at least the same size as that in dentin (pit & fissure caries)

Primary Caries

Residual Caries

Secondary Caries

According to whether it is a NEW LESION or RECURRENT CARIOUS LESION

Primary Caries

Lesions on unrestored surface;

Original carious lesion of the tooth

Residual Caries

Caries that is not removed during restorative procedure, either by accident, neglect or intention

Secondary Caries (recurrent)

Occurs at the junction of a restoration and the tooth and may progress under restoration.

Incipient Caries

Cavitated Caries

Extent of Caries

Incipient Caries

First evidence of caries activity in the enamel

Consists if demineralized enamel which has NOT extended to DEJ.

This lesion can be remineralized by proper preventive procedures.

Cavitated Caries (non-reversible)

The enamel surface is broken & usually the lesion has advanced into dentin.

Acute

Chronic

Rampant

Rate of Caries

Acute Caries

Is when the disease is rapid in damaging the tooth.

Usually in the form of many, soft, light-colored lesions in a mouth and is infectious.

Chronic Caries (Slow/Arrested)

Slowly progressing long-standing caries.

Lesions is hard in consistency & dark-colored.

Rampant Caries

Multiple carious lesions occurring in the same patient, frequently involving surfaces of teeth that are usually caries free

Early Childhood

Bottle/Nursing

Xerostomia Induced Rampant

3 types of rampant caries

Early Childhood Caries

Used to described dental caries present in the primary dentition of young children

Bottle or Nursing Caries

Used to describe a particular form of rampant caries in the primary dentition of infants and young children.

The clinical pattern is characteristics, with the four (4) maxillary deciduous incisors most severely affected.

Radiation Rampant Caries

Commonly observed that after radiotherapy of malignant areas of or near the salivary glands because of radiotherapy salivary flow is very much reduced.

Simple Caries

Compound Caries

Complex Caries

Cavities according to the number of surface involved

Simple Caries

Caries involving only one (1) tooth surface

Compound Caries

Two (2) surfaces are involved

Complex Caries

More than two surface are involved

Abrasion

Erosion

Attrition

Abfraction

Non-carious tooth defects terminology

Abrasion

Abnormal tooth surface loss resulting from direct friction forces between the teeth and external objects or from frictional forces between contacting teeth components in the presence of abrasive medium

a. IMPROPER TOOTH BRUSHING TECHNIQUES

b. HABITS - holding pipe stem by the teeth

c. TOBACCO CHEWING

d. Use of toothpicks

Toothbrush Abrasion

Sharp, V-shaped notch in the gingival portion of the facial aspect of the teeth

LOSS of TOOTH STRUCTURE at site of wear

POSSIBLE SENSITIVITY

Clinical Features of toothbrush abrasion

Repetitive mechanical habit:

Using a HARD TOOTHBRUSH

IMPROPER TOOTHBRUSHING TECHNIQUE along the gumline

GRINDING or CHEWING HARD objects or food

Etiology of toothbrush abrasion

Prevention:

RESTORATION

FLUORIDE APPLICATIONS

TOOTH-COLORED BONDING

Treatment of toothbrush abrasion

Once the GUMS begin to recede:

ROOT SURFACES become EXPOSED

SENSITIVITY to HOT & COLD temperatures soon follow.

Prognosis of toothbrush abrasion

Well-defined horizontal radiolucency

On a dental radiograph, toothbrush abrasion appears as ________ along the cervical region of the tooth

HARD, HIGHLY DEFECT

Clinically, The areas affected by abrasion appear as _________________ in dentin and should NOT be confused with root caries that appears brown and leathery.

Erosion

Progressively loss of dentin tissue by chemical means not involving bacterial actions;

The wear or loss of tooth surface by chemicomechanical action.

Regurgitation of stomach acids

Habitual sucking of lemons

Attrition

Mechanical wear of the incisal or occlusal surface as a result of FUNCTIONAL or PARAFUNCTIONAL MOVEMENTS of the mandible.

Affects proximal contact areas.

Abfraction

Microfractures occur as the cervical of the tooth flexes under loads.

Wedge-shaped notching at cervical areas of involved teeth.

Adults

Clinical features of abfraction

Biochemical forced on teeth

Etiology of Abfraction

Once the enamel is gone, then dentin is exposed & the teeth are more susceptible to decay, sensitivity and more wearing down

Prognosis of Abfraction

FALSE. It is different

TRUE OR FALSE. Is abfraction the same with toothbrush abrasion?

Overbrushing with a hard bristle toothbrush

Toothbrush abrasion is caused by

Excessive pressure applied to the teeth by severe bruxing habits.

Abfraction is caused by

Notch

Toothbrush abrasion tends to ________ in the tooth surface just above the gumline

Dished out

Abfraction tends be a ______________ defect

Fractures

Incomplete fracture not directly involving vital pulp → GREENSTICK FRACTURE

Complete fracture not involving the vital pulp

Fracture involving vital pulp

Non-hereditary enamel hypoplasia

Occurs when the ameloblasts are injured during enamel formation

Seen on anterior teeth and first molars; opaque white or light brown areas with smooth intact hard surface.

Amelogenesis Imperfecta

Enamel is defective either in form or calcification as a result of heredity

Dentinogenesis Imperfecta

Hereditary condition in which dentin is defective.

Class I

Carious lesion that are located in Pits & fissures of the occlusal surfaces of molars and premolars

Occlusal 2/3 of the buccal & lingual surfaces of molars, and + lingual surface of anterior teeth

Class II

Carious lesions that are located on the PROXIMAL SURFACES of the premolars & molars

Class III

Carious lesions that are located in the PROXIMAL SURFACES of anterior teeth that do NOT involved the incisal angle

Class IV

Carious lesions that are located on the PROXIMAL SURFACES of anterior teeth that involving the incisal angle.

Class V

Carious lesions that are located on the GINGIVAL 1/3 of facial & lingual surface of anterior & posterior teeth.

Class VI

Cavities on the INCISAL EDGES and CUSPS TIPS