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Histopathology of root surface caries.


Schüpbach, P; Guggenheim, B; Lutz, F (1990). Histopathology of root surface caries. Journal of Dental Research, 69(5):1195-1204.

Abstract

The histopathology of active and arrested human root caries was examined in extracted teeth by different optical methods. Significant differences were observed between the mechanisms operating on the various dental structures. Three different patterns of initial cementum and dentin lesions could be distinguished, depending on the severity of the cariogenic attack, the degree of sclerosis of the peripheral dentin, and the presence of calculus. Advanced lesions were characterized by various patterns of demineralization. In particular, a massive lateral spread of bacteria into intertubular dentin was observed. Consequently, unaffected dentinal areas became continuously undermined. In arrested lesions, either a partial or complete mineralization of the intertubular dentin was apparent. Dentinal tubules were sclerosed passively by re- or precipitation of Ca and PO4 ions. In contrast, tubules filled with ghosts of bacteria appeared mineralized by fine-granular crystals. Our observations indicate that both the arrestment and the remineralization of active lesions depend on (1) the degree of active sclerosis of dentinal tubules in areas underlying the lesion, (2) the degree of the bacterial infection of the dentin, (3) the degree of progression of the lesions, and (4) the location of the lesions at the various root surfaces. It is suggested that remineralization of active lesions can occur. This supports the concept of non-invasive treatment of root caries lesions without cavitation.

Abstract

The histopathology of active and arrested human root caries was examined in extracted teeth by different optical methods. Significant differences were observed between the mechanisms operating on the various dental structures. Three different patterns of initial cementum and dentin lesions could be distinguished, depending on the severity of the cariogenic attack, the degree of sclerosis of the peripheral dentin, and the presence of calculus. Advanced lesions were characterized by various patterns of demineralization. In particular, a massive lateral spread of bacteria into intertubular dentin was observed. Consequently, unaffected dentinal areas became continuously undermined. In arrested lesions, either a partial or complete mineralization of the intertubular dentin was apparent. Dentinal tubules were sclerosed passively by re- or precipitation of Ca and PO4 ions. In contrast, tubules filled with ghosts of bacteria appeared mineralized by fine-granular crystals. Our observations indicate that both the arrestment and the remineralization of active lesions depend on (1) the degree of active sclerosis of dentinal tubules in areas underlying the lesion, (2) the degree of the bacterial infection of the dentin, (3) the degree of progression of the lesions, and (4) the location of the lesions at the various root surfaces. It is suggested that remineralization of active lesions can occur. This supports the concept of non-invasive treatment of root caries lesions without cavitation.

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Additional indexing

Item Type:Journal Article, refereed
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Institute of Oral Biology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 May 1990
Deposited On:11 Feb 2008 12:24
Last Modified:21 Feb 2018 09:04
Publisher:Sage Publications
ISSN:0022-0345
OA Status:Green
Publisher DOI:https://doi.org/10.1177/00220345900690051601
Related URLs:http://jdr.iadrjournals.org/cgi/content/abstract/69/5/1195
PubMed ID:2335654

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