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1、HistopathologyofDentalCariesProf.d-rR.Kabaktchieva-2014WhatisDentalCaries?Itisamicrobialdiseaseofthecalcifiedtissuesoftheteeth,characterizedbydemineralizationoftheinorganicportionanddestructionoftheorganicsubstanceofthetooth.Enameliscoveredbyplaque,whichconsistsmainly
2、ofbacteria.Plaqueisoftenfoundclosetothegum,inbetweenteeth,infissuresandatother"hidden"sites.Adetailofatooth-totherightisenamelDemineralization:Whensugarandotherfermentablecarbohydratesreachesthebacteria,theyformacidswhichstarttodissolvetheenamel-anearlycarieslesionocc
3、ursduetolossofCalciumandPhosphatesRemineralization:Whensugarconsumptionhasceased,salivacanwashawaysugarsandbuffertheacids.CalciumandPhosphatescanagainenterthetooth.TheprocessisstronglyfacilitatedbyfluoridesACAVITYoccursiftheDemineralization"wins"overtheRemineralizatio
4、novertimeThefirstindicationoftoothdecayarewhitespotsontheenamelcausedbythelossofcalcium.Ifthedemineralizationprocessoutrunsthenaturalremineralisationprocess,thelesiongrowsandacavityisformed.Thebacteriamayinvadethepulpofthetooth,causingaconsistenttoothpain,especiallydu
5、ringthenight.Thebacteriamayalsoproduceanabscess,andeventuallythetoothmaybeextractedbythedentist.Atoothsurfacewithoutcaries.Thefirstsignsofdemineralization.Theenamelsurfacehasbrokendown.Afillinghasbeenmadebutthedemineralizationhasnotbeenstopped.Thedemineralizationproce
6、edsandunderminesthetooth.Thetoothhasfractured.11223TerminologyPrimaryCaries:lesionsonunrestoredtoothsurface.Secondary(recurrent)caries:lesionsthatdevelopedadjacenttoafilling.Residualcaries:demineralizedtissuethathasbeenleftbehindbeforeafillingisplaced.TerminologyActiv
7、ecarieslesion:aprogressivecariouslesion.Arrested(inactive)cariouslesion:Alesionthatmayhaveformedyearspreviouslyandthenstoppedfurtherprogression.TerminologyWhitespotcaries:thefirstsignofacarieslesiononenamelthatcanbedetectedwiththenakedeye.Alsoknownasinitialorincipient
8、caries.TerminologyRampantcaries:isthenamegiventomultipleactivecariouslesionsoccurringinthesamepatient.Thisfrequentlyinvolves
