dental caries
TRANSCRIPT
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1. A tooth surface without caries.2. The first signs of demineralization.3. The enamel surface has broken down.4. A filling has been made but the demineralization has not been stopped.5. The demineralization proceeds and undermines the tooth.6. The tooth has fractured.
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Class III interproximal decay of incisors that appears as a brownish triangle just below the contact point
transillumination
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Ground section
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CARIES OF DENTIN
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CARIES OF DENTINBegins with the natural spread of the process along the DEJ
and rapid involvement of the dentinal
tubules. The dentinal tubules act as tracts leading to
the pulp (path for micro-organisms).
Early Dentinal Changes:-initial penetration of the dentin
by caries dentinal sclerosis,-calcification of dentinal tubules
and sealing off from further penetration by
micro-organisms,-more prominent in slow chronic
caries.
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Behind the transparent sclerotic zone, decalcification of dentin appears .
In the earliest stages, when only few tubules are involved, microorganisms
may be found penetrating the tubules
Pioneer Bacteria.
Behind the transparent sclerotic zone, decalcification
dentin appears .In the earliest stages, when only few tubules
are involved, microorganisms may be found penetrating the tubules Pioneer
Bacteria .
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This initial decalcification involves the walls allowing them
to distend as the tubules are packed with microorganisms. Each
tubule is seen to be packed with pure forms
of bacteria, eg., one tubule packed with
coccal forms the other tubule with bacilli.
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Advanced Dentinal Changes; -decalcification of walls, confluence of the dentinal tubules, -tiny
“liquefaction foci”, described by Miller are formed by the focal coalescing and breakdown of dentinal tubules. These are ovoid areas of destruction parallel to the course of the tubules which
filled with necrotic debris and increase in size by expanding. The adjacent tubules are distorted and their course is bent due to this
expansion .
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The destruction of dentin by decalcification and then proteolysis occurs in numerous focal areas- leading to
a necrotic mass of dentin of a leathery consistency.-clefts present in the carious dentin that extends at
right angles to the dentinal tubules, accounts for the peeling off of dentin in layers while excavating.
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A detail of a tooth (to the right = enamel). It is covered by plaque, which consists mainly of bacteria. Plaque is often found close to the gum, in between teeth, in fissures and at other "hidden" sites.