Cariology - Lecture 1 Flashcards by Savannah Glenn

the evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body; provided by a dentist, within the scope of his/her education, training and experience, in accordance with the ethics of the profession and applicable law

Dentistry

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Prevent and control dental disease through community efforts. (Research and community outreach

Dental Public Health

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Treat disease and injury of the dental pulp (root canals)

Endodontics

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Identify and study diseased tissues of the oral and maxillofacial region

Oral and Maxillogacial Pathology

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Straighten malpositioned teeth

Orthodontics

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Preform Dentistry on Children

Pediatric Dentistry

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Treat diseases of the supporting and surrounding tissues of teeth

Periodontics

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Treat advanced restorative dental cases

Prosthodontics

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Concerns the production and interpretation of radiographs of the oral and maxillofacial region

Oral and maxillofacial Radiology

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Gums and jaw

Periodontium

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TMJ

Temporal Mandibular joint

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50-90% of what a general dentist does

Restorative and prosthetic Dentistry

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Cut or shear food

- Phonetics, function & esthetics

Incisors

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Seize, pierce, tear and cut food
Longest roots and strategic position in arch
Key to occlusion (protection)

Canines

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Grind and tear

- Fine chewing

Premolars

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Large multi-rooted strong

- Crushing, grinding and chewing

Molars

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Hard
Translucent white
Shell structure

Enamel

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Yellowish

- Softer

Dentin

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90-95% inorganic hydroxyapatite
4-8% water
1-2% protein

Composition of enamel

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Rods or prisms
striated appearance
Runs from DEJ to surface

Enamel

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Epithelial origin

- Ameloblasts extinct after deposition

Enamel

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Mesenchymal origin

- Odontoblasts remain in pulp

Dentin/pulp complex

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-Rods are about 4-8µm
\+Interlocking Prisms
--Head region (5µm  wide)
--Tail region (5µm long)
-Rods surrounded by an  organic sheath

Enamel organization

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What are rods made up of

Millions of crystallites

- Each crystallite surrounded by an organic film or matrix

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What are crystallites composed of

Calcium phosphate | - Hydroxyapitite

What are crystallites shaped as?

- Needle-like - 200-400 A wide - 1600 A long - Surrounding organic matrix

Long axis of crystals parallel to rod direction

Body

Up to 65 deg from prism or rod direction

Periphery and tail

- Occurs at cervical and incisal/occlusal areas | - Harder to cleave

Gnared enamel

Resists fracture better than regular enamel

Gnared enamel

- Very hard, brittle, stiff - - Parallel to rod direction - Low tensile strength - -Perpendicular to rod direction

Properties of enamel

Same in all directions

isotropic

Depends on direction

Anisotropic

Enamel should go ____ to enamel rods and be supported by dentin

Parallel

Less translucent than enamel

Dentin

- 50% HA - 25% collagen - 25% water includes tubules

Dentin Composition

Come from odonotoblastic cells

Dentinal tubules

- Tubules extend from pulp chamber to DEJ | - Tubules related to cells that line the pulpal wall (Odontoblasts)

Pulp/Dentin Complex

Allow fluid movement and ion transport - Remineralizaiton - Apposition of peritubular dentin - Pain preception

Dentinal tubule function

Cytoplasmic extensions of cell body (tomes fibers)

Odontoblastic processes

Cell bodies line the wall of pulp chambers

Odontoblasts

Can you grow new enamel?

What is the difference in superficial dentin compared to deeper dentin?

Tubules are smaller and more sparsely distributed in superficial

What is the difference in tubules in superficial & deep root dentin vs coronal dentin

Tubules in superficial and deep are smaller and less numerous

Which dentin is more mineralized?

Peritubular dentin is more mineralized than intertubular dentin

Which dentin is more mineralized? Near DEJ or Near pulp

Near DEJ

What is the principal organic component in dentin structure?

Collagen | long rope-like protein & adds toughness

What is contained within HA crystals?

Collagen

- 20% less hard than enamel - higher tensile strength (tough) and lower stiffness (modulus of elasticity) than enamel - isotropic properties - stops the propagation of most cracks in the enamel

Properties of dentin

Unmineralized zone of dentin immediately adjacent to cell bodies of odontoblasts

Predentin

Forms up to 3 years after tooth eruption

Primary Dentin

Without any obvious stimulus, dentin direction changes and deposition slows

Secondary Dentin

Which dentin is closer to the DEJ

Older Dentin

Doesn't follow patterns- kind of like gnarled enamel

Sclerotic Dentin

Differences in Dentin and Enamel

- Less mineral content - small tubules run throughout (more fluid and ion transport) - Ability to repair or regenerate (physical chemical response - cellular response)

What do radiographs of enamel look like?

- Enamel is more mineralized - More radiopaque - Whiter Xray

Functions of Dental pulp

1- Formative or development 2- Nutritive 3- Sensory or protective 4- Defensive or reparative

What produces Dentin?

Odontoblasts

What is the nutritive function of Dentin?

Supplies nutrients and moisture to dentin through the blood vascular supply to the odontoblasts and their processes

What does the sensory function do to the dentin?

Provides nerve fibers within the pulp to mediate the sensation of pain

Can dentin receptors differentiate pain?

What is the defensive response of dentin?

Inflammation to severe irritation. May result in pulp death

- Lightly yellow, slightly lighter in color than dentin - Rarely seen clinically - Lost as periodontium is lost - Removed by scaling, polishing and abrasion

Cementum

5-10% mineral content 45-50% Inorganic hydroxyapitite 50-55 organic matter and water (collagen & protein polysaccharides)

Cementum

Highest fluoride content of all mineralized tissue

Cementum

Hard, avascular dental tissue covering anatomic roots

Cementum

Formed continually through life: acellular and cellular

Cementum

What is cementum formed by?

Cementoblasts

Develop from undifferentiated mesenchymal cells in connective tissue of the dental follicle

Cementoblasts

What is an indicator that cementum is still forming

Periodontal fibers present

Attachment of cementum to dentin

Cementodentinal junction (CDJ)

Referred to as the cervical line, where the cementum joins enamel

Cementoenamel junction (CEJ)

Can undergo self repair to a limited degree

Cementum

Slightly softer than dentin (less mineral) | Permeable to a variety of materials

Cementum