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Cariology > Demineralization and Remineralization > Flashcards

Demineralization and Remineralization Flashcards

1
Q

What are the three main clinical reasons for losing teeth?

A

1) Non-restorable cavity
2) Loss of periodontal support
3) Trauma

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2
Q

Minerals that make up the teeth

A

Apatite

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3
Q

Apatite is considered a ____

A

Salt

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4
Q

How many forms can apatite exist in?

A

Numerous forms

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5
Q

What are teeth?

A

Mineral objects or salts that exist in solution

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6
Q

How does teeth behave in a solution?

A

Like any other salt would in a solution.

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7
Q

What happens to salt in a solution?

A

Any salt placed in a solution becomes saturated with the ions making up that salt. The solution achieves an equilibrium.

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8
Q

What two elements must the solution (saliva) be saturated with in order to prevent the teeth from dissolving away?

A

Calcium and phosphate ions

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9
Q

Four ways apatite mineral is lost:

A

1) Corrosion
2) Attrition
3) Abrasion
4) Abfraction/Fracture

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10
Q

Corrosion

A

Chemical dissolution of tooth structure

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11
Q

Abrasion

A

Pathogenic wearing of tooth structure

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12
Q

Attrition

A

Physiologic wear due to occlusal forces.

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13
Q

Abfraction/Fracture

A

Due to occlusal forces/trauma. Tooth flexure.

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14
Q

Dental Caries = Dental Cavities. T or F?

A

False. Dental caries≠ dental cavities.

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15
Q

Dental Caries

A

The progressive loss, by bacterially-generated acid dissolution, of the apatite (mineral) composition of the enamel and dentin, or the cementum and dentin. It is the disease.

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16
Q

Dental Cavity

A

The clinically evident result (sign) of the disease. A “hole” in the tooth caused by the caries process.

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17
Q

What are the factors needed for dental caries to occur?

A

1) Tooth structure
2) Acidogenic and aciduric bacteria
3) Fermentable carbohydrate

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18
Q

Chemical make-up of enamel

A

Similar to hydroxyapatite, Ca10 (PO4)6 (OH)2. May contain stray ions including Na2+, Mg2+, Cl-, Fl-, CO3^2-.

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19
Q

Apatite Crystals

A
  • Long (100um) and thin (50nm)
  • tightly packed in repeating arrangement to form crystals.
  • may run the full length of the enamel
  • may fuse with adjacent crystals along their length.
  • parallel like angel hair pasta
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20
Q

Spaces in between the apatite crystals are occupied by what?

A

Water and organic material.

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21
Q

What determines the solubility of individual enamel apatite crystals?

A

The solubility of enamel as a tissue.

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22
Q

T or F. All minerals have solubility in water at any given temperature?

A

True

23
Q

What is the rate of dissolution in water? (Not a numerical number)

A

It is fast at first, then it slows down as ions accumulate in solution.

24
Q

When does net dissolution stop?

A

When an equilibrium is formed between the rate of mineral dissolution and re-crystallization.

25
Q

Solubility Product Principle

A

The velocity of a reaction (ion activity product (IAP)) is proportional to the product of the masses of the reacting substances, each raised to a power equal to the number of molecules taking part.

26
Q

What is IAP?

A

Ion activity product. The velocity of a reaction.

27
Q

What is activity in IAP?

A

It is the “effective” concentration of an electrolyte or ion and is related to the chemical energy of salts or ions.

28
Q

Solubility product constant (Ksp)

A

Identifies the equilibrium point of mineral dissolution (point of saturation of the solution) at a specific pH and temperature. Indicates the degree to which a compound dissociates in water.

29
Q

T or F. The lower the solubility product constant (ksp) the more soluble the compound is.

A

False.

30
Q

What is the Ksp of HA (hydroxyapatite)?

A

7.41 x 10^-60 mol9/l9 at a ph +6 and 37ºC

31
Q

The solution is in what when IAP = KSP?

A

Equilibrium

32
Q

The solution is in what when IAP < KSP?

A

Demineralization and under saturated.

33
Q

The solution is in what when IAP > KSP?

A

Remineralization and supersaturated.

34
Q

What is the IAP of HA?

A

When you multiply the concentrations of the calcium ion, hydroxyl ion and phosphate ion (mol/l).

35
Q

Why is enamel solubility increased by acid?

A

The solubility of calcium phosphates is greatly affected by the pH of the water in which it is dissolving, unlike many other salts like NaCl, whose solubility is unaffected by pH.

36
Q

What happens when you add hydrogen ions to make the water more acidic?

A

The hydrogen ions are attracted to and bond with negative charges such as the hydroxyl ion, thus producing more water and making enamel more soluble.

37
Q

What is Critical pH?

A

The pH at which a supersaturated solution becomes JUST saturated with respect to the mineral (back to normal).

38
Q

What is the critical pH of HA?

A

5.5

39
Q

Common ion effect

A

The excess of one ion in soliution requires less of the other ion(s) in solution to attain the KSP.

40
Q

T or F. The addition of calcium or phosphate to the solution reduces the amount of hydroxyapatite that dissolves.

A

True.

41
Q

What has a greater affect on IAP, doubling OH- or doubling Ca2+?

A

Doubling OH-. Adding OH- removes H+ ions in the solution and thus affecting the concentration of phosphate as well. Ca2+ has no affect.

42
Q

What are the four most common types of apatite crystals that compose enamel?

A

1) Carbonated hydroxyapatite (CAP)
2) Hydroxyapatite (HA)
3) Flourhydroxyapatite (FHAP) - flouride ion replaces the OH- ion.
4) Flourapatite - two flouride ions replacing the OH- ion.

43
Q

Has the highest concentration in newly erupted teeth

A

Carbonated hydroxyapatite (CAP)

44
Q

What is the most soluble to least soluble of the four apatite types?

A

CAP > HAP > FAP > FHAP

45
Q

Which apatite type has a higher KSP, CAP or HAP?

A

CAP does at 7.41 x 10^-58.

46
Q

When remineralization occurs (IAP > KSP), what happens to the enamel after?

A

It can change into a more mature and more acid resistant mineral form.

47
Q

Which apatite type is more stable in a acidic solution, HAP or CAP?

A

HAP because CAP is more soluble in this solution.

48
Q

What is Ostwalt ripening?

A

Over time, the crystals tend to re-form and grow to reach their maximum size.

49
Q

Describe newly precipitated crystals

A

They are usually small and contain many defects, causing them to be more soluble.

50
Q

What is crystal growth susceptible to?

A

Poisoning by various substances.

51
Q

What is a pellicle?

A

Salivary proteins such as tyrosine peptides, statherin, and various proline proteins that coat the plaque free enamel surface to prevent seeding of apatite crystals.

52
Q

What inhibits the formation of hydroxyapatite crystals on teeth?

A

Plaque that contains plaque fluids with lowered pH.

53
Q

How is calculus formed?

A

When the plaque pH rises above the critical pH.

54
Q

If you apply flouride product to the teeth, is there greater flouride uptake in plaque-covered teeth or on “clean” teeth?

A

Plaque covered teeth because there are more minerals available to be replaced by flouride, so there is more HFAP that is formed.

Cariology (5 decks)

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