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Oral Biology > Histopathology of Caries > Flashcards

Histopathology of Caries Flashcards

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1
Q

What are Dental Caries?

A
  • Bacterial disease of the calcified dental tissues

- Characterised by the demineralisation of the inorganic an destruction of the organic substance

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2
Q

Classifications of Dental Caries: What are the different sites of attack?

A
  • Pit and fissure caries
  • Smooth surface caries
  • Cemental or root caries
  • Recurrent caries
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3
Q

What are Pit & Fissure Caries?

A
  • On the occlusal surfaces of molars and premolars
  • Buccal and lingual surfaces of molars
  • Lingual surfaces of incisors
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4
Q

What are Smooth surface caries?

A

Approximal surfaces typically:

  • Below contact points
  • Progression leads to cavitation

Gingival 3rd of buccal and labial surfaces:

  • Similar to proximal caries
  • Almost always produce wide open cavity
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5
Q

What are Cemental (root) Caries?

A
  • The root surface exposed to oral environment
  • Periodontal disease
  • Causes softened root surface
  • Shallow cavities with ill defined boundaries
  • Subsurface demineralisation may reach the dentine
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6
Q

What are Recurrent caries?

A
  • Occur around the margin or at the base of a previously existing restoration
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7
Q

What are the Classifications of Dental Caries based on the rate of attack?

A
  1. Rampant (Acute) caries
  2. Slow progressive (chronic) caries
  3. Arrested caries
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8
Q

What are Rampant/Acute Caries?

A
  • Rapidly progressing caries
  • Many or all of the erupted teeth
    (kids + bottle milk)
  • Rapid coronal destruction
  • Rapid involvement of the pulp
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9
Q

What are Slowly Progressive (Chronic) Caries?

A
  • Slow progression
  • Late pulp involvement
  • Common in adults
  • Reaction from the pulp (tertiary dentine - sclerosis & reactionary)
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10
Q

What are Arrested Caries?

A
  • Caries of enamel or dentine or root caies that becomes static and shows no tendency for further progression
  • BASICALLY - STOP PROGRESSING
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11
Q

Arrested Caries and Enamel: What effect might the removal adjacent teeth have on approximal lesions?

A
  • They can become arrested
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12
Q

Arrested Caries and Dentine: What happens to the caries if Tertiary dentine is produced?

A
  • Lesions with early tertiary dentine (sclerosis) limit inward spread of caries
  • They appear deeply stained brown-blackish colour
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13
Q

Histopathology: What’s the appearance of Early Lesions (White Spot Lesion)?

A
  • Cone shaped with the base on the enamel surface (top facing inwards)
  • Apex pointing towards the amelodentinal junction
  • Different zones reflecting different degrees of demineralisation
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14
Q

What are the 4 zones within Enamel Caries?

A
  • Translucent Zone
  • Dark Zone
  • Body of the lesion
  • Surface Zone
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15
Q

What is the Translucent Zone?

A
  • Advancing edge of the lesion moving towards the amelodentinal junction
  • More porous than normal enamel
  • Large pores

Could be partially or totally missing

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16
Q

What is the Dark Zone?

A
  • 2-4% of volume of pores
  • Larger and smaller pores than translucent zone
  • Remineralisation due to precipitation of minerals lost from Translucent zone
  • Narrow in rapidly advancing lesions
  • Wider in slow lesions with more remineralisation
17
Q

What’s the body of the lesion?

A
  • 5-25% of pore volume
  • Larger crystals than normal enamel
  • More prominent Striae of Retzius
18
Q

What’s the surface zone?

A
  • Highly mineralised zone with minerals coming from the plaque and from the demineralised deeper layers
  • Little change in early lesion
19
Q

What’s the Histopathogenesis of Enamel Caries?

A
  1. Subsurface translucent zone
  2. Enlarges and a dark zone develops in the centre
  3. Body of the lesion forms in the centre of the dark zone (hite spot)
  4. When reaching the dentinoenamel junction, caries spread laterally undermining adjacent enamel (bluish)
  5. After a critial stage, enamel breaks forming a cavity
20
Q

What are the characteristics of Fissure Caries?

A
  • Caries start to form in the wall of the fissure
  • Caries spread outwards to adjacent enamel and downwards towards dentine
  • The lesions meet at the base of the fissure
  • Cone shaped lesion with a base towards the dentinoenamel junction
  • Larger area of involved dentine
21
Q

What are the characteristics of Dentine Caries?

A
  • Living tissue is capable of responding to carious attacks
  • High organic content that might be destroyed
  • Pulpal reaction before the lesion reaches the dentine
  • Demineralisation occurs before the bacterial front
  • Organic matrix break down by bacterial invasion
22
Q

Dentine Caries: What are the 4 Zones? (1)

A

Zone of Sclerosis:

  • Translucent zone
  • Beneath and at the sides of the lesion
  • Broader beneath the lesion
  • Reaction of odontoblasts to caries
  • Higher mineral content = acceleration of peritubular dentine formation & calcification of the odontoblastic process
23
Q

Dentine Caries: What are the 4 Zones? (1b)

A

Zone of Sclerosis:

  • Dead tracts (dead tracts of fish)
  • Death of Odontoblasts
  • Air filled (appear black)
  • Ready access to the pulp
  • Pulpal cells occlude the tracts with hyaline calcified material
24
Q

Dentine Caries: What are the 4 Zones? (2)

A

Zone of Demineralisation:

  • Intertubular dentine is affected by an acid wave
  • Acid diffuses ahead of the bacteria
  • Soft dentine and sterile
  • Might become stained yellow to other bacterial products
25
Q

Dentine Caries: What are the 4 Zones? (3)

A

Zone of bacterial invasion:

  • Bacteria proliferate within the tubules
  • 2 waves of invasion:
    + acidogenic bacteria
    + mixed acidogenic and proteolytic organisms
  • Tubular walls become soft from acid environment
  • Liquefaction foci
  • Beaded appearance histologically
26
Q

Dentine Caries: What are the 4 Zones? (4)

A

Zone of Destruction:

  • Increase in the number and size of liquefaction foci
  • Cracks appear at the right angles of the tubules (transverse clefts)
  • Bacteria invade intratubular dentine
  • Cavitation

Oral Biology (33 decks)

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