Lecture 15: Remineralization Flashcards
Snacking, dry mouth, dental appliances, medical status are all
risk factors for caries
recall in months for patients implementing primary prevention strategies
6-12 months
recall in months for patients implementing secondary prevention strategies
6 months
recall in months for patients implementing tertiary prevention strategies
3 months
brush 2x, education
primary prev
varnish, sealant, chew sugar free gum, prescription fluoride gel/rinse
secondary prev
minimally invasive treatments, restoration
tertiary prev
hydroxyapatite is what we want to _____
remineralize
has a hexagonal, lattice striation and hydration shell
hydroxyapatite
enamel is __% hydroxyapatite and __% water
97%, 3%
enamel prisms/rods ____ um and interprismatic area ___um
4-8um, .1um
Surface demineralization AKA ___
surface softening
first 10um of demineralization
caused by acids in food/bev. - citric acid and hydroc from our stomach
surface demineralization/ surface softening
sub surface demineralization AKA __
caries lesion
20um surface lesion, 20-1000um lesion body
biofilm induced
pH 4.5-6.5
sub surface demineralization/caries lesion
10-20 sec of a strong acid
clean/roughen tooth surface
etch enamel demineralization
etch demineralization is a stronger or weaker demin than surface demin
stronger
true or false: dentin can have extensive dentin demineralization without a lot of enamel demin present
TRUE in fissure demineralization. This is why fluoride and remineralization treatments are more effective for smooth surface lesions
our goal for remineralization: remineralize ____ first
body of lesion first, THEN surface area
ion deposition via saliva, biofilm, tooth into voids (any intercrystal or interrod spaces caused by dissolution) to produce a net mineral gain
definition of remineralization
remineralization NEEDS
- bioavailable calcium and phosphate (mainly from saliva)
thats all
remin NOT possible if
lesions has become cavitated
fluoride increases the deposition rate by a factor of
2-3
fluoride actually becomes incorporated into the mineral as
flurohyroxyapatite
what results in: reduced acid solubility of remineralized enamel and development of fluoride gradients
fluoride incorporating into the mineral
theraputic remin by fluoride: up mineral saturation
CPP-ACP: helps to maintain ionic phos/calcium supersaturation
-electroneutral : can remin from bottom up
hehe
helps to maintain ionic phos/calcium supersaturation
CPP-ACP
