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Journal of Dental Research

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Dental Morphology in Relation to Caries Resistance with Special Reference to


Fissures as Susceptible Areas
Klaus G. König
J DENT RES 1963 42: 461
DOI: 10.1177/00220345630420015401

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Dental Morphology in Relation to Caries Resistance with
Special Reference to Fissures as Susceptible Areas
KLAUS G. KONIG
Experimental Caries Research Laboratory, Dental Instiute, University of Zurich, Switzerland

The observation of relationships between the morphologic characteristics of teeth and


the location of carious lesions has been the basis of G. V. Black's classification of
cavities according to susceptible areas and of his description of caries-immune areas
more than half a century ago. Black' had already realized the existence of combined
influences on caries of tooth morphology and other developmental and environmental
factors, conditions which have been investigated recently by Parfitt2, 3 and by Nevin.4
In smooth surfaces, especially proximal ones, besides diet, function, and cleaning
mechanisms, a great variety of factors interferes in the relations between morphology
and caries: shape and condition of the gingival margin and of the papilla, proximity
of a tooth, width of the interdental space, degree of tooth mobility, and others. In
contrast to this very complex situation, the interrelationship of tooth morphology and
caries resistance is more easily accessible regarding occlusal fissures.
Bossert,5 on stone models of 100 selected upper right first permanent molars, has
shown that a correlation exists between the steepness of the walls of the groove leading
down to a fissure and the incidence of dental caries, most lesions occurring in the
deepest grooves with steeply sloping sides. The relation between the types of fissures
and initial caries has been studied in ground sections of human teeth by Nagano.6
Both Bossert and Nagano in their investigations have dealt with steepness of cuspal
walls or morphologic types of fissures as characteristics of the tooth and have studied
different shapes in different teeth. It has to be realized, however, that conditions within
the same tooth may vary depending on which part of the whole length of the fissure
the section is taken from. In a tooth showing signs of early decay in the occlusal fis-
sures, carious decalcification does not start over the whole length of the fissure simul-
taneously. Therefore, in the first part of the present investigation, regions of different
width, depth, and configuration of the same fissure within teeth were studied in relation
to susceptibility and resistance to caries.
Human teeth show a great variety of morphologic types. Kraus and Furr,7 for ex-
ample, classified and defined 17 different morphologic traits in a study including 800
lower first premolars. Unlike in man, rat molars and the form of their fissures are
highly constant morphologically. They were therefore considered a useful additional
means to study the relations between dental morphology and caries (second part of
the present study), as has been done by Kifer, Hunt, Hoppert, and Witkop8 and by
Grainger, Paynter, and Shaw9 in strains of rats of different susceptibility to caries.
OBSERVATIONS IN HUMAN TEETH
Materials and methods.-From teeth extracted for orthodontic reasons, 10 upper
and 2 lower first premolars showing varying grades of dark discoloration in the depth
461

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462 KOrfN"-G J. dent. Res. Supplement to No. I
of their fissures upon macroscopic examination were chosen. Between 8 and 16 non-
decalcified vertical buccolingual serial sections were prepared from each tooth with
the Jansen'o sectioning machine. The sections were about 150 il thick, and approxi-
mately 100 , of tooth substance were lost between two subsequent sections. A total
of 140 sections was obtained; they were imbedded in Canada balsam, and microphoto-
graphs were taken under incident light at 4 and 6.4 times original magnification. These
series of sections allowed the study of the extension of early lesions in relation to the
characteristics of grooves and fissures.
Results and discussion. Correlated variations were observed with respect to the
morphology of fissures and to the stage of progression of early various lesions, not only

:EFin 1i Adacent setin acos V Eyp fissure


oi upe prmlr one of caries nea thedeps
poin A X er smal earls dclifcto in,"th eto hs n 0age d ne etu
tiniusqun eto oftesmesu inS whc the; anl is muc sal r(gmgX4
bewe diffrn tet but als beve difeen location wihi th sam fisr

Shallow porjaet etions


of roovs formped bysur wallupinpar
unerr widet agl
ffcre
o ear h epprox

mately 90°-70° showed low susceptibility to decay. In grooves formed by angles small-
er than about 70 , initial decalcifications of enamel were rather common and usually
started at or near the deepest point of the sulcus (Figs. 1 and 2). Severe various attack
in a groove, with involvement of dentin, was always located in those parts where the
sulcus ended in a deep and narrow fissure. The areas of the most severe decalcifications
in this type were found to be both sides of the entrance to the deep. narrow part (Fig.
3), causing the enamel-denltin junction to be reached at different points, down from
the buccal and lingual site of initial attack, respectively (Fig. 4, d and 1). This is in
accordance with the findings of (X. Gustafson'1 and olf Naganoj; the latter giving the
following clasification of pits and fissures: (1s) V-type, wide at the top and gradually
narrowing toward the bottom; (2) U-typve, almost the same width from top to bottom;
(3) 1-type, an extremely narrow slit; (4) 1K-typze, extremely narrow slit associated
with a large space at the bottom; (5) other types. Nagano6 has founl~d the various

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Ft(. 2. Section of upper premolar showing moderately deep U-type fissure orimed bv cuspal walls
of medlium angle. Main point of initial various attack at the basis of the fissuie (Orig. mag. X24.)

FIG. 3. Sections of two different upper premolars with I- to U-type (A) and IK-type (B) narrow
fissures. Most extensive various decalcifications starting, around the entrance of the narrow parts.
(Orig. mag. X45.)

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9

FIG. 4. Twelve out of a series of 15 subsequent buccolingual serial sections of an upper premolar
(sections numbered 1-15 from distally). (Orig. mag. X l5.) a, Section 2: distal end of fissure, starting
as a broad sulcus showing signs of very early decalcification at the bottom; b, section 3: initial de-
calcifications in both walls of narrowing fissure; V-type configuration; c, section 4, and d, section 6:
carious attack, having started from both sides near the top of this narrow IK-shaped part of the
fissure, has reached the enamel-dentin junction at two points independent of each other; e, f, and g,
sections 8, 9, and 10: in the central portion of its whole mesiodistal length, the fissure has flattened
out (V-type) nothing but very small superficial decalcifications; h, section 11, and i, section 12: the
angle of the cuspal walls is narrowing again and shows, near the deepest point, once more the start
of initial decalcification; k, section 13: marginal part of progressed dentinal lesion in the mesial pit
shown in sections 14 and 15; 1, section 14, and m, section 15: center of lesion having started from
mesial narrowing of the fissure to I-type configuration; various attack has reached enamel-dentin
junction from both lateral sites of initiation independently; in section 14 (I), part of the decalcified
enamel has been lost in the course of preparation.

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Vol. 42,1/963 4DEoT .NID) CARIES -RESISITANCE 465
9 I)VJ iL M-OldI'ILOLOGVX

forms in the following percentages: V-type, 34 per cent; IK-type, 26 per cent; I-type,
19 per cent; U-type, 14 per cent; others, 7 per cent. Nagano has found form and depth
of pits and fissures to be closely related, the V-type being shallow, the U-type of
medium depth, and most of the remaining types deep. Moreover, he has observed a
relation between the localization of the primary lesion and the form and depth of the
fissure: in the V-type, shallow in most cases, caries starts from the bottom; it starts
halfway down in the U-type, and from the top in the 1-type and IK-type.
Nagano's findings were fully confirmed in the present investigation. As to localization
of the initial lesion in narrow fissures, a plug of plaquelike material was occasionally
observed closing the entrance of the fissure proper (Fig. 5), within which the produc-
tion of considerable amounts of acid might take place, whereas diffusion of substrate
down the narrow fissure might be slow, resulting in the formation of less acid in the
depth of the fissure than at its entrance.

FIG. 5.-Section of upper bicuspid showing narrow fissure, the entrance of which is barred by
plaquelike material. (Orig. mag. X 24.)

The strongly predisposing nature of the morphology of the groove is illustrated by


a series of 15 buccolinaiual vertical sections through subsequent mesiodistal planes of
an upper first premolar. The photographs of 12 of these sections are given in Figure
4, aces. In the first sections from the distal end, (a d), increasing severity of altera-
tions is found with increasing narrowness and depth. Toward the center, the fissure
smooths out, with nothing but very slight superficial decalcifications of the enamel
visible (eg). Again, toward the mesial third of the whole length, the groove narrows
(h and i), with more severe onset of acid attack. The last three sections show the most
severe carious destruction, apparently due to the favoring presence of another narrow-
ing of the fissure, visible in I and 1x, at its mesial end. Quite similar relations between
the form of a groove at different points and its resistance or non-resistance to carious
attack were found in the other teeth examined. A deep, narrow fissure may resist
carious destruction, but whenever a sulcal occlusal lesion gets started, alterations al-
ways are most severe in the steep, narrow, deep parts and least severe in the shallow
parts. As to narrowness, a deep fissure too narrow to allow of impaction or even diffu-

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-160 KONIGl J. deal. Rcs. Supplenenl to No . I

sion of considerable amounts of substrate (I-type, Fig. 6, .1) seems to be less liable to
various attack than one providing some space for plaque and debris to accumulate.
Steepness of walls and ample space for retention above the entrance to the fissure
appear to be the more important features, the depth of the fissure proper being of
secondary significance.
The material upon which these conclusions are based is rather limited. However,
the validity of the findings seems to be strengthened by the presence of the above-
mentioned relationships within teeth, i.e., under practically identical environmental
and developmental conditions. Moreover, the findings are in accordance with those of
other investigators derived from studies of single examinations of a great number of
teeth.

FiG. 6.-Adjacent sections of an upper first premolar from region near the distal end of the fissure.
A: I-type fissure starting from rather wide and shallow groov e; no marked alterations B: deep
fissure visible in A has disappeared; groove is getting steeper with initial decalcifications starting
halfway down in both walls. (Orig. mag. X 24.)

STUDY OF RAT MOLARS


Distribution of sulcal various lesions. In 1950. Hunt and Hoppert12 described the
frequency distribution of occlusal gross lesions in the various susceptible areas of the
lower molars of resistant and susceptible Hunt-Hoppert rats. These data having been
reported "with a minimum attempt to interpret observations," the investigators paid
no special attention to what seems to be a remarkable fact: regarding the frequencies
of those occlusal lesions apparently having started from the central and distal fissures
of the first and second lower molars, the ratios of the numbers of lesions central : distal
were reversed in susceptible and resistant rats.
The central: distal ratio of lesions in the first molars was 5.5: .0 in the susceptible,
compared with 1.0:3.9 in the resistant strain (Fig. 7). Respectively. for the second
molars, the central: distal ratio was 2.6:1.0 in the susceptible, whereas it was 1.0:2.2

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S
A
B C C~D E

FIG. 7. Above: Simplified diagram of distribution of carious lesions in central and distal fissure of
first lower molars of Hunt-Hoppert rats (H. R. Hunt and C A. Hoppert, J. dent. Res., 29:157,
1950). Below: Lower molars in more detail for comparison (K. G. Kbnig, T. Marthaler, and H. R.
Miihlemann, Dtsch. Zahn-, Mond- Kieferleilk., 29:99, 1958).
Accompanying table shows ratio of distribution of lesions in susceptible and resistant rats. (Hunt
and Hoppert, ioc. cit.)

RAT\I [0 D)11Sf RIBLUTlIO.N 01 LEMOl()NS

Strain Loasation Absolute No. Ratio


S sce tiblte 19362 248 5 .:1 10
Resistant B 219.861 1 0: 1)

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100 3 2 4 5 6 7 8

90
80
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70 00 N
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a b c d e f g h i k 1 m n
FIG. 8.-Percentage frequency in fissures (a-h; see insert) and proximal surfaces (i-n) of slight +
more severe dentinal lesions (dotted + black columns) in right (re) and left (li) lower molars in
253 Osborne-Mendel (above) and 61 Sprague-Dawley (below) rats after 15-30 days on diet 580.
Numbers above columns represent ranking of fissures according to frequency of slight + more severe
dentinal lesions. (F. Trechslin, medical thesis, in press.)

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Vol. 42, 1963 DENTAL MORPHOLOGY AND CARIES RESISTANCE 469
in the resistant rats. Since this reciprocity of central: distal ratios is similar in its tend-
ency for highly susceptible Osborne-Mendel as compared with the relatively resistant
Sprague-Dawley rats used at the Experimental Caries Research Laboratory in Zurich
(Figs. 8, 9, and 10), measurements were performed to investigate various morphologic
traits as possible reasons causing or being involved in this phenomenon.
Materials and methods.-Serial non-decalcified mesiodistal sections of right and left
lower molars from 24 Osborne-Mendel and 24 Sprague-Dawley rats were prepared.
The animals were 40 days of age at sacrifice. The series of sections, one of which is
shown in Figure 11, were coded, and the mid-sections were selected under a micro-
scope for measuring. The 24 rats from each of the two colonies were from 6 litters,
each 4 littermates being 2 male and 2 female animals.
The following morphologic characteristics were measured with the aid of a dissec-
tion microscope and a filar micrometer eyepiece (cf. Fig. 12): (a) mesiodistal cervical
diameter, z, of crowns of right and left first, second, and third molars according to
Grainger, Paynter, and Shaw,9 at 16 times magnification; by right-left comparison of
these data, bilateral similarity, already described by Kifer, Hunt, Hoppert, and
Witkop,8 was found, and consequently all further measurements were made in the left
molars only; (b) width of entrances of central and distal fissures of the first and
second molars according to Kifer et al.8; length of dotted line through x, perpendicular
to the mesial wall of fissure, at 25 times magnification; (c) depth of fissures down
from the perpendicular through point x to the deepest point of the fissure, at 25 times
magnification; (d) fissure angles formed by tangents s and t; (e) vertical step u, from
top of the distal minor cusp of the first to the top of the mesial cusp of the second
molar. Both measurements (d) and (e) were taken not directly but upon drawings
from the projection of the microscopic pictures.
Statistical calculations of the data were performed on the relative figures obtained
by the micrometer readings. For presentation in tables, the averages ± standard de-
viations are given in millimeters or hundredths of millimeters.
Results and discussion.- (a) The differences of cervical mesiodistal diameters
(Table 1) between Osborne-Mendel (OM) and Sprague-Dawley (SpD) rats were
weakly significant for the first (p < 0.05) but not for the second and third molars.
Between right and left molars, as well as between litters, no significant differences
were present (Table 2).
b. On width of fissures, the influence of sex and again of litters was tested. No dif-
ferences were found in these respects, and therefore the whole matrial was analyzed
only for differences "central vs. distal fissures," for differences between OM and SpD
rats, and for the interaction of these two main factors. The mean widths of fissures
are tabulated in Table 1. The order of magnitude of these values and their variation
compare quite well with the figures found by Kifer et al.,8 who, however, did not in-
clude the distal fissures in their measurements.
Attention should be drawn to the fact that, for both OM and SpD rats, in the first
molars the central fissure shows greater "width" than the distal one, whereas in the
second molars this situation is reversed. Incidentally, in OM rats the widest fissure-
the distal one in the second molar-is the most resistant of all fissures in the first and
second molars (Fig. 8). This finding is in contrast to the observation of Kifer et al.8
who found fissures of significantly greater width in the Hunt-Hoppert susceptible

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Fi(;s. 9 AND 10.-Photographs showing typical distribution of carious lesions in rats of different
susceptibility. Fig. 9: First and second molar of highly susceptible Osborne-Mendel rat after 20 das
on cariogenic 580 diet; initiation of lesions starting halfway down or in the depth of fissures. Fig. 10:
Sprague-Dawley rat of low caries susceptibility after 30 days on 580 diet. Dentinal lesions at the
distal fissures presumably started from occlusallv (cf. Fig. 13).
Accompanying tables show comparison ot sexeritx of lesions in distal and corresponding central
fisures in 2 times 50 first molars of OM and Spl) rats. E enamel lesion; Dss,Dir, Dx= slight,
moderate, and extensive dentinal lesion, respectively. (Scores according to P. H. Kecyes, J. dent. Res.,
37:1088, 1958).
SU1CIR PTIBIF OlStrI)RNE-.XIIJN RAlit!.
RTS

(o RRF, F ERI'S
'IIX(IXINI; ( CEN-IRRI. II
Dl1S 'AL FISSIJRIS
(o )
ore EI r)s)ll ) [rotal
Score 0 1.; r I -
Sbore E. 14 r122 r 14
Score D., 21 16 21
Total 5

RE SIANTI SPRAUI. 1-)A LIE \ RATS

(I.RRI i'INDIINGI NTR AL SI1 RE


1)1 TAL 1F 1-URI,
SIcorC 0 p, ) D)il DN iotal
Score P
store
.Score
DS
D
11, _ _12
3
--20
--J --- 50
:1 :31
__
1T tal. -()

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VolZ. 42, 1 963 42, 13 D S MALIORPIOLOGY AN D CARJES RESISI1VCE' 471
Dol.

strain. These Hunt-Hoppert rats had been fed a HWC-coarse-rice type of diet, whereas
OMi and SpD rats in our experiments got the high-sugar soft Stephan 580 cariogenic
diet; therefore, there may be an interaction with the type of diet, or otherwise the
characteristic defined as "width" of a fissure is not strongly correlated with its resist-
ance to caries. The first possibility seems more probable: different influences on occlusal
caries by corn and sugar diets of different fineness and an influence of function and
non-function have been found by Kbnigi1
c. As to the depth of fissures (Table 3), the central fissures are deeper than the
distal ones (p < 0.001) both for first and second molars in OM and SpD rats. Be-

0~s 4; fN sf .?tt0

aStS: \\0

Fic. 11. -Series of non-decalcified sections of t-igrht and letlt 1owxer jaws of one rat. on slide, covered
by cellophane tape. Preparation has heo1 destsINI 1)xy Konig. Marthaler. and Miihlemann, D!sc/s.
Zian-, Mund-) Kieferheilk., 29:99, 19.S.

FIn. 12.- Diagrammatic side view of section of second and first lower molar of rat to define land-
marks for measurements (refer to text).

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472 KONIG 4. dent. Res. Supplement to No. 1
tween OM and SpD, there is a significant difference only between the depth of fissures
in the first molars (p < 0.001), but no significant interaction "OM vs. SpD X central
vs. distal."
d. The fissure angles are assembled in Table 3. The shallow distal fissures open
more widely than the deep and narrow central fissures (p < 0.001). This is the only
finding of interest with respect to the first molars. Regarding the data for the second
molars, the analysis of variance of the opening angles is given in Table 4. Although in
TABLE 1 *
CERVICAL MESIODISTAL DIAMETER AND WIDTH OF ENTRANCE OF FISSURES OF LOWER
MOLARS IN 24 HIGHLY SUSCEPTIBLE OSBORNE-MENDEL RATS AND
24 RELATIVELY RESISTANT SPRAGUE DAWLEY RATS
(Averages + standard deviations)
CERVICAL MESIODISTAL DIAMETERS (MILLIMETERS)

FIRST LOWER MOLAR SEcoND LOWER MOLAR THIRD LOWER MOLAR

Right Left Right Left Right Left

Osborne-Mendel. 2. 67 ±0. 10 2.68+0.17 1.60+0.12 1.58+0.14 1.55 ±0.16 1.50±0.14


Sprague-Dawley. 2.61+0.13 2.62 +0.13 1.62 +0. 14 1.58+0.09 1.48±0.13 1.47+0.13

WIDTH OF FISSURES (HUNDREDTHS OF MILLIMETERS)

FIRST LOWER MOLAR SEcoNnD LOWER MOLAR

Central Fissure Distal Fissure Central Fissure Distal Fissure

Osborne-Mendel ........ 25.46+3.83 23.81 +5.30 24.37 + 5.02 29.25 ±6.53


Sprague-Dawley ..........I 25.31 +6.83 20.44+4. 12 20.66+4.15 24.34+5.34

Hunt-Hoppert* susc .......1 25.90±6.04f ................ 27.70+6. 16t ...............


Hunt-Hoppert* res. 20.70+3.51t ................ 20.70+3.51t ................

* Corresponding data from P. E. Kifer, H. R. Hunt, C. A. Hoppert, and C. J. Witkop, f. dent. Res., 35:620, 1956.
t Standard deviation calculated back from standard error of the means in the original tables.

TABLE 2
ANALYSIS OF VARIANCE OF CERVICAL DIAMETERS OF FIRST LOWER
MOLARS OF OSBORNE-MENDEL (OM) AND SPRAGUE DAWLEY
(SpD) RATS, ELIMINATING LITTER VARIANCE*

Degrees Sum of
Source of Variance of Mean Square
Freedom
Squares

OM vs. SpD.............. 1 0.4134 0.4134 P<0.05


Right vs. left............. 1 0.0176 0.0176
Interaction ............... 1 0.0001 0.0001
Litters ................... 11 1. 5111 0. 1374 N.S.
Discrepancy (error) ........ 81 6.1651 0.0761
Total ................ 95 8. 1074
* Measurements were taken in 24 rats from each colony, from 2 X 6 litters.

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TABLE 3
DEPTH OF FISSURES, ANGLE OF FISSURE WALLS, AND OCCLUSAL STEP BETWEEN FIRST AND
SECOND LEFT MOLARS IN LOWER JAWS OF 24 CARIES SUSCEPTIBLE
OSBORNE-MENDEL AND 24 RESISTANT SPRAGUE DAWLEY RATS
(Averages ± Standard Deviations)
DEPTH OF FISSURES

FIRST MOLAR SECOND MOLAR (mMl100)

Mesial Central Distal Central Distal

Osborne-Mendel .... 49.16+ 6.49 67.31+ 6.77 37.91 + 5.80 67.28+13.27 42.75 ±5.72
Sprague-Dawley.... 52.88+ 10.45 67.05± 10.36 33.98±+5.36 60.37± 9.54 36.64+ 5. 78

OPENING ANGLE OF FISSURES

FIRST MOLAR SECOND MOLAR


STEP Ml-M2
(mm/ 100)
Central Distal Central Distal

Osborne-Mendel.... 10.25 +5.11 28.42 +8.89 7. 79 +5. 79 31.96 +3. 74 12. 50±8.04
Sprague-Dawley.... 10.79+6.32 25.00+8.14 9.46±4.43 22.71± 7.80 21.08± 9.50

TABLE 4
ANALYSIS OF VARIANCE OF OPENING ANGLES OF CENTRAL
AND DISTAL FISSURES
IN LEFT LOWER SECOND MOLARS OF 24 OSBORNE-MENDEL (OM)
AND 24 SPRAGUE-DAWLEY (SPD) RATS

Degrees
Source of Variance of Sum of Squares Mean Square
Freedom

Rat strains and fissures.......... 3 9,460. 12 3, 153.37


OM vs. SpD................ 1 345.04 345.04 P<0.005
Central vs. distal............ 1 8,400.04 8,400.04 p <0.001
Interaction ................. 1 715.04 715.04 p <0. 001
Remainder (error)............... 92 2,945.84 32.02
Total ...................... 95 12,405.96

MATRIX OF ORTHOGONAL COMPARISONS (C,-C3)

OM c* OM df SpD c SpD d
C, +1 ... +1 -1 -1
C2 +1 .... -1 +1 -1
C3 +1 ... -1 -1 +1
Avg. opening angles 7.79 31.96 9.46 22. 71
* Central.
t Distal.

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474 KONIG 4. dent. Res. Supplement to No. 1
both OM and SpD rats the distal fissures open under a much wider angle than the
central ones, there remains a highly significant interaction "OM vs. SpD X central
vs. distal." In detail, the opening angle of the central fissure is somewhat smaller in
OM than in SpD rats (7.790 compared with 9.46° in the average), whereas in the
distal fissure the angle is wider in OM (31.960) than in SpD rats (22.71°). The ratio
of mean to standard deviation for the small angles shows that the distribution is some-
what skewed.
If one considers the hypothesis that a narrow sulcus and a small opening angle is
no severe obstacle to food impaction and diffusion of substrate but is a hindrance to
the influence of physical self-cleaning forces in the mouth, this might account for the
greater susceptibility of the deep and narrow central fissures in OM rats. However,
since the opening angle in central fissures of second molars of SpD rats is only 20
wider than in OM rats, the difference cannot be assumed to be the cause of the much
higher resistance of this fissure to caries in SpD rats.
e. The vertical step (u in Fig. 12) between first and second molars was found to
be significantly higher in SpD (0.211 mm.) than in OM rats (0.125 mm.). This step
may favor the retention of food debris in the proximal area, facilitating the onset of
caries in this region, in spite of generally low susceptibility to fissure caries as encoun-
tered in rats from this SpD colony.
In OM rats, the markedly higher caries resistance of the distal fissures compared
with that of the central ones seems to be closely related to the fact that these fissures
are the least deep and open under the widest angles. This is in full accordance with
the findings of Grainger, Paynter, and Shaw9 in Harvard rats and of Bossert5 in human
upper first molars. The conclusion drawn regarding OM rats is not invalidated by the
association of the same morphologic trends with a different frequency distribution of
lesions in SpD rats; the higher liability to caries of the distal fissure, at least in the
first molar, is found to be due to an atypical occlusal onset of caries via the enamel-free
summit of the distal minor cusp (Figs. 9, 10, and 13). Second, for the animals whose
caries distribution is given in Figure 8, somewhat longer periods on cariogenic diet have
been necessary for SpD with lower, than for OM rats with higher, susceptibility (25
days for SpD versus 15 days for OM rats in general). Interestingly enough, the caries
susceptibility of SpD rats has been found to be subject to sudden changes for unknown
reasons, and, as it increases, the caries process seems to be accelerated, and the pattern
of decay tends to imitate the one encountered in highly susceptible OM rats, i.e., caries
starting in the depth of the fissures. As to the form of fissures in comparison with
those occurring in human teeth, they are in between the U-type and the very steep
V-type, and, according to Nagano,6 lesions start between halfway down the fissure
and its deepest point, which generally is the case, at least in OM rats (Fig. 9).
SUMMARY AND CONCLUSIONS
In 140 non-decalcified serial sections from 12 human premolars, the relations be-
tween morphology and early caries in the occlusal fissures were studied. In all teeth,
the initial lesions over the whole length of a fissure were small in shallow parts and
comparatively well progressed in narrow parts with steep walls. In 24 highly suscep-
tible OM and 24 relatively caries-resistant SpD rats, the relationship between the
frequency distribution of sulcal carious lesions in first and second lower molars and

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Vool. 42, 1963 .E16AL 1[ORIPIIOLOG
IT V A NVD C RIES RESIS TANCE 475

measurable morphologic characteristics in these teeth was investigated. In OM rats,


the least susceptible fissure was the shallowest one with the widest opening angle, a
finding which corroborates the results from human teeth. In the generally resistant
SpD rats, special conditions seem to prevail. Fissures almost as narrow and deep as
in the susceptible OM rats -fissures, therefore, which might be supposed to become
decayed under environmental conditions favoring caries are rather resistant to decay.
On the other hand, a caries-promoting morphologic trait appears to be present in
these rats in a step between the occlusal levels of the first and second molars. This
step seems to favor food retention and also, perhaps, prevents the proximal area from
being self-cleaned under mastication. Narrowness and steepness of fissure walls appar-
ently may favor the onset of caries, but they seem to be facultatively predisposing
characteristics. As is seen in Spl) rats, narrow and deep fissures do not necessarily

FIG. 13. -Carious destruction starting from enamel-free top of distal minor cusp of a rather re-
sistant Sprague-Dawley rat after 25 days of feeding 580 diet.

become decayed on a highly cariogenic diet if certain unknown supplementary environ-


mental cariogenic factors are missing or if some protective environmental or develop-
mental factor, unknown in nature, is present.
The author is indebted to Dr. T. M. Marthaler for valuable suggestions and to Mr. M. Schlienger
and Mr. R. Schmid for skilful technical help.

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