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    © All Rights Reserved
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    9 views36 pages

    Rodica Luca Metode de Preventie Carie

    Uploaded by

    Popovici Corina

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 36
    RODICA LUCA METODE LOCALE DE PREVENIRE A CARIEI IN SANTURI SI FOSETE - editia a Ta reviizuta si adiugitl - Editura Cerma BUCURESTI rad W2vauaNUHaIe9 WOIOEA p’E snsedojoumg eg a1asoy 18 umnjtes IP ofeznfoo some snp ap jnurstuRoayy * San eee ee ‘oenpa eo aroonpoud { Z0p}OS0} |e JS JOPLINJueS [JOY “ZT * soyte> eajprede uy asp1 9p 09203 - afezn/90 sopo}ayEIGns wPBO|O}AOYY | SNTadnd eS € I-€2-9976-€L6 NEST ‘marozas tans wunyoa msoow dase opMdOHp aI} 6661 "26610. nosouoy BURN :eezZLEOINdw09 areDepaLOUYE, vruodojoy FoyTA eUEPEY eULOY “3G :TPHONIpS soITISUOD YEP Woy “Ig 10,9"Poy, CAPITOLUL 1 MORFOLOGIA SUPRAFETELOR OCLUZALE - FACTORI DE RISC IN APARITIA CARIILOR fn practica stomatologicd se recunoaste cd santurile si fosetele ocluzale reprezinti zonele cele mai vulnerabile 1a proceselor carioase, Aceasti recunoaslere este urmarea epidemiologice efectuate 1.2. DATE PRIVIND PREVALENTA CARIET OCLUZALE fntr-un studiu asupra rez la sase luni ickerson din crescute a cariei ocluzale in raport cu celelalte topografii. intre acestea se retin: ~ studiul intreprins intre 1971-1974 de First National Health and Nutrition Examination Survey pe un lot de 20.000 de subie ca varste cuprinse intre 1 si 74 de ani care a aritat ca in jurul varstei de 18 ani mai mult de 50% din suprafetele ocluzale ale molarilor permanenti prezintd carii sau restaurdri, in timp ce suprafejele proximale rman sanatoa - studiul efectuat intre 1979-1980 pe copii din $.U.A, cu vi cuprinse intre 5 si 17 ani, care a demonstrat ci 83% din carii ‘aint plasate pe suprafete ocluzale si vestibulare sau orale; ‘A. rece in revista care se desprinde ideea frecvent: Moroes JoyNUE Pour UNFiORLaTUT osatorep a8 a[eZN}o0 Jaume v pinosaro elueproUT IS wluajeAesd “Tpuod oisooe Up amquap atapesdns aypejaqo 1gsap aurea x asndsipa ‘au afeznjoo ajajoyesdns ‘onauad arapoa op yound wip ‘yo wynzas a[eznoo sop qe arzonposd op npow putaud aqypms wig ROP op viuaAsaNy aySo1o TIE no ‘puerpidsn> vareUrTOUL aysalo 10 NO “Ro WAISqO B-§ “JO[TLeS BaMMJOAZep nnuad nipoutt ung fur [90 yroyo aisnBur 1$ toupe opuMiues yo rxeprsuos ag ‘Ise ‘sz ‘p] vunmopyjpems zounriouof op ojoomp apunxa aywod as azo “YS1e{ yzeq 0 puyuozaid rep essay ‘oummoy yoadse un quamde pupae iniues “zfons ap 1e8 nun mnuose aiwod as 18 1e]nduenis ap mIsap aise ,.[* ap eULLOY uy jniuEy vansnSuy ‘Jougpe “(9p uLog uy Lanjures - sJougpe urind 1$ ares uneurenp no ¢,,** op wULsOy ur Sze LINjues - tundyy pnop nuosap os qWaAoaNy TEU “oreo Us UROTSeTO INU TELL Indes Ne-s 18 a[ezZNJoO Joyjuniues eYZopoyiom yeipms v-s mnyndumy jasmoep ul Teanjo0 myniues vomouype IS wULIOS no woaNp eIMeFa] UL o1S9 IONICS varaonposd yo eaapt 2] snpuoo nv aotu THazasqo a1saoy {gZ] usar 18 oWaUNTTe UHfar area a[au0Z UIp 10}29 B Woop vor TeUT BluaAsaTy O no sep ‘aren ‘apolou ofoloyesdns ad 18 soytues erivede eazesqo uosucqoy ‘Segt U] ‘AreqUep TWIEIOAz9p v RANRULIOY epeoLTad Ut iadind e ,.pseorpuesaU atfovar o 9 Inmde myniqeurs ye jooyop un gutzoudar opunjues ¥O Blopisuo |g "ID ap amorous JOPOUT aye ,areuToeUt ap rojaiayeidns ajtiginenBarou* sussop ¥ xog ‘gogt Up “oan InpATooes rIndaouy vy op your JopTusconowd eHUoTe seNe e “oqeznjoo Yates foriurede ye juezuOARy WaUE|D [EqISOd vo “yeI01e] JoftiIp ee afeznjoo sojsiayeidns ye repaaruap |nyoury WIVZN100 TaRIV Vawsondowd NJ YOTHLASOT TV IS YOTANINVS TATION “ZT {2Z] aleznpoo forme & J01 aya azeut TEU v0 BjUEADaY Je “2p0S'Ep Feu ap arsa ejuapeaasd “eD|Lop Te [mio] e7] “woUdns 89 Teo9p MUI FeU WO BnOp ap HeIZaRe Pury HOLE HxejOU eT “plezn}D0 vEED pupAR RMoAdayy areUT YUE Bad ‘9,6¢"pY Op IRD ® Riuoqeaaid o yoy jnasyzd ef ywereisuoo ne OMY “We ¢ ap dum aleziuatSr mov} v-s axed B] (Tue OT 18 g ant Hdoo) apOp [e [MO] 2p anigesoap ards areziuorSt ap yoyousg # nu UE |] 18 ¢ aNUT aisiga no tidoo ap yeuttoy *jo} ntutig “doo ap mor ynop ad {tte asv8 op JoyLEjour JoyTLIea vadnse vo!Tojonuapide ari99109 0 Z86I W P2voMID9F9 HoTwIOqe}O> 15“ NALD “eIUEWOY UL “Eep] queuoden jor un -npumuaaar amps op poruysy ‘oanuanard umspus op wesSord un-nund yeznjao ww grejonuod ¥y areod - £9506 0p attiodoud ur nro pruyzaud JopLejout som ope ayezn]90 ajaiageadns we gy sp vIsHEA el - yur gf ef eed 99] ne 1S rue 99 wissga vdnp doour a1asoj 18 umn}tes up asvou ojeszoosd - ‘yzundes JopLrejout ae ayeanjoo afotoyexdns ‘iu ¢] op wIsIeA dnp sey “uejour sopmud ape apeznjo0 ajotosedns quns re Oy] 9p FISIEA qns eLTeD vf inosala six no anEIUap apoiayeadns 18 wuEp - 9 asafar nipms se08 ug] “‘epurrury mp oodsy varentyes0y ur ndoo ap undnus ad yenisej0 ‘anes ud aropored 18 wsewap arereups op Jepout nun zidnsv njdure nipms un vognd pe|qpioNn ouUY “Oger Uf [ep] azeiuewaye afrjoos Up s0pA2[9 ape aRRUEP ayFLBeD vUIUNTD ‘anoesd “oC as “tidnza qua0a IO]HUIP e]aresoy 18 opLMjuRs uT JOpLfURPLBIS vaxIsoJO} no vjecgurmdes amo ap umesford mun vareuiquioo und “po wiznjouco vy Sunfe Lome ASooy “ymuUes 1$ arosoy puradno ayemeysay Nes ayeLeD apaioyeadns uIp ay p6 vo pmidey eZeIUNTGNS ‘sony no zin8 op ade negin o> amuowsfo yoos mp 14912 9P OOO'L oP 10] un ad “tur 7 op ypeorad o ad rypms mun uLIN UE ‘OLVSOdS “FAST ‘VaIe ap o1euodes ajareqnzos - 9 8 9 - capacitatii de retentie a microorganismelor si alimentelor in fosetele si santurile adénci ca intr-o nisa retentiva; - imposibilitatile realizéirii unei curatiri foarte bune indiferent de mijlocul utilizat, ceea ce face ca procesul carios sf apara in santurile si fosetele susceptibile curand dupa eruptia dintelui; = cantitatii de smal} mai mici intre suprafaya dintelui si jonctiunea smalt/dentina in cazul santurilor, comparativ cu cantitatea de la celelalte suprafete (0,6 mm fata de circa 2 mm pentru varful cuspidului sau 1,5 mm pentru suprafati nereda). Aceasta permite 0 progresie mai repida spre dentind a ceriilor din santuri si fosete; - concentrafici mai mici a fluorului in smaltul ocluzal dec&t in cel proximal (4, 25] 1.3. MECANISMUL DE PRODUCERE A CARTILOR OCLUZALE DIN $ANTURI $I FOSETE Initial se credea c& debutul leziunifor din sanjurile ocluzale are loc in adéncimea santului si cuprind zonele profunde ale suprafetei ocluzale inainte ca procesul carios si afecteze peretit fisurii si pantele cuspidiene. Acum, ins&, se stie ci debutul se produce ta orificiul santului prin doua leziuni bilaterale independente in smaltul pantelor cuspidiene opuse. Ulterior leziunea cuprinde peretii santului. in progresiunea sa, procesul urmareste structura prismatica, extinzandu-se. Baza sanjului se demineralizeaza dupa ce cele doua leziuni bilaterale se unesc la baza acestuia, Se crede c& orificiul si peretii santului se demineralizeaza inaintea bazei santului deoarece prezenta unui corp organic poate tampona metabolitii acizi ai plicii dentare si, de asemenea, actioneazA cao bariera de difuziune avand drept rezultat reducerea atacului acid la baza santului. Evolutia leziunii poate fi influenfata prin prezenta in mod obisnuit la baza santului a unor cantitati crescute de proteine ale tufelor de smalt. Acest tip de proteine asigura: rezistenta fata de progresia cariei faverizénd redepunerea fazei_ minerale (remineralizare) si limitand accesul acizilor produsi de placa bacteriand la cristalele ce smalt [25]. saommuryo alueisqns ayLoyIp WezyyHn nv “TeODS IN|MID9F ‘warautigo Uf seoonsut efI0e ND a1eplos sep ‘ayasoy 18 Uniuvs uy soiree writede risasud w nnued amnoey poss: . 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