Lecture 1

Classification of Dental Caries

- According to anatomical site :-
1- Pits & fissures
2- Smooth surfaces : - interproximal surfaces ( contact areas ) - cervical surfaces
3- Root surfaces

gingival inflammation & periodontal ‫ نتيجة‬gingival recession ‫ دايما بيحصل نتيجة‬root caries ‫ال‬
oral cavity ‫ لل‬expose ‫ يبقي‬root ‫ و دا بيخلي ال‬root ‫ لل‬exposure ‫ و البالتالي بيحصل‬inflammation

- According to occurrence :-
Primary lesion Secondry ( recurrent ) Residual
‫ اول مرة تحصل في‬caries ‫ لو ال‬- ‫ و شيلناه و عملنا‬caries ‫ حصل‬- unexcavated caries -
‫السنة‬ ‫ حصله‬caries ‫ و ال‬restoration ‫ ما اتشالتش كلها و اتبقي‬caries ‫ ال‬-
‫ بعرفه عشان مفيش بواقي‬- along ‫ و بيكون‬recurrence remaining caries
restoration restoration margins ‫ بعرفه لما افتح و اشيل ال‬-
restoration ‫ عشان اعرفه الزم االقي‬- ‫ تحتها‬caries ‫ هالقي‬restoration

The cause of secondry caries ?

Cuz of food accumulation around restoration making caries
and the cuz of food accumulation : defective anatomy , rough surface , fracture , gingival
margin overhangs

- According to severity ( how bad ) of the caries lesion :

1- Incipient lesion : - Just demineralized enamel - One surface of enamel
- Very faint radiolucency - Crescent shape
- Chalky white appearance

Why Incipient lesion appear like crescent ?

Cuz it is parallel with gingival margin ( take patern of gingival margin )

Why Incipient lesion became chalky white appearance ?

Cuz when mineral leave spaces (pores) filled with saliva so refractive index differ from sound
surface of enamel to demineralized enamel
Is recurrence of defect in this stage is available ? Yes (reversible)
Cuz minerals can get back to structure of tooth
2- Moderate lesion : - denaturation ( breakdown) of oraganic content and collage fibers and
attack dentin
- More progressing and advancing
- Radiolucency takes the whole enamel
- Chromogenic bacteria and food stains in pores lead to discoloration &
attacking dentin
3- Advanced lesion : - come deeper to dentin
- cause undermining of cusp and fracture of cusp
4- Severe lesion : - exposure of the pulp ( pulp involvement )

- Initial caries : demineralization

- Superfacial caries : enamel
- Moderate caries : dentin caries
- Deep caries : dentin close to pulp
- Deep complicated caries : pulp involvement

- According to progession :-
Acute caries Chronic caries Rampant caries
More common
- rapid but not as rampant - slow progration - multiple regions
caries - occurs in old age - very severe
- occurs in younger age - long duration to reach pulp - very aggressive
Short duration to reach pulp ( years) - reach pulp in weeks
(weeks or months ) - hard so removed by burs - cause pulp exposure
- soft so removed by (resistance to removed by
excavator excavators)
‫ و بالتالي مفيش‬rapid ‫ علشان‬soft - ‫ و فيه وقت يعمل‬slow ‫ علشان‬hard -
reparative dentin ‫وقت يكون‬ reparative dentin
yellowish or yellowish ‫ بيكون‬- ‫ علشان ال‬black ‫ بيكون‬-
‫ و بالتالي‬rapid ‫علشان هوا‬brown ‫ عندها‬chromogenic bacteria
‫ ما‬chromogenic bacteria ‫ال‬ ‫ دخل فيها‬pores ‫فرصة تصبغه و ال‬
‫بتاخدش فرصتها‬ food stains

- According to activity of the lesion :-

Active Arrested
- softness - no cavitation
- cavitation - no plaque
- food accumulation - there is oral hygiene
- plaque hard & ‫ بس‬discolored ← lesion ‫ ممكن االقي ال‬-
- no oral hygiene shiny
‫ لكن افرق بال‬discoloration ‫ ← علشان االتنين بيحصلهم‬color ‫ بال‬arrested ‫ و ال‬active ‫ مينفعش افرق بين ال‬: Note -
hardness
‫ ؟‬arrest ‫ ازاي بيحصله‬-
‫ تاني و بكدا ال‬pores ‫ ترجع تملي ال‬saliva ‫ اللي جوا ال‬minerals ‫ هتدي فرصه لل‬floss ‫ لما تغسل اسنانك وتنضفها بال‬-
‫ بيفضل زما هوا‬color ‫ بس ال‬... shiny and glossy appearance ‫ و بقي‬hard and translucent ‫ هيرجع‬enamel
bleaching ‫ اتصبغت و مش بترجع اال بال‬pores ‫عشان ال‬

- According to restoration design :-

- G.V black :

- Class I : caries occurs in pits and fissures in all teeth

- Class II : caries occurs in smooth surface interproximal of posterior teeth only

- Class III : caries occurs in proximal surface of anterior teeth only

- Class IV : caries occurs in proximal surface involved incisal edge in anterior teeth

- Class V : caries occurs in cervical areas of all teeth

- Class VI : caries occurs in area not mentioned above