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ENAMEL CARIES:-
Studied through the use of ground section of tooth.
Preceded by microbial plaque.
Attack cores of rods & striae of retzius.
There is loss of continuity of enamel surface and surface becomes rough and
roughness is due to disintegration of enamel prism after decalcification of
interprismatic substance and accumulation of debris & microorganism over
enamel rods.
With fissure caries, enamel lesion broadens as it approaches the underlying
dentin.
The small carious lesion has been divided into different zones based upon
histological appearance when longitudinal ground sections are examined.
Four zones- start from inner advancing front of region.
These are:_
a) translucent zone
b) dark zone
c) body of lesion
d) surface layer.
A) TRANSLUCENT ZONE:-
Lies at advancing front of enamel lesion & is first recognizable zone of
alteration from normal enamel
It is examined in cleaning agent like quinoline having refractive index
identical to that of enamel & this zone appear structure less.
This zone is not always present.
Space or pores created in the tissue in this stage are located at prism
boundaries and other junctional sites. therefore when pores are filled with
quinoline, normal structural marking are not visible.
This zone is more porous than sound enamel having pore volume of 1%
compared with 0.1% in sound enamel/
Fluoride concentration of this zone is increased.
No protein loss.
Carious attack had preferentially remove magnesium and carbonate rich
mineral from this zone & not organic material.
Change in this zone are due to demineralization.
4) SURFACE ZONE:
This zone indicate partial demineralization equivalent to about 1-10% loss
of mineral salts & pore volume of surface zone is less than 5% of space.
After imbibing with water although the porous substance surface zone is
seen to be positively birefringent, the surface zone retains a negative
birefringence.
This zone can be identified on micro radiographs as a sharply demarcated
from the underlying radiolucent regions of the lesion .
This zone is the zone of negative birefringence, superficial to the positive
birefringence body of lesion
All 4 zones cannot be seen if section is examined in a single medium.
The greater resistance of surface layer may be due to a greater degree of
mineralization or a greater concentration of fluoride in the surface enamel.
( relatively unaffected by caries attack)
This surface zone remain intact and well mineralized because it is a site
where calcium and phosphate ions, released by subsurface dissolution
become reprecipited. This process is remineralization high fluoride
concentration of enamel will favors this.
This zone is demineralized usually at the stage when lesion has penetrated
some way into the dentin.
Enamel lamellae may also play some role in development of caries by
invasion of proteolytic microorganism,
Scott & Wycoff reported no relation between enamel lamellae and caries.
When the lesion reaches the DEJ there is involvement of large no. of dentinal
tubules.
Pits & fissure caries of occlusal surface produce greater cavitiaions than proximal
smooth surface caries.\
Carious lesion is to be stained with brown pigment and tend to produce more
undermining of enamel because of different shape.
In newly erupted tooth, brown stain indicate underlying decay .in the teeth of
older individual it may be due to arrested lesion.
Histochemical staining of early lesions of enamel has shown to be more
permeable to methyl green and contain free Ca+2 detected with Alizarin reduction.
Normal enamel remains uncoloured.