Is the morphology and activity of the occlusal carious lesion related to the lesion progression stage?

Publication date: December 2016
Source:Archives of Oral Biology, Volume 72
Author(s): Aline Almeida Neves, Daniel Otero Amaral Vargas, Thais Maria Pires Santos, Ricardo Tadeu Lopes, Frederico Barbosa Sousa
ObjectiveTo investigate the relationship between degree of dentin demineralization with both lesion activity and morphology of the occlusal carious cavity.DesignOcclusal sites (n=138) were identified by visual examination (Nyvad's scores 0–6) in 67 extracted teeth which were scanned in a high energy micro-CT. After 3D reconstruction, each stack was resliced in the mesio-distal direction and tooth mineral density (MD) was measured along a path from enamel to the deepest part of dentin in the slice showing the most severe carious involvement. Each site was classified in "open" or "closed" (if cavitated) depending on the morphology of the surrounding enamel walls as measured using micro-CT and as active or inactive in enamel or dentin by a clinical scoring system.ResultsLesions showing dentin cavitation presented higher demineralization degree compared to non-cavitated, or enamel cavitated lesions. Inactive lesions presented lower demineralization degree compared to active lesions, although with a low effect size. According to the morphological aspect of the carious cavity, open enamel lesions showed lower dentin demineralization degree than closed lesion environments.ConclusionActive lesions showed higher dentin demineralization degree than inactive ones, while lesions showing closed cavitation resulted in higher dentin demineralization degree only for enamel lesions. Including those parameters in treatment decisions may help to improve prognosis and increase effectiveness of the caries diagnostic systems in the clinical setting.



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