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Dental Caries, I presented this topic in my 3rd Year of BDS at Hamdard College of Medicine and Dentistry
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CLASSIFICATION OF DENTAL CARIES
Presented by:
Haris Mehmood.BDS-III
CRITERIA OF CLASSIFICATION
Location
Rate Of Progression
According to whether lesion is new one or is occuring around restoration
G.V. Black’s classification
Site and Size Classification
LOCATION:
• Pit or Fissure Caries
• Smooth surface caries
Pit and Fissure Caries:
• Occlusal surface of molars and premolars• Buccal and lingual surface of molars• Lingual surface of maxillary incisors
Why they are more prone to caries?
• High steep walls & narrow bases• Enamel in extreme depth is often very thin
or even absent• Resulting in “Exposure of Dentine”• Deep narrow pits and fissures favour
retention of food debris and microorganisms
Clinical Appearance
• Early carious lesion may appear brown or black
Progression
• Caries extend laterally at DEJ without fracturing away overhanging enamel.
SMOOTH SURFACE CARIES
• Proximal surfaces of teeth
• Gingival third of buccal and
lingual surfaces.
Why caries usually do not occur on other smooth surfaces than these?
• SELF CLEANSING PROPERTIES
Cervical Caries
Buccal, Labial or Lingual surfaces
Crescent shaped
– Always an open cavity– No narrow area of penetration– Of all dental caries:
• LEAST EXCUSE FOR CERVICAL CARIES
It can be prevented at any instance by proper hygiene.
ACCORDING TO RATE OF PROGRESSION
• Acute Dental Caries
• Chronic Dental Caries
ACUTE DENTAL CARIES
• Runs a rapid clinical course• Result in early pulp involvement• Occur most frequently in children and
young adults====}
»WHY???
– Dentinal tubules are large and open.– No sclerosis.
NURSING BOTTLE CARIES
• Nursing caries• Baby bottle syndrome• Bottle mouth syndromeEtiology:Prolonged use of Nursing bottle containing milk or formula
Breast feeding
Sugar or honey sweetened pacifiers
• Habitual use of one of above after 1 year of age as an AID for sleeping at night or at naptime.
CLINICAL PICTURE
widespread caries destruction of deciduous teeth
Occur most commonly in four maxillary incisors…
followed by
First molars…. And then the cuspids if the habit prolonged.
BUT
How we distinguish it from ordinary Rampant caries???
• ABSENCE OF CARIES IN MANDIBULAR INCISORS
RADIATION CARIES
• result of receiving radiation treatment to the head and neck region for cancer
• Caries develop as a result of “Xerostomia”
CHRONIC DENTAL CARIES
• Progress slowly• Involve the pulp much later• Most common in adults• Stained deep brown• Entrance of lesion is invariably larger than
acute caries
• Slow progression allows sufficient time for:
• Sclerosis of dentinal tubules• Deposition of secondary dentine
PAIN IS NOT A COMMON FEATURE.
WHY???
• PRIMARY (virgin) CARIES
• SECONDARY (recurrent) CARIES
PRIMARY CARIES
• Any new carious lesion on tooth surface
RECURRENT DENTAL CARIES
• Occurs in immediate vicinity of the original restoration
• Poor adaptation of the filling material to cavity resulting in “LEAKY MARGINS”
• Favors retention of debris • Bacteria and substrate enter through leaky
margins easily
INFORMATION
• Within Dentinal tubules:::::}}}
– Lactobacilli ~ DIES– Streptococci ~ PERSIST
ARRESTED CARIES
Static or stationary
Does not show any tendency towards further progression
large open cavity
lack of food retention
Formation of a self cleansing area.
G.V. BLACK’S CLASSIFICATION• Class I
– Occlusal Pit and fissure of molars and pre molars– Buccal and lingual grooves of molars– Lingual pits of anteriors
• Class II– Proximal surface of posteriors
• Class III– Proximal surface of anteriors
• Class IV– Proximal surface of anteriors including incisal edge
• Class V– Gingival third of facial and lingual surfaces of all teeth
• Class VI– Cusp tips
SITE AND SIZE CLASSIFICATION
• Proposed by Dr. Graham J. Mount and Dr. W. Rory Hume in May 1997.
• Three sites and four sizes description.
G.I. MOUNT’S CLASSIFICATION
SITE
1Fissure
2Proximal
3Cervical
SIZE
1
Minimal
2
Moderate
3
Enlarged
4
Extensive
1.1 1.2 1.3 1.4
2.1 2.2 2.3 2.4
2.1 3.2 3.3 3.4