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Structural events in the caries process in enamel, cementum, and dentin
1Centre de Recherches (Unité mixte CNRS-INSERM), Faculté de Chirurgie Dentaire, Université Louis Pasteur, Strasbourg, France.
Journal of Dental Research
|February 1, 1990
Summary
Dental caries involves complex structural changes in enamel, cementum, and dentin. New research reveals surface pathways in enamel and distinct microbial invasion patterns in root caries, challenging previous understandings of tooth decay.
Area of Science:
- Oral biology
- Dental research
- Microbiology
Background:
- Dental caries is a multifactorial disease affecting tooth structure.
- Understanding the structural changes during caries progression is crucial for effective prevention and treatment.
- Previous models of early enamel lesions suggested an intact surface layer, which is now being re-evaluated.
Purpose of the Study:
- To review and synthesize current knowledge on the structural events occurring in enamel, cementum, and dentin during the caries process.
- To highlight new findings from scanning electron microscopy (SEM) and transmission electron microscopy (TEM) on early enamel demineralization.
- To compare the mechanisms of bacterial invasion and tissue destruction in enamel, cementum, and dentin caries.
Main Methods:
- Review of existing literature and scientific observations.
- Analysis of scanning electron microscopy (SEM) and transmission electron microscopy (TEM) data.
- Comparative analysis of structural changes across different tooth tissues (enamel, cementum, dentin).
Main Results:
- Incipient enamel caries involves structural pathways (e.g., enlarged prism junctions) allowing surface-to-lesion access, challenging the intact surface layer concept.
- Root caries demonstrates cementum destruction along collagen fiber junctions and incremental lines, followed by Gram-positive microorganism invasion.
- Dentin caries (coronal and root) exhibits tubule sclerosis, intertubular demineralization, and bacterial invasion, with cementum showing simultaneous mineral and organic component destruction.
Conclusions:
- Dental caries progression involves intricate structural modifications at the microscopic level in enamel, cementum, and dentin.
- SEM and TEM reveal subsurface demineralization pathways in enamel, necessitating revised understanding of early lesion development.
- Distinct microbial invasion and destruction patterns occur in cementum compared to enamel and dentin, highlighting tissue-specific responses to cariogenic challenges.