The use of scanning electron microscopy in studying enamel caries

SEM studies related to carious change in dental enamel are reviewed, and their contribution to understanding the mechanism of formation of the early enamel lesion and of its repair evaluated. SEM has contributed significantly to understanding the mechanism of enamel dissolution at the level of the single crystal. Etching studies have yielded useful information on the effect of enamel structure on the pattern of acid dissolution at the microscopic level and have highlighted the importance of re-precipitation phenomena in modifying the pattern of mineral loss. High-resolution studies have provided interesting quantitative data on changes in crystal size, and also information on changes in crystal shape and orientation, during lesion formation and remineralization. However, further work is required in this area to clarify uncertainties about sampling bias and to relate the observed changes more precisely to the larger-scale structure of the tissue. Numerous observations on the surface morphology and internal structure of carious lesions have been made but preparation techniques used to date introduce artifact to a greater or lesser extent and interpretation of some of these results is therefore handicapped. We propose the use of a methacrylate replication technique as the method of choice for studying pore distribution in carious enamel and present preliminary results using this technique.