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DENTAL CARIES(Classification And Theories)
Dr. Shahzadi Tayyaba Hashmi
DNT 353
CLASSIFICATION
CLASSIFICATION BY THE RATE OF ATTACK:• Acute caries• Chronic caries• Arrested caries
CLASSIFICATION BY THE SITE OF ATTACK:• Pits and fissure caries• Smooth surface caries• Root caries (cemental caries)• Recurrent caries
CLASSIFICATION
BLACK'S CLASSIFICATION:• Class I• Class II• Class III• Class IV• Class V• Class VICLASSIFICATION BASED ON VIRGINITY OF LESIONS:• Primary caries (initial)• Secondary caries (recurrent )
CLASSIFICATION
CLASSIFICATION BASED ON NUMBER OF TOOTH SURFACE INVOLVED:
• Simple• Compound• ComplexEARLY CHILDHOOD CARIES :• Rampant caries (nursing bottle caries)
CLASSIFICATION BY THE RATE OF ATTACK
Acute caries:• Most common in young patients because they have teeth with large pulp
chambers and short dentinal tubules with no or little sclerosis• Caused by diet rich in refined carbohydrates and less than adequate oral
hygiene• Multiple advanced carious lesion develops simultaneously that reaches the
pulp and cause severe pain
CLASSIFICATION BY THE RATE OF ATTACK
Chronic caries:• Most common in older patients whose teeth have small
pulp chambers with additional deposits of dense tubular dentin on the pulpal walls known as tertiary dentin
• They have significant degrees of sclerosis which provides resistance to the progression of dental caries
• Less pain occurs
Arrested caries:• Enamel, dentine or root caries that become static and slower• No tendency for further progress
Acute caries in a child
Chronic caries
Arrested caries
CLASSIFICATION BY THE SITE OF ATTACK
Pits and fissure caries:• Most common type of caries• Appears at an early age on the occlusal and
buccal surfaces of molars of the primary and secondary dentition
• This form of caries is most destructive because it goes deeply into dentin and clinically appears as a large cavity which is painful
CLASSIFICATION BY THE SITE OF ATTACK
Smooth surface caries:• Less common• Occurs on the interproximal contact areas of
teeth that are not self cleansing• Cervical regions of the buccal and lingual surfaces of teeth are involved
CLASSIFICATION BY THE SITE OF ATTACK
Root caries (cemental caries):• Always found in old people who have roots exposed to
oral environment as a result of gingival recession• This form of caries initiates differently than enamel and
dentin caries, because root surfaces are soft and thin and can be traumatized by abrasive action during tooth brushing
• Cementum is readily decalcified and presents little barrier to infection
• Saucer shaped shallow cavity is formed with ill defined boundaries
ROOT CARIES ROOT CARIES IN LOWER PREMOLARS
ROOT CARIES AS A RESULT OF AGINGROOT CARIES DIFFICULT TO DETECT CLINICALLY, BECAUSE THEY ARE FREQUENTLY HIDDEN BY GINGIVA
CLASSIFICATION BY THE SITE OF ATTACK
Recurrent Caries: Caries that arises around an existing restoration Lesions arises as a result of alteration in the integrity of a
restoration results in marginal leakage It causes accumulation of food and bacteria around the
tooth where oral hygiene restricts the removal of those bacteria and food
Carious lesions progress according to patients diet and oral hygiene habits
BLACK’S CLASSIFICATIONCLASS I:• Class I cavity is that in which Caries affect pits and fissures on
occlusal surfaces of posterior teeth (molars and premolars) , lingual or buccal pits of posterior teeth and Lingual pit of incisors
CLASS II:• Class II cavity is one in which carious process affects approximal
(mesial or distal ) surfaces of posterior teeth
CLASS III:• Class III cavity is one which is present in the approximal surface
of the anterior teeth but does not involve the incisal edge
BLACK’S CLASSIFICATION
CLASS IV:• Class IV Caries affecting proximal surfaces including incisal
edges of anterior teeth
CLASS V:• Class V Caries is one in which carious process creates
defects in the cervical third of any tooth
CLASS VI:• Class VI Cavity is one in which the cusp tips or the incisal
edges are involved in carious process
CLASS I CLASS II
CLASS III
CLASS IV CLASS V
CLASS VI
BLACK’S CLASSIFICATION
CLASS I CLASS IICASS III CLASS V
EARLY CHILHOOD CARIES
Rampant caries (nursing bottle caries):• Present on the labial surfaces of the primary teeth of
infants• Caused by a habit of leaving the feeding bottle • containing milk or juice in the infants mouth when sleeping
THEORIES OF DENTAL CARIES
There are different theories about the progress of dental caries,
a. Acidogenic theory (miller’s theory)b. Proteolytic theoryc. Proteolytic chelation theory
Acidogenic theory
• Proposed by W.D Miller in 1882• Miller proved after certain experiments that certain
bacteria present in mouth, produce acids from carbohydrates which causes demineralization of the dental tissues
• Consumption of more refined carbohydrates was associated with more caries
• Frequency of carbohydrate foods (snacks and drinks) also contribute to incidence of dental caries• Widely accepted theory
Proteolytic theory
• Proposed by Gottlieb • According to this theory, the organic or protein elements of
tooth are the initial pathways of invasion by microorganismsAnd, caries is essentially a Proteolytic process , in which the microorganisms invade the organic pathways and destroy them while advancing through them by forming acids
• Hence certain structures of enamel having high organic material composition, like enamel lamellae and enamel rod sheaths, could serve as a pathway for microorganism invasion through the enamel
Proteolytic chelation theory
• It was postulated that certain chelate compounds are present in the carious lesion
• These types of compounds have a secondary role in the carious process
THANK YOU