This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Schüpbach, P. Articles by Lutz, F. Search for Related Content PubMed PubMed Citation Articles by Schüpbach, P. Articles by Lutz, F. Social Bookmarking                         What's this?

Histopathology of Root Surface Caries

Department of Oral Microbiology and General Immunology, Dental Institute, University of Zurich, Plattenstrasse 11, CH-8028 Zurich, Switzerland

B. Guggenheim

Department of Oral Microbiology and General Immunology, Dental Institute, University of Zurich, Plattenstrasse 11, CH-8028 Zurich, Switzerland

F. Lutz

Department of Cariology, Periodontology and Preventive Dentistry, Dental Institute, University of Zurich, Plattenstrasse 11, CH-8028 Zurich, Switzerland

The histopathology of active and arrested human root caries was examined in extracted teeth by different optical methods. Significant differences were observed between the mechanisms operating on the various dental structures. Three different patterns of initial cementum and dentin lesions could be distinguished, depending on the severity of the cariogenic attack, the degree of sclerosis of the peripheral dentin, and the presence of calculus. Advanced lesions were characterized by various patterns of demineralization. In particular, a massive lateral spread of bacteria into intertubular dentin was observed. Consequently, unaffected dentinal areas became continuously undermined. In arrested lesions, either a partial or complete mineralization of the intertubular dentin was apparent. Dentinal tubules were sclerosed passively by re- or precipitation of Ca and P04 ions. In contrast, tubules filled with ghosts of bacteria appeared mineralized by fine-granular crystals. Our observations indicate that both the arrestment and the remineralization of active lesions depend on (1) the degree of active sclerosis of dentinal tubules in areas underlying the lesion, (2) the degree of the bacterial infection of the dentin, (3) the degree of progression of the lesions, and (4) the location of the lesions at the various root surfaces. It is suggested that remineralization of active lesions can occur. This supports the concept of non-invasive treatment of root caries lesions without cavitation.

REFERENCES

• Adriaens, P.A.; Edwards, C.A.; DE Boever, J.A.; and Loesche, W.J. (1988): Ultrastructural Observations on Bacterial Invasion in Cementum and Radicular Dentin of Periodontally Diseased Human Teeth, J Periodontol 8:493-503.
• Anderson, T.F. (1951): Techniques for the Preservation of Three-Dimensional Structures in Preparing Specimens for the Electron Microscope, Trans NY Acad Sci 13:130-134.
• Billings, R.J. (1986): Restoration of Carious Lesions of the Root, Gerodontol 5:43-49.[CrossRef]
• Daculsi, G.; Kerebel, B.; LE Cabellec, M.T.; and Kerebel, L.M. (1979): Qualitative and Quantitative Data on Arrested Caries in Dentine, Caries Res 13:190-202.[Medline] [Order article via Infotrieve]
• Daly, C.; Seymour, G.; Kieser, J.; and Corbet, E. (1982): Histological Assessment of Periodontally Involved Cementum, J Clin Periodontol 9:266-270.[CrossRef][Medline] [Order article via Infotrieve]
• Fejerskov, O. and Nyvad, B. (1986): Pathology and Treatment of Dental Caries in the Aging Individual. In: Geriatric Dentistry, P. Holm-Pedersen and H. Löe, Eds., Copenhagen: Munksgaard, pp. 238-262.
• Frank, R.M.; Steuer, P.; and Hemmerle, J. (1989): Ultrastructural Study on Human Root Caries, Caries Res 23:209-217.[Medline] [Order article via Infotrieve]
• Frank, R.M. and Voegel, J.C. (1980): Ultrastructure of the Human Odontoblast Process and its Mineralization During Dental Caries, Caries Res 14:367-380.[Medline] [Order article via Infotrieve]
• Furseth, R. (1974): The Fine Structure of Acellular Cementum in Young Human Premolars, Scand J Dent Res 82:437-441.[Medline] [Order article via Infotrieve]
• Furseth, R. and Johansen, E. (1968): A Microradiographic Comparison of Sound and Carious Human Dental Cementum, Arch Oral Biol 13:1197-1206.[CrossRef][Medline] [Order article via Infotrieve]
• Furseth, R. and Johansen, E. (1970): The Mineral Phase of Sound and Carious Human Dentinal Cementum Studied by Electron Microscopy, Acta Odontol Scand 28:305-322.[CrossRef][Medline] [Order article via Infotrieve]
• Hughes, F. and Smales, F. (1986): Immunohistochemical Investigation of the Presence and Distribution of Cementum-associated Lipopolysaccharides in Periodontal Disease, J Periodont Res 21:660-667.[CrossRef][Medline] [Order article via Infotrieve]
• Jones, S.J. and Boyde, A. (1987): Dentine Mineralization, Demineralization and Microhardness: Recent Studies Using Scanning Microscopies. In: Dentine and Dentine Reactions in the Oral Cavity, A. Thylstrup, S.A. Leach, and V. Qvist, Eds., Oxford: IRL Press, pp. 33-85.
• Jordan, H.V. and Sumney, D.L. (1973): Root Surface Caries: Review of the Literature and Significance of the Problem, J Periodontol 44:158-163.[Medline] [Order article via Infotrieve]
• Karnovsky, M.J. (1965): A Formaldehyde-Glutaraldehyde Fixative of High Osmolarity for Use in Electron Microscopy, J Cell Biol 32: 137A-138A.
• Kostlan, J. (1963): L'Image Histologique de la Caries du Cement Dentaire, Bull Group Int Rech Sci Stomatol 6:339-353.[Medline] [Order article via Infotrieve]
• Levine, R.S. (1973): The Differential Inorganic Composition of Dentine within Active and Arrested Carious Lesions, Caries Res 7:245-260.[Medline] [Order article via Infotrieve]
• Levine, R.S. (1974): The Microradiographic Features of Dentine Caries, Br Dent J 137:301-306.[CrossRef][Medline] [Order article via Infotrieve]
• Miller, W.A.and Massler, M. (1962): Permeability and Staining of Active and Arrested Lesions in Dentine, Br Dent J 112:187-197.
• Moore, J.; Wilson, M.; and Kieser, J.B. (1986): The Distribution of Bacterial Lipopolysaccharide (Endotoxin) in Relation to Periodontally Involved Root Surfaces, J Clin Periodontol 13:748-751.[CrossRef][Medline] [Order article via Infotrieve]
• Nalbandian, J.; Gonzales, F.; and Sognnaes, R.F. (1960): Sclerotic Age Changes in Root Dentin of Human Teeth as Observed by Optical, Electron, and X-ray Microscopy, J Dent Res 39:598-607.
• Nyvad, B. and Fejerskov, O. (1982): Root Surface Caries: Clinical, Histopathological and Microbiological Features and Clinical Implications, Int Dent J 32:312-326.
• Nyvad, B. and Fejerskov, O. (1987): Active and Inactive Root Surface Caries-Structural Entities? In: Dentine and Dentine Reactions in the Oral Cavity, A. Thylstrup, S.A. Leach, and V. Qvist, Eds., Oxford: IRL Press, pp. 165-179.
• Parikh, S.R.; Massler, M.; and Bahn, A. (1963): Microorganisms in Active and Arrested Carious Lesions, N Y St Dent J 29:347-355.
• Sarnat, H. and Massler, M. (1965): Microstructure of Active and Arrested Dentinal Caries, J Dent Res 44:1389-1401.[Free Full Text]
• Schroeder, H.E.; Rossinsky, K.; and Mueller, W. (1980): An Established Routine Method for Differential Staining of Epoxy-embedded Tissue Sections, Micros Acta 83:111-116.
• Schupbach, P.; Guggenheim, B.; and Lutz, F. (1989): Human Root Caries: Histopathology of Initial Lesions in Cementum and Dentin, J Oral Pathol Med 18:146-156.[CrossRef][Medline] [Order article via Infotrieve]
• Schupbach, P.; Guggenheim, B.; and Lutz, F. (1990): Human Root Caries: Histopathology of Advanced Lesions, Caries Res 24:145-158.[Medline] [Order article via Infotrieve]
• Selvig, K.A. (1965): The Fine Structure of Human Cementum, Acta Odontol Scand 23:423-441.[Medline] [Order article via Infotrieve]
• Silverstone, L.M. (1974): Structure of Carious Enamel, Including the Early Lesion. In: Oral Science Reviews. 3: Dental Enamel, A.H. Melcher and G.A. Zarb, Eds., Copenhagen: Munksgaard, pp. 100-160.
• Silverstone, L.M. and Hicks, M.J. (1985): The Structure and Ultrastructure of the Carious Lesion in Human Dentin, Gerodontics 4:185-193.
• Takuma, S.; Ogiwara, H.; and Suzuki, H. (1975): Electron-probe and Electron Microscope Studies of Carious Dentinal Lesions with Remineralized Surface Layer, Caries Res 9:278-285.[Medline] [Order article via Infotrieve]
• Thylstrup, A.; Featherstone, J.D.B.; and Fredebo, L. (1983): Surface Morphology and Dynamics of Early Enamel Caries Development. In: Demineralisation and Remineralisation of the Teeth, S.A. Leach and W.M. Edgar, Eds., Oxford: IRL Press, pp. 165-184.
• Thylstrup, A. and Fejerskov, O. (1986): Pathology of Dental Caries. In: Textbook of Cariology, A. Thylstrup and O. Fejerskov, Eds., Copenhagen: Munksgaard, pp. 204-234.
• Vahl, J.; Hohling, H.J.; and Frank, R.M. (1964): Elektronenstrahlbeugung an rhomboedrisch aussehenden Mineralbildungen im kariosen Dentin, Arch Oral Biol 9:315-320.[Medline] [Order article via Infotrieve]
• Wefel, J.S.; Clarkson, B.H.; and Heilman, J.R. (1987): Histology of Root Surface Caries. In: Dentine and Dentine Reactions in the Oral Cavity, A. Thylstrup, S.A. Leach, and V. Qvist, Eds., Oxford: IRL Press, pp. 139-146.

Journal of Dental Research, Vol. 69, No. 5, 1195-1204 (1990)
DOI: 10.1177/00220345900690051601


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Schüpbach, P. Articles by Lutz, F. Search for Related Content PubMed PubMed Citation Articles by Schüpbach, P. Articles by Lutz, F. Social Bookmarking                         What's this?