CLASSIFICATION OF DENTAL CARIES. Dr shabeel pn. dr shabeel's presentations. DEFINITION.
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Dr shabeel pn
dr shabeel's presentations
DENTAL CARIES IS AN IRREVERSIBLE MICROBIAL DISEASE OF THE CALCIFIED TISSUES OF THE TEETH, CHARECTERIZED BY DEMINERALIZATION OF THE INORGANIC PORTION AND DESTRUCTION OF THE ORGANIC SUBSTANCE OF THE TOOTH , WHICH OFTEN LEADS TO CAVITATION
1.BASED ON ANATOMICAL SITE
2.BASED ON PROGRESSION
3.BASED ON VIRGINITY OF LESION
4.BASED ON EXTEND OF CARIES
5.BASED ON TISSUE INVOLVEMENT
6.BASED ON PATHWAY OF CARIES SPREAD
7. BASED ON NUMBER OF TOOTH SURFACE INVOLVED
8. BASED ON CHRONOLOGY
9 .BASED ON WHETHER CARIES IS COMPLETLY REMOVED OR NOT DURING TREATMENT
10.BASED ON TOOTH SURFACE TO BE RESTORED
(PIT AND FISSURE)
SMOOTH SURFACE CARIES
(PROXIMAL AND CERVICAL CARIES)
LINEAR ENAMEL CARIES
NANGO (1960):Based on the alphabetical description of shape– 4 types
V&U type: self cleansing and somewhat caries resistant
U type: narrow slit like opening with a larger base as it extend towards DEJ .Caries susceptible; also have a number of different branches
K type: also very susceptible to caries
1. it has a comparatively rapid progression
2. it is often asymptomatic
3. it is closer to the pulp
4, it is more difficult to restore
INCIPIENT CARIES plaque formation in the absence of good oral hygiene.
These white spot lesion may be confused initially with white developmental defects of enamel formation, which can be differentiated by their position away from the gingival margin], their shape [unrelated to plaque accumulation] and their symmetry [they usually affect the contralateral tooth].
Also on wetting the caries lesion disappear while the developmental defect persist
Dental caries can be divided into 4 or 5 stages noninvasive adjuncts like fiber optic transillumination (FOTI),laser luminescence, electrical resistance method (ERM) are used for diagnosis these occlusal lesions.
3. noninvasive adjuncts like fiber optic transillumination (FOTI),laser luminescence, electrical resistance method (ERM) are used for diagnosis these occlusal lesions.Moderate caries (Caries media): Dentin caries. Extensive structural defect. Caries has penetrated up to the dentin and spreads two-dimensionally beneath the enamel defect where the dentin offers little resistance.
4. Deep caries (Caries profunda): Deep structural defect. Caries has penetrated up to the dentin layers of the tooth close to the pulp.
5. Deep complicated caries(Caries profunda complicata) :Caries has led to the opening of the pulp cavity (pulpa aperta or open pulp).
In concave surface (pit and fissures) base towards DEJ.
In convex surfaces (smooth surface) base away from DEJ.
DENTIN graphical representation of the pathway of dental caries.
Simple the caries cone in enamel is larger or at least the size as that of dentin, it is called forward decay (pit decay)
A caries involving only one tooth surface
A caries involving two surfaces of tooth
A caries that involves more than two surfaces of a tooth7.BASED ON NUMBER OF TOOTH SURFACE INVOLVED
EARLY CHILDHOOD CARIES
SYNONYMS i.e. the number of new lesions occurring in a year, shows three peaks-at the ages 4-8,11-19 and 55-65 years
Nursing caries, Nursing bottle mouth, Nursing bottle syndrome, Bottle-Propping caries, comforter caries, Baby Bottle mouth, Nursing Mouth Decay, Baby bottle tooth decay, tooth cleaning neglect
Maternally derived streptococcus mutant disease (MDSMD)
O for occlusal surfaces
M for mesial surfaces
D for distal surfaces
F for facial surfaces
B for buccal surfaces
L for lingual surface
Various combinations are also possible, such as MOD –for mesio-occluso-distal surfaces.
Class 1 lesions:
Class 2 lesions:
Class 3 lesions: TREATMENT
Class 4 lesions:
Class 5 lesions:
Class 6 (Simon’s modification):
Class I TREATMENT
Class III TREATMENT
Class V TREATMENT
In this classification the shape and depth of the caries lesion scored on a four point scale
D1. clinically detectable enamel lesions with intact (non cavitated) surfaces
D2. Clinically detectable cavities limited to enamel
D3. Clinically detectable cavities in dentin
D4. Lesions extending into the pulp
CLASSIFICATIONS TREATMENT OF CAVITY PREPARATION
Class 1 restoration:
Class 2 restoration :
Class 3 restoration : TREATMENT
Class 4 restoration :
Class 5 restoration :
Class 6 (Simon’s modification):
cavity on single proximal surface of bicuspids and molars
b) Class 6:
Cavities on both mesial and distal proximal surfaces of posterior teeth that will share a common occlusal isthmus
c) Lingual surfaces of upper anterior teeth.
d) Any other unusually located pit or fissure involved with decay.
A cavity involving only one tooth surface
A cavity involving two surfaces of tooth
A cavity that involves more than two surfaces of a tooth3.Sturdevant’s classification
a). Pit and fissure cavities
b). Smooth surface cavities
Site 1 anterior tooth which involves the restoration of an incisal angle.
Pits, fissures and enamel defects on occlusal surfaces of posterior teeth or other smooth surfaces
Proximal enamel immediately below areas in contact with adjacent teeth
The cervical one third of the crown or following gingival recession, the exposed rootThe three sites of carious lesions:
Size1:Minimal involvement of dentin just beyond treatment by remineralization alone.
Size2: Moderate involvement of dentin. Following cavity preparation, remaining
enamel is sound, well supported by dentin and not likely to fail under normal occlusal load. The remaining tooth structure is sufficiently strong to support
Size 3: the cavity is enlarged beyond moderate. The remaining tooth structure is weakened to the extent that cups or incisal edges are split, or are likely to fail or left exposed to occlusal or incisal load. the cavity needs to be further enlarged so that the restoration can be designed to provide support and protection to the remaining tooth structure.
Size4: Extensive caries with bulk loss of tooth structure has already occurred.
THANK YOU remaining tooth structure is weakened to the extent that cups or incisal edges are split, or are likely to fail or left exposed to occlusal or incisal load. the cavity needs to be further