scholarly journals O Uso do Diamino Fluoreto de Prata na Prevenção e Paralisação da Cárie Radicular: uma Abordagem não Invasiva e Eficiente no controle da Doença em Idosos

2021 ◽  
Vol 24 (5-esp.) ◽  
pp. 655-659
Author(s):  
Flaviana Alves Dias ◽  
Yana Cosendey de Mello Peixoto ◽  
Murilo Baena Lopes ◽  
Ricardo Danil Guiraldo ◽  
Sandrine Bittencourt Berger
Keyword(s):  
Cost Benefit ◽  
Organic Matrix ◽  
Pathological Process ◽  
Root Caries ◽  
Matrix Degradation ◽  
Electronic Library ◽  
Injured Area ◽  
Final Sample ◽  
Surface Staining ◽  
Carious Process

A cárie dentária é o processo patológico bucal mais prevalente em todo o mundo, acometendo todas as idades, inclusive a população idosa com um risco aumentado para as lesões nas superfícies radiculares. O desenvolvimento da cárie radicular é o resultado de repetidos ciclos de desmineralização associado à degradação da matriz orgânica da dentina. Com a progressão da lesão, a matriz orgânica da dentina é invadida por toxinas bacterianas e algumas proteases intrínsecas conhecidas como metaloproteinases e catepsinas. Quando há a perda mineral no desafio cariogênico, colágeno é parcialmente exposto, onde as metaloproteinases e catepsinas podem atuar na degradação das moléculas da matriz extracelular. Este estudo trata-se de uma de uma revisão da literatura, na qual foram incluídos artigos publicados entre os anos de 2010 a 2020 disponíveis nas bases de dados: Scientific Electronic Library Online (SciELO), Medline e Pubmed, sendo a amostra final composta por 28 estudos. Esta revisão de literatura objetiva mostrar as abordagens não invasivas para o controle da doença, atuando diretamente na área comprometida, promovendo a prevenção e paralisação da progressão do processo carioso. Os estudos mostram que o diamino fluoreto de prata (DFP) é um agente fluoretado, seguro e não oneroso, que vem se mostrando efetivo no controle da cárie radicular em idosos, com melhor custo-benefício. Sua ação efetiva em dentina é baseada na remineralização da fase inorgânica e diminuição da degradação da fase orgânica, com recuperação de toda a complexidade estrutural dentinária. Efeitos adversos relatados do DFP estão relacionados principalmente ao escurecimento da superfície após a sua aplicação.   Palavras-chave: Saúde Bucal. Cariostáticos. Cárie Radicular.   Abstract The dental caries is the most prevalent oral pathological process in the world, affecting all ages, including elderly with a high risk of root caries lesions. The root caries development is a result of several demineralization cycles associated to dentin organic matrix degradation. There is a bacterial toxins and intrinsic proteases (metalloproteases and cathepsins) invasion during the lesion progression. With the mineral lost in the cariogenic challenge, collagen is partially exposed, and the metalloproteases and cathepsins would act in the extracellular matrix degradation. In this review study, there were included published articles between 2010 until 2020, available in the databases: Electronic Library Online (SciELO), Medline and Pubmed, including 28 studies in the final sample. This literature review aims to show the noninvasive approaches to disease control, acting directly in the injured area, promoting prevention and arrestment of carious process. The silver diamine fluoride (SDF) is a fluoride agent, safe and inexpensive, that have been showing effective root caries control in elderly, with the best cost benefit. Its effective action in dentin bases in inorganic remineralization associated to organic degradation decreased, recovering the complex dentin structure. Related adverse effects are mainly the surface staining after its application.   Keywords: Oral Health. Cariostatic Agents. Root Caries.

scholarly journals Enamel Proteases Reduce Amelogenin-Apatite Binding

2008 ◽  
Vol 87 (12) ◽  
pp. 1133-1137 ◽  
Author(s):  
Z. Sun ◽  
D. Fan ◽  
Y. Fan ◽  
C. Du ◽  
J. Moradian-Oldak
Keyword(s):  
Protein Adsorption ◽  
Binding Affinity ◽  
Organic Matrix ◽  
Cleavage Product ◽  
Langmuir Model ◽  
Crystal Nucleation ◽  
Matrix Degradation ◽  
Kallikrein 4 ◽  
C And N ◽  
Mineral Interaction

Organic matrix degradation and crystal maturation are extracellular events that occur simultaneously during enamel biomineralization. We hypothesized that enamel proteases control amelogenin-mineral interaction, which, in turn can affect crystal nucleation, organization, and growth. We used a recombinant amelogenin (rP172), a homolog of its major cleavage product (rP148), and a native amelogenin lacking both N- and C-termini (13k). We compared apatite binding affinity between amelogenins and their digest products during proteolysis. We further compared binding affinity among the 3 amelogenins using a Langmuir model for protein adsorption. Amelogenin-apatite binding affinity was progressively reduced with the proteolysis at the C- and N- termini by recombinant pig MMP-20 (rpMMP20) and recombinant human kallikrein-4 (rhKLK4), respectively. The binding affinity of amelogenin to apatite was found to be in the descending order of rP172, rP148, and 13k. Analysis of our data suggests that, before its complete degradation during enamel maturation, stepwise processing of amelogenin by MMP-20 and then KLK4 reduces amelogenin-apatite interaction.

In vitro Study of the Role of Human Neutrophil Enzymes on Root Caries Progression

2021 ◽  
pp. 1-9
Author(s):  
Camila A. Zamperini ◽  
Berdan Aydin ◽  
Herve Y. Sroussi ◽  
Ana Karina Bedran-Russo
Keyword(s):  
Human Neutrophil ◽  
In Vitro Study ◽  
Organic Matrix ◽  
Root Surface ◽  
Host Immune System ◽  
Root Caries ◽  
Caries Progression ◽  
And Control

The role of the host immune system in caries progression is mainly speculative, and it is believed that it entails the enzymatic degradation of the dentin organic matrix. The aim of this study was to evaluate the proteolytic effect of human neutrophil enzymes on root caries progression. For this, specimens of bovine root dentin were divided into 4 groups (<i>n</i> = 30): caries (C), caries + neutrophils (C + N), no caries (Control), and no caries + neutrophils (Control + N). <i>Streptococcus mutans</i> biofilm (10<sup>5</sup> CFU/mL) was grown on the root surface to artificially induce root carious lesions (C and C + N groups). Specimens were then exposed to neutrophils (5 × 10<sup>6</sup> cells/mL) for 48 h (C + N and Control + N groups). Caries development and neutrophil exposures were repeated a 2nd and 3rd time. Caries depth (CD) and dentin demineralization (DD) were assessed by infiltration of rhodamine B using fluorescence microscopy. Collagen fibril ultrastructure was characterized under a polarized microscope with Picrosirius red staining. There were no significant differences (<i>p</i> &#x3e; 0.05) in CD and DD between the C and C + N groups for 1, 2, and 3 caries-neutrophil exposures. Immature collagen was significantly less present in the carious groups (C, <i>p</i> = 0.003; C + N, <i>p</i> = 0.01) than in the noncarious groups in the most superficial 200 µm. We thus concluded that human neutrophil enzymes did not influence short-term root caries progression, and immature collagen fibrils were more susceptible to degradation during <i>S. mutans</i>-induced root caries progression.

scholarly journals OPTIMIZATION OF DIAGNOSIS OF EARLY STAGES OF LEGG-CALVE-PERTHES DISEASE IN CHILDREN

2020 ◽  
Vol 8 (4) ◽  
pp. 574-581
Author(s):  
T.I. Menshchikova ◽  
◽  
S.N. Luneva ◽  
Е.L. Matveeva ◽  
A.G. Gasanova ◽  
...  
Keyword(s):  
Femoral Head ◽  
External Rotation ◽  
Organic Matrix ◽  
Pathological Process ◽  
Chloride Ions ◽  
Perthes Disease ◽  
Ultra Sound ◽  
Healthy Children ◽  
Serum Total Calcium ◽  
Subchondral Plate

Aim. Optimization of the diagnosis of the initial stages of Legg-Calve-Perthes disease in children of 4-7 years old using biochemical and ultrasound methods. Materials and Methods. Patients aged 4-9 years (15 boys, 10 girls) complaining of morning pain in walking, contracture in the hip joint, lameness, were examined. The duration of the disease ranged from several days to 2-3 months. The control was a group of healthy children aged 4-9 years (n=22, 12 boys, 10 girls). Ultrasound of the hip joints was performed on Hitachi scanner (Japan) using a linear sensor with 7.5 MHz frequency. In the blood serum of patients, the follow-ing markers of resorption of the organic matrix of bone tissue were determined: the amount of sulfate sulfur, hexuronic acids (HAC), hexoses, hexosamines, sialic acids with calculation of their ratios: hexoses/hexuronic acids, hexoses/sulfate, sulfate/hexuronic acids, hexuronic ac-ids/hexosamines. Besides, concentration of electrolytes was determined in serum: total calcium and chloride ions and inorganic phosphate. On the basis of these fata, the system index of elec-trolytes SIE=ССа.CCl/CPO4 was calculated. The concentrations of parameters obtained in the ex-amination of 25 healthy children of 4 to 7 years of age were taken for norm. Results. In children with duration of the disease from several days to several weeks, an ultra-sound scan along the neck of the femur revealed thickening of the joint capsule to 0.73 (0.7:0.77) mm. With the progression of the pathological process, separate lumpy formations were visualized in the region of the subchondral plate of the femoral head in the position of abduction of the limb and internal/external rotation, which indicated the appearance of initial destructive changes in the region of the subchondral plate of the femoral head. Using biochemical methods, besides increase in the concentration of organic matrix degradation markers, there were also determined increase in the extent of sulphatation of the organic matrix and insignificant alterations of the content of separate electrolytes. Conclusions. The use of biochemical and ultrasound research methods allows optimization of the diagnosis of the initial stages of Legg-Calve-Perthes disease.

Ecological Hypothesis of Dentin and Root Caries

2016 ◽  
Vol 50 (4) ◽  
pp. 422-431 ◽  
Author(s):  
Nobuhiro Takahashi ◽  
Bente Nyvad
Keyword(s):  
Organic Material ◽  
Organic Matrix ◽  
Root Caries ◽  
Bacterial Metabolites ◽  
Dentin Caries ◽  
Degrading Bacteria ◽  
Dental Hard Tissues ◽  
Prevention And Treatment ◽  
Root Dentin ◽  
Root Surfaces

Recent advances regarding the caries process indicate that ecological phenomena induced by bacterial acid production tilt the de- and remineralization balance of the dental hard tissues towards demineralization through bacterial acid-induced adaptation and selection within the microbiota - from the dynamic stability stage to the aciduric stage via the acidogenic stage [Takahashi and Nyvad, 2008]. Dentin and root caries can also be partly explained by this hypothesis; however, the fact that these tissues contain a considerable amount of organic material suggests that protein degradation is involved in caries formation. In this review, we compiled relevant histological, biochemical, and microbiological information about dentin/root caries and refined the hypothesis by adding degradation of the organic matrix (the proteolytic stage) to the abovementioned stages. Bacterial acidification not only induces demineralization and exposure of the organic matrix in dentin/root surfaces but also activation of dentin-embedded and salivary matrix metalloproteinases and cathepsins. These phenomena initiate degradation of the demineralized organic matrix in dentin/root surfaces. While a bacterial involvement has never been confirmed in the initial degradation of organic material, the detection of proteolytic/amino acid-degrading bacteria and bacterial metabolites in dentin and root caries suggests a bacterial digestion and metabolism of partly degraded matrix. Moreover, bacterial metabolites might induce pulpitis as an inflammatory/immunomodulatory factor. Root and dentin surfaces are always at risk of becoming demineralized in the oral cavity, and exposed organic materials can be degraded by host-derived proteases contained in saliva and dentin itself. New approaches to the prevention and treatment of root/dentin caries are required.

scholarly journals Postnatal care of newborns in the family context: an integrative review

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Fernanda Garcia Bezerra Góes ◽  
Maria da Anunciação Silva ◽  
Andressa Silva Torres dos Santos ◽  
Brenda Freitas Pontes ◽  
Ingrid Lucchese ◽  
...  
Keyword(s):  
Latin American ◽  
Postnatal Care ◽  
Cultural Practices ◽  
Caribbean Literature ◽  
Family Context ◽  
Electronic Library ◽  
Neonatal Deaths ◽  
Final Sample ◽  
The Family

ABSTRACT Objective: to analyze the postnatal care practices of newborns in the family context from the scientific literature. Methods: the searches of the integrative literature review were carried out in the Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Database (BDENF), Scientific Electronic Library Online (SciELO), and U.S. National Library of Medicine (PubMed) databases. Results: sixteen studies composed the final sample and, from these, two analytical categories emerged: Practices and doubts of families in postnatal care of newborns; and Best practices in postnatal care of newborns. Final considerations: several cultural practices of families differ from scientific recommendations, which can generate risks to the health of newborns. Therefore, it is essential to consolidate educational programs with family members, to improve the quality of care offered and to reduce preventable neonatal deaths in different socio-family contexts.

In Vitro Root Caries: Hexamethyldisilazane Treatment For SEM

1985 ◽  
Vol 43 ◽  
pp. 450-451
Author(s):  
D.C.N. Chan ◽  
J.S. Wefel ◽  
Umran Dogan
Keyword(s):  
Light Microscopy ◽  
Polarized Light ◽  
Root Caries ◽  
Additional Information ◽  
Equal Importance ◽  
Transmitted Light Microscopy ◽  
Carious Process

Characterization of in vivo and in vitro root caries systems have traditionally been carried out with transmitted light microscopy, polarized light microscopy and microradiography. Electron microscopy and probe analysis will provide additional information regarding the morphological and chemical features of sound and carious dentin-cemental surfaces. Of equal importance is the correlation of E.M. observations to that ovtained by light microscopy and microradiographic techniques.Previous E.M. investigations of early carious cementum showed a characteristic cross-striations of collagen fibers in sound cemental matrix. These striations were observed to be partially or completely lost in cemental lesions. Another study suggested that the breakdown of the major portion of the collagen occurred late or was the final step in the destructive phase of the carious process.

scholarly journals Tratamento de Superfície em Cerâmicas de Dissilicato de Lítio: uma Revisão de Literatura

2020 ◽  
Vol 24 (4) ◽  
pp. 422-425
Author(s):  
Gabriela Torres Zanin ◽  
Omar Geha ◽  
Ricardo Danil Guiraldo ◽  
Murilo Baena Lopes ◽  
Sandrine Bittencourt Berger
Keyword(s):  
Latin American ◽  
Hydrofluoric Acid ◽  
Preparation Method ◽  
Surface Preparation ◽  
Lithium Disilicate ◽  
Caribbean Literature ◽  
Electronic Library ◽  
Ceramic Surfaces ◽  
Final Sample ◽  
Wide Range

O preparo das superfícies cerâmicas é umas das etapas fundamentais para uma adesão duradoura e satisfatória no substrato dentário, garantindo o sucesso do tratamento. A escolha dos produtos corretos confere à prótese maior estabilidade após cimentação, evitando: infiltrações, cáries secundárias e deslocamento da peça cerâmica. Nos últimos tempos, vários protocolos para preparo das superfícies cerâmicas estão sendo usados em função da ampla oferta de produtos no mercado. Diante da diversidade de produtos disponíveis, esta revisão de literatura tem como objetivo mostrar, por meio de artigos, qual o protocolo mais seguro a ser seguido para a cimentação de cerâmicas de dissilicato de lítio. Realizou-se uma revisão de literatura baseada em artigos científicos publicados nas seguintes bases de dados: Scientific Electronic Library Online (SciELO), Medline: Pubmed e Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), sendo a amostra final composta por vinte e seis estudos. Verificou-se que, para uma adesão adequada das cerâmicas de dissilicato de lítio ao substrato dentário, deve-se seguir o passo a passo do preparo da superfície, sendo a aplicação do ácido fluorídrico, seguido de silano e adesivo a opção mais segura. O modo simplificado de preparo, usando sistemas autocondicionantes pode ser promissor, porém mais estudos são necessários para comprovar sua eficácia.   Palavras-chave: Ácido Fluorídrico. Adesivos. Dissilicato de Lítio.   Abstract The  ceramic surfaces preparation is one of the fundamental steps for a lasting and satisfactory adhesion to the dental substrate, guaranteeing the success of the treatment. The  correct products choice gives the prosthesis greater stability after cementation, avoiding: infiltrations, secondary caries and e ceramic piece displacement. In recent times, several protocols for preparing ceramic surfaces have been used due to the wide range of products in  the market. Due to the diversity of products available, this literature review aims to show, through articles, which is the safest protocol to be followed for the cementation of lithium disilicate ceramics. A review was carried out based on scientific articles published in the databases: Scientific Electronic Library Online (SciELO), Medline: Pubmed and Latin American and Caribbean Literature in Health Sciences (Lilacs), with the final sample comprising twenty-six studies. It was found that, for an adequate lithium disilicate ceramics adhesion to the dental substrate, one must follow the step by  step of the surface preparation, with the hydrofluoric acid (HF) application, followed by silane and adhesive which is the safest option. The simplified  preparation method, using self-etching systems, can be promising, however, more studies are needed to prove its effectiveness.   Keywords: Hydrofluoric Acid. Adhesives. Lithium Disilicate.

scholarly journals The scientific production on myelodysplastic syndromes: a systematic review

2011 ◽  
Vol 5 (8) ◽  
pp. 2008
Author(s):  
Marcos Antonio Ferreira Júnior ◽  
Maria Lúcia Ivo
Keyword(s):  
Latin American ◽  
Myelodysplastic Syndromes ◽  
Retrieval System ◽  
Medical Literature ◽  
Scientific Production ◽  
Refractory Anemia ◽  
Literature Analysis ◽  
Electronic Library ◽  
Final Sample ◽  
Communications System

AbstractObjective: to map the brazilian scientific production on myelodysplastic syndromes (MDS) in order to highlight points for investigation. Method: this is a literature review study carried out through electronic search in indexed databases, between October 2010 and January 2011. Papers on myelodysplastic syndromes published in Brazil were surveyed, indexed in the databases available in the site of Biblioteca Virtual em Saúde. The databases used in the survey were the Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin-American and Caribbean Literature on Health Sciences Information (LILACS), Integrated Building Environmental Communications System (IBECS), and Scientific Electronic Library Online (SciELO Brasil). Results: the final sample involved 32 full papers. Through systematic reading, five categories of analysis were identified: the (1) diagnostic and (2) prognosis studies show the beginning of MDS classifications based on analysis of peripheral blood, myelogram, and bone marrow biopsy, combined with clinical evaluation of patients. The (3) treatment remains supportive for most patients. Few (4) case studies have been carried out, with no conclusive correlations. The (5) reviews brought significant guidelines for the management of patients. Conclusion: there is a need for clinical trials in larger populations, in order to gain power of generalization of results, as well as to find the epidemiological characterization of the Brazilian myelodysplastic population. Descriptors: preleukemia; refractory anemia; refractory anemia with excessive blasts.ResumoObjetivo: mapear a produção científica brasileira sobre síndromes mielodisplásicas (SMD), a fim de evidenciar pontos para investigação. Método: trata-se de estudo de revisão de literatura, realizado por meio de busca eletrônica em bases de dados indexadas, entre os meses de outubro de 2010 e janeiro de 2011. Foram rastreados artigos publicados sobre síndromes mielodisplásicas no Brasil, indexados nas bases de dados da Biblioteca Virtual em Saúde: Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Integrated Building Environmental Communications System (IBECS) e Scientific Electronic Library Online (SciELO Brasil). Resultados: a amostra foi composta por 32 trabalhos completos. Por meio de leitura sistemática, foram identificadas cinco categorias de análise: os (1) estudos de diagnóstico e de (2) prognóstico evidenciam o início das classificações de SMD baseadas na análise do sangue periférico, mielograma e biópsia de medula óssea, aliados à avaliação clínica dos pacientes. O (3) tratamento continua sendo de suporte para a maior parte dos pacientes. Poucos (4) estudos de casos foram realizados, sem correlações conclusivas. As (5) revisões trouxeram significativas orientações para o manejo dos pacientes. Conclusão: há necessidade de estudos com ensaios clínicos em populações maiores, de forma a se obter poder de generalização dos resultados, bem como caracterização epidemiológica da população mielodisplásicas brasileira. Descritores: pré-leucemia; anemia refratária; anemia refratária com excesso de blastos.RESUMENObjetivo: mapear la producción científica brasileña sobre los síndromes mielodisplásicos (SMD), a fin de evidenciar puntos para investigación. Método: esto es un estudio de revisión de literatura realizado por medio de búsqueda electrónica en bases de datos indexadas, entre los meses de octubre de 2010 y enero de 2011. Fueron rastreados artículos publicados sobre síndromes mielodisplásicos en Brasil, indexados en las bases de datos disponibles en el site de la Biblioteca Virtual em Saúde. Las bases de datos usadas en la encuesta fueron la Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latinoamericana y del Caribe de Información en Ciencias de la Salud (LILACS), Integrated Building Environmental Communications System (IBECS) y Scientific Electronic Library Online (SciELO Brasil). Resultados: la muestra final incluyó 32 trabajos completos. Por medio de lectura sistemática, se identificaron cinco categorías de análisis: los (1) estudios de diagnóstico y de (2) pronóstico muestran el inicio de las clasificaciones de SMD basados ​​en el análisis de la sangre periférica, mielograma y biopsia de médula ósea, junto con la evaluación clínica de los pacientes.  El (3) tratamiento sigue siendo de suporte para la mayoría de los pacientes. Pocos (4) estudios de caso fueron llevados a cabo, sin correlaciones concluyentes. Las (5) revisiones trajeron directrices significativas para el manejo de los pacientes. Conclusión: hay necesidad de estudios con ensayos clínicos en poblaciones más grandes, con el fin de obtener poder de generalización de los resultados, así como caracterización epidemiológica de la población mielodisplásica brasileña. Descriptores: preleucemia; anemia refractaria; anemia refractaria con exceso de blastos.

scholarly journals Estrogen Reduces the Depth of Resorption Pits by Disturbing the Organic Bone Matrix Degradation Activity of Mature Osteoclasts

Endocrinology ◽  
2001 ◽  
Vol 142 (12) ◽  
pp. 5371-5378 ◽  
Author(s):  
Vilhelmiina Parikka ◽  
Petri Lehenkari ◽  
Mirja-Liisa Sassi ◽  
Jussi Halleen ◽  
Juha Risteli ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Type I Collagen ◽  
Bone Matrix ◽  
Organic Matrix ◽  
Cysteine Proteases ◽  
Bone Collagen ◽  
Type I ◽  
Matrix Degradation ◽  
Carboxyl Terminal

Abstract Decreased E2 levels after menopause cause bone loss through increased penetrative resorption. The reversal effect of E2 substitution therapy is well documented in vivo, although the detailed mechanism of action is not fully understood. To study the effects of E2 on bone resorption, we developed a novel in vitro bone resorption assay in which degradation of inorganic and organic matrix could be measured separately. E2 treatment significantly decreased the depth of resorption pits, although the area resorbed was not changed. Electron microscopy further revealed that the resorption pits were filled with nondegraded collagen, suggesting that E2 disturbed the organic matrix degradation. Two major groups of proteinases, matrix metalloproteinases (MMPs) and cysteine proteinases, have been suggested to participate in organic matrix degradation by osteoclasts. We show here that MMP-9 released a cross-linked carboxyl-terminal telopeptide of type I collagen from bone collagen, and cathepsin K released another C-terminal fragment, the C-terminal cross-linked peptide of type I collagen. E2 significantly inhibited the release of the C-terminal cross-linked peptide of type I collagen into the culture medium without affecting the release of cross-linked carboxyl-terminal telopeptide of type I collagen in osteoclast cultures. These results suggest that organic matrix degradation is initiated by MMPs and continued by cysteine proteases; the latter event is regulated by E2.

Odontoblast Function Seen as the Response of Dentinal Tissue to Dental Caries

2001 ◽  
Vol 15 (1) ◽  
pp. 68-71 ◽  
Author(s):  
Markku Larmas
Keyword(s):  
Degradation Products ◽  
Organic Matrix ◽  
Degradation Process ◽  
Caries Lesion ◽  
Cellular Event ◽  
Phosphate Ions ◽  
Extracellular Compartment ◽  
Inorganic Composition ◽  
Matrix Components ◽  
Carious Process

Microbes are responsible for the initiation and maintaining of carious processes. They have an efficient machinery for dissolving crystalline hydroxyapatite. When initiating carious processes, microbial acid formation determines the rate of the process in enamel. When the process reaches dentin, the micro-environment changes. Dentinal fluid in dentin tubules is the liquid where dissolving products of apatites are destroyed. Inorganic composition of dentinal fluid, however, is not altered much during the carious process, indicating that a functional secretory domain is working to pump the dissolved calcium and phosphate ions out of the fluid. Activation of odontoblast alkaline phosphatase and dentin latent collagenases is the known cellular event during the carious process in dentin. Because the caries lesion is by definition undermining, this suggests that, in this degradation process, the extracellular compartment, crystalline hydroxyapatite is dissolved by microbial acids, and a mixture of proteinases degrades the organic matrix. The degradation products of collagen and other matrix components in dentinal fluid must be transported either through the caries lesion in the enamel to saliva or through the odontoblast to the pulp (active transport). This facilitates further processing of the degradation products intracellularly during the passage through the cell.

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