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  • Tampilan Klinis Karies

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    5 tayangan10 halaman

    Tampilan Klinis Karies

    Diunggah oleh

    Gisha Salwa
    dari ebook

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    © All Rights Reserved
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    8 The disease and its diagnosis What do caries lesions look like clinically? As was stressed in the previous chapter, dental cries lesions are the outcome, or symptoms, of innumerable metabolic events in biofilms which have covered & tooth surface. ‘When this outcome results in & cumulative loss of mineral from the tooth of such a magnitude thatthe porosity in the enamel (see Chapter 3) gives rise to a decrease in enamel ‘translucency, we can diagnose white opaque lesions. Early stages in enamel lesion formation will therefore manifest ‘themselves as white-spot lesions, Because these are indica- tive of increased porosity of the enamel itis to be expected ‘that food stain will sive into the enamel and hence a white- spot lesion may, over time, change color to brown and even almost black ‘The shape of the lesion reflects where the biofilm has ‘been allowed to grow and remain for prolonged periods. In the days — not long ago — where children had no or very Deciduous dentition Figure 2.1 A3-yarold chil wit thick acculations of eta paque along ‘the nga margin of the buccal suraces covering ative cares Ison, some of which present with distin cavities Figure 2.2 Inactive or amet cas lesins on buccal sues of vper etal incor teeth na S-yearolé child. Noe that the shape ofthe lesan indates where the gingal margin nas located atthe time wen these lesions ‘eveoped. The ol hyiene snow improved and the surfaces ofthese non ‘avtated opaque lesions are sth and shin. poor oral hygiene it was common to see kidney-shaped lesions beneath contact facets approximally extending onto buccal and lingual surfaces as a band of dull, chalky white ‘enamel along the gingival margin, With the much better ‘oral hygiene in today’ populations the extent of lesions is much reduced, and the shape will be determined by the particular shape of the stagnation area ‘The following will demonstrate a spectrum of manifes- tations of caries lesions in children, adults and elderly people, Be aware that what you see here is photographed and magnified and reproduced at high quality. In the clinic visual inspection is much more difficult. Therefore, several chapters in this book ate devoted to covering various aspects of diagnosis of dental caries lesions (Chapters 4-6), and Chapter 7 focusses on what it means (o learn good diagnostic practice & me , ~~ a Figure 23 Upper deciduous canine om a5-yearald wth an aciv, caved lesion along the gingival margin. On prebing it would be sty, but there ire reason to probe such lesin unless you wish provoke 2 pan reacian’ Figure 2.4 Upprincsorsina 5.yeaeld chil. Several narrow, hie opaque inactive cares lesions are locate 1-2 mm from the ging margins. One of the lesan exhib a age cviy whch on probing i had, Tis an example fan naive, ated sion. Glinical appearances of caries lesions 9 re 25 Deciduous fst lower molar in a 2i-yeareld child with two Figure 2.6 Lowe fist deciduous molars with active, atte lesions inthe cated active cates lesions dtl and dsto-ecusal surfaces ofa 6yeteld ch, Ec Figures 2.7, 2.8 A case of a2-yeareld il wth exersve,acive, parlycavated cares sions ening the teeth, Tiss an example of bette nursing cares, for bottle cares. Al figures or deciduous tech couresy ef. Mele} Figures 2, 2.10 sighty discolored noncaviatedapproxinal lesions on exlated deciduous mela Note that the shape of the lesions reflects where dental aque has been retained above the poston of the gingival marin 10. The disease and its diagnosis Permanent dentition Free smooth surfaces Figure 2.11 Active, on cavtated carious lesion ower second prema). The shape is ypc as i follows the curvature af the marginal gingiva and conespands a where anata band of deal plague has ben loated in 2 Stagrant area. The surac is dll and chalky. cle a white spt eso, though tertends am te apprxinal amalgam filing al alang the gingiva margin. On the mesbucal surface ofthe lower fist molar aneter non ‘avtated lesion has taken up brown stain. Note als the very thn lesion on the buccal surface ofthe fst premolar along the shiva magi Figure 2.13 Anescediacive, white pe lesion on the lowest malar which is or-eavtaed exept fr alaclzed crear surace detec. The postion of is lesan corespods to where he marcal gingiva would have been dung pa ‘ofthe eruption tis teth 30 years ear When viewing telson tom fret angles iis apparent hat the surface issn and smoot, although a prove ip moved along the surface il arf into the defect (nhich sao hard io ee fg so ata teen oe ear ot weegseaighieedatans gatas ese nscale sitet ener eee meee sisson deat unt atteeberiepeay Saag aie cyan ent tals oe nebo n Sanyo cays j Figure 2.14 Extensive active, white, opaque an chalky buccal lesions which enon

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