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CARIES, UNCARIOUS TEETH ILLNESS. PULPIT. PERIODONTIT. GUMS AND PARODONTAL ILLNESSES: GINGIVITIS, PARADONTIUMS, PARADONTOLIZ.

(Concordantly Yu.Pospishil, V.Vovk )

V.Voloshyn

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Every tooth anatomically consists of a crown, neck and root. A crown comes forward above the surface of gums, a root is sunk in a dental alveolus, a neck is the area of transition of tooth crown in a root .

Hard tissues of tooth: enamel,dentine,cement. Soft tissue - pulp.

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ILLNESSES OF HARD TISSUES OF TOOTH

Hard tissues of tooth : enamel, dentine, cement.

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CARIES

- - disease which develops after the teeth cutting and expressed by the demineralization and progressive destruction of hard tissues of tooth with formation of defect as a cavity.

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Etiology and pathogenesis

A dental caries is a «infection» of hard tissues of tooth, caused by acid produce bacteria

Theories of caries development: acid, proteolytic, combined.

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Damaging factors: dental plaque, dental stone, certain

features of feed of habitants of the modern countries (soft meal, use of sugar), hyposecretion of saliva, diminishing of parotin in saliva, violations of mineral exchange;

diminishing of calcium, phosphorus, fluorine in the teeth;

endocrine diseases, pregnancy, periods of change of baby teeth, pubescence.

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Factors, slowing a caries :

remineralization of tooth hard tissues due to the receipt of salts from saliva;

formation of «barrier»: transparent dentine; regenerator dentine.

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Morphogenesis of carious defeat

An enamel struck at first by a caries is usually, farther dentine, rarer cement of tooth .

The morphogenesis of caries in different hard tissues of tooth has the features.

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Caries of enamel

develops mainly on the lateral surfaces of the tooth crown.

the area of damage of enamel has a form of cone, basis of which oriented to the surface, apex - in the direction of dentinal-enamel connection.

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The caries of enamel in the enamel folds area and fossulas

develops on the masticator surface of teeth. The area of damage of enamel has a form of cone also, but his basis is oriented to dentinal-enamel connection, and apex - to the masticatory surface of tooth.

At distribution of carious defeat from an enamel to dentine the vast area of dentine is damaged at once.

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The dentine caries makes progress more quickly than the

enamel caries. Because the dentine contains calcium less than an enamel (70% and 96% accordingly)

contains dentinal tubules through which microorganisms and products of their vital functions can spread for

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The cement caries develops, as a rule, in senior people

in which the tooth root is uncovered and cement contacts with the liquid of oral cavity.

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Pathological anatomy According clinico-morphologic displays

they select 4 stages development of caries:

1) stage of spot 2) superficial 3) middle 4) deep.

According to character of passing:

a) rapid; b) slow.

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Middle caries: dentinal-enamel connections destroy, a cariosities passes to the dentine. Dentinal tubules broaden, filled plenty of microorganisms. Under toxins act of microorganisms dystrophy and necrosis develop in the procesuses of odontoblast. A shell which covers dentinal tubulis from within collapses also.

It is instrumental in penetration of products of vital functions and microorganisms in the tubulis of dentine are deeper located, strengthens his demineralization and soften.

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Children with the wrong formed teeth and violations of calcium exchange have next

variants of caries:

1. Circular caries at which a carious defeat is localized in the area of tooth neck, engulfing it circular. Such caries develops quickly and a transparent dentine (which is the Factors, slowing a caries) does not appear here.

2. An early, subenamel caries develops directly under the layer of enamel.

3. A lateral caries develops on the lateral surfaces of tooth as well as circular caries, but ran across him more slow.

4. A stationary caries develops, as a rule, only in first molyare. A carious defeat is localized only in an enamel and does not make progress.

5. Retrograde caries. Development of carious defeat begins from the side of pulp. A dentine is damaged at first, then enamel. Such caries can develop at festerings pulpits, when an exciter gets in pulp by haematogenic way, at traumas and anomalies of odontogenesis.

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UNCARIOUS DEFEATS

wedge-shaped defects fluorosis erosion acid necrosis of teeth

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Degrees of fluorosis 1st degree is a very weak defeat. On the lip and lingual surfaces

of teeth no more than on 1/3 their areas observed poorly expressed separate shallow chalky spots and ribbons;

2nd degree is a weak defeat. The chalky spots and ribbons occupy near a half of the areas of teeth crown. There are separate pigmented spots, but a defeat is localized only in an enamel;

3rd degree - a defeat is moderato expressed. More than on the half of surface of teeth spots are placed which meet between itself;

4th degree is a heavy defeat. On the tooth surface separated and plural enamel erosions of different form appear. They can be colourless or pigmented (from yellow brown to black). In consequence of (внаслідок) the mineralization violation of tooth hard tissues at the 3rd and 4th degrees of fluorosis defeat teeth become fragile, easily rub off away and destroyed.

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REACTIVE CHANGES OF PULP

disorders of blood- and lympho circulation; atrophy; necrosis; dystrophy; denticles; intrapulp cysts.

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PULPIT acute chronic chronic with acute condition diffuse (total) nidus:

crown root.

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A fibrotic pulpit is characterized substituting of greater

part of tooth by connecting tissue with collagen fibers

plenty and nidus infiltration by lymphocytes,

macrophages and plasmatic cells.

The amount of cells diminishes in course of time, collagens fibers transform into gialin, petrifikat and denticles appear often.

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Periodontitis (or pericementitis) is inflammation which is localized directly in roundroot connective tissue shell of tooth - periodont

Distinguish : nidus; diffuse.

According to motion : acute; chronic (simple, (or ephithelial) granulema

and cistogranulema); chronic with acute conditions.

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Granulematic periodontitis expressed by formation of granulosums in an apexes area of root, which are named apical granulosums.

Distinguish the followings types of apikal granulosums:1) simple granulosum, 2) complexity or epithelial granulosum, 3)

cystogranulema.Histological simple granulema consists of ordinary granulation tissue on peripheries of which there is connective tissue as a dense capsule

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At hypertrophy gingivitis in gums productive inflammation develops with infiltration limphocytes and plasmaticcells, hyperkeratozis and by the acanthuses of multi-layered flat epithelium. .

In acute periods in gums they find neutrophilic leucocytes infiltration & obese cells else.

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DENTAL ADJOURMENTS

dental raid; odontolith (dental stone).

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Resorbtion degrees of alveoli bone tissue maxilla/mandibula):

I degree - the bone edges of alveoli are diminished, on a height to 1/4 root size of tooth;

II degree - the bone edges of alveoli are diminished, on a height to 1/2 root size of tooth;

III degree - the bone edges of alveoli are diminished, on a height to 2/3 root size of tooth;

IV a degree - is complete dissolve of bone tissue of alveoli, the apex of tooth root is placed in soft tissues of paradontium.

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EPULIS

- formation of gums, which develops as a result of chronic irritation of tissues of gums by crown, stopping, root of the destroyed tooth. The formation develops more frequently than all on gums of incisivus, canine teeth, rarer on premolar and, as a rule, on a vestibular surface Epulis has a mushroom-like shape, sometimes rounded form, and sizes 0.5 – 2.0 sm in a diameter, rarely greater.

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Epulis distinguish according a histological structure:

•angiomatic; •fibrotic; •giganticcells.

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Giganticcells epulis or peripheral giganticcells granulose

The osseoid tissue islets and primitive bones beams can appear in this epulis

consists of connecting tissue with the plenty thin-walled vessels of sinusoid type and large or more small the amount of giant cells of osteoclast type and the little cells of osteoblast type. There are the plural little-nidus hemorrhage, nidus of haemosiderosis, that is why macroscopically such epulis has brown color.

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Thank You

For your attention!