牙体牙髓病学教学课件电子教案全套课件.pptx

Etiology of Dental Caries;The four circles diagrammatically represent the factors involved in the carious process.all four factors must act concurrently (overlapping of the circles)for caries to occur;Host factor: saliva What is saliva here mean? a. major saliva glands Saliva parotid, submandibular, sublingual b. minor gland c. gingival exudate;Why Saliva?;Animal experiment;Clinical observations;Clinical observation;Caries in a patient with impaired salivary function as result of radiation therapy (courtesy of Drs Jansma and Vissink, RUG, the Netherlands.;The caries is different from common. Decay offer seen in cervical area, a rapid demineralization over broad surfaces with no cavity. the huge change in quantity of saliva is responsible.;In xerostomia The amount of bacteria The quality of plaque change S.mutans, Lactobacillus, Yeast, Actinomyce S. sanguis, Veillonella, Neisseria;A case report;Decayed, missing, and filled teeth prior to the anticholinergic therapy obtained from the patient’s dental records and roentgenographs;Full-mouth roentgenographs of patient showing rampant caries and pulpal involvement of mandibular anterior teeth;Decayed, missing, and filled teeth of a patient who received prolonged anticholinergic therapy for a duodenal ulcer. Note the steep caries increment (DMFT 27) that occurred during the time of xerostomia;Salivary composition and caries;Why flow rate?;Flushing and neutralizing effect refered as “Salivary Clearance” or “Oral Clearance Capacity”;The Dawes (1983) model of oral clearance. Saliva is produced at a rate dependent on the concentration of sugar in the saliva. When a maximum volume of saliva (Vmax) is reached, a swallow occurs and the salivary volume decreases to a residual volume (Resid), thereby eliminating some of the sugar;Flow rate of saliva;A computer simulation of the effect of changes in the unstimulated flow rate on the clearance of sucrose after a 10% sucrose mouthrinse. The simulation assumed average va