TREATMENT OF INCIPIENT CARIOUS LESIONS

Öz

-

Anahtar Kelimeler

• -

BAŞLANGIÇ ÇÜRÜK LEZYONLARININ TEDAVİSİ

Öz

Başlangıç çürük lezyonları, “düz yüzey çürüğü” ya da “beyaz nokta lezyonu” olarak da adlandırılan, mine dokusuyla sınırlı, yüzeyel yapısı sağlıklı mineden daha pörözlü olmasına rağmen kavitasyonsuz demineralize alanlardır. Başlangıç çürükleri, diş çürüğü oluşumunun en erken safhasıdır ve bu aşamada çürük lezyonun durdurulması ve tedavi edilebilmesi mümkündür. Bu lezyonların tedavisi çürüğün ilerlemesiyle oluşacak diş dokusundaki aşırı madde kaybını engellemesi ve tedavi süresi ve maliyetini azaltması açısından oldukça önemlidir. Bu amaçla, günümüze kadar başlangıç çürük lezyonlarının tedavisinde birçok farklı yöntemin etkinliği araştırılmıştır. Bu derlemenin amacı başlangıç çürük lezyonlarının yapısının, klinik özelliklerinin ve tedavi alternatiflerinin bu konuyla ilgili yapılan araştırmalar ışığında incelenmesidir

Anahtar Kelimeler

• Başlangıç çürük lezyonları, beyaz nokta lezyonları, düz yüzey lezyonları, remineralizasyon, düşük viskoziteli rezinler

Kaynakça

1. Arends J, Christoffersen J. The nature of early caries lesions in enamel. J Dent Res 1986; 65(1):
2. Koray F. Diş Çürükleri. İstanbul; Dünya Tıp Kitapevi: 1981. p. 41-43.
3. Cengiz T. Endodonti. 4. Baskı. Ankara; Barış Yayınları: 1996. p. 43-56.
4. Axelson P. Diagnosis and Risk Detection of Dental Caries. Germany; Quintessence Pub Co: 2000. p. 179-247.
5. Kidd E, Fejerskov O. Dental Caries. Oxford; Blackwell Munksgaard: 2003. p. 75-83.
6. Mount GJ. Defining, classifying, and placing incipient caries lesions in perspective. Dent Clin North Am 2005; 49(4): 701-723.
7. Kudiyirickal MG, Ivancaková R. Early enamel lesion part I. Classification and detection. Acta Medica (Hradec Kralove) 2008; 51(3): 145-149.
8. Roberson TM, Heymann H, Swift E Jr. Sturdevant’s Art & Science of Operative Dentistry. 4th ed. St. Louis, MO: Mosby/Elsevier: 2002. p. 93.

9. Choo-Smith LP, Dong CC, Cleghorn B, Hewko M. Shedding new light on early caries detection. J Can Dent Assoc 2008; 74(10): 913-918.
10. Marthaler TM. Cariostatic efficacy of the combined use of fluorides. J Dent Res 1990; 69(Spec No): 797-800.
11. Zimmer S, Bizhang M, Seemann R, Witzke S, Roulet JF. The effect of a preventive program, including the application of low-concentration fluoride varnish, on caries control in high-risk children. Clin Oral Investig 2001; 5(1): 40-44.
12. Kleber CJ, Milleman JL, Davidson KR, Putt MS, Triol CW, Winston AE. Treatment of orthodontic white spot lesions with a remineralizing dentifrice applied by toothbrushing or mouth trays. J Clin Dent 1999; 10(1 Spec No): 44-49.
13. Al-Khateeb S, Forsberg CM, de Josselin de Jong E, Angmar-Månsson B. A longitudinal laser fluorescence study of white spot lesions in orthodontic patients. Am J Orthod Dentofacial Orthop 1998; 113(6): 595-602.
14. Kerebel LM, Le Cabellec MT, Daculsi G, Kerebel B. Report on caries reduction in French schoolchildren 3 years after the introduction of a preventive program. Community Dent Oral Epidemiol 1985; 13(4): 201-204.
15. Von Der Fehr FR, Löe H, Theilade E. Experimental caries in man. Caries Res 1970; 4(2): 131-148.
16. Artun J, Thylstrup A. Clinical and scanning electron microscopic study of surface changes of incipient enamel caries lesions after debonding. Scand J Dent Res 1986; 94(3): 193-210.
17. Nyvad B, Fejerskov O. Assessing the stage of caries lesion activity on the basis of clinical and microbiological examination. Community Dent Oral Epidemiol 1997; 25(1): 69-75.
18. Lo EC, Schwarz E, Wong MC. Arresting dentine caries in Chinese preschool children. Int J Pediatr Dent 1998; 8(4): 253-260.
19. Rekola M. Changes in buccal white spots during 2- year consumption of dietary sucrose or xlitol. Acta Odontol Scand 1986; 44(5): 285-290.
20. Rekola M. Quantification of incipient approximal caries during fructose and sucrose consumption. Acta Odontol Scand 1989; 47(2): 77-80.
21. Duggal MS, Toumba KJ, Amaechi BT, Kowash MB, Higham SM. Enamel demineralization in situ with various frequencies of carbonhydrate consumption with and without fluoride toothpaste. J Dent Res 2001; 80(8): 1721-1724.
22. Walsh TF, Unsal E, Davis LG, Yilmaz O. The effect of irrigation with chlorhexidine or saline on plaque vitality. J Clin Periodontol 1995; 22(3): 262-264.
23. van Strijp AJ, Gerardu VA, Buijs MJ, van Loveren C, ten Cate JM. Chlorhexidine efficacy in preventing lesion formation in enamel and dentine: an in situ study. Caries Res 2008; 42(6): 460-465.
24. Dolles OK, Gjermo P. Caries increment and gingival status during 2 years use of chlorhexidine and fluoride containing dentifrice. Scand J Dent Res 1980; 88(1): 22-27.
25. de Amorim RG, Leal SC, Bezerra AC, de Amorim FP, de Toledo OA. Association of chlorhexidine and fluoride for plaque control and white spot lesion remineralization in primary dentition. Int J Paediatr Dent 2008; 18(6): 446-451.
26. Scheaeken MJM, Keltjens HM, Van Der Hoeven JS. Effects of fluoride and chlorhexidine on the microflora of dental root surfaces and progression of root surface caries. J Dent Res 1991; 70(2): 150-153.
27. McCoy LC, Wehler CJ, Rich SE, Garcia RI, Miller DR, Jones JA. Adverse events associated with chlorhexidine use: results from the Department of Veterans Affairs Dental Diabetes Study. J Am Dent Assoc 2008; 139(2): 178-183.
28. Davies RM, Ellwood RP, Davies GM. The rational use of fluoride toothpaste. Int J Dent Hyg 2003; 1(1): 3-8.
29. Petersson LG, Hakestam U, Baigi A, Lynch E. Remineralization of primary root caries lesions using an amine fluoride rinse and dentifrice twice a day. Am J Dent 2007; 20(2): 93-96.
30. Lynch E, Baysan A, Ellwood R, Davies R, Petersson L, Borsboom P. Effectiveness of two fluoride dentifrices to arrest root carious lesions. Am J Dent 2000; 13(4): 218-220.
31. Baysan A, Lynch E, Ellwood R, Davies R, Petersson L, Borsboom P. Reversal of primary root caries using dentifrices containing 5000 and 1100 ppm fluoride. Caries Res 2001; 35(1): 41-46.
32. Geiger AM, Gorelick L, Gwinnett AJ, Griswold PG. The effect of a fluoride program on white spot formation during orthodontic treatment. Am J Ortod Dentofac Orthop 1988; 93(1): 29-37.
33. Ferreira MA, Latorre Mdo R, Rodrigues CS, Lima KC. Effect of regular fluoride gel application on incipient caries lesions. Oral Health Prev Dent 2005; 3(3): 141-149.
34. Kukleva MP. Treatment of incipient caries in children with fluoride gel. Folia Med 2002; 44(1-2): 50-55.
35. Jardim JJ, Pagot MA, Maltz M. Artificial enamel dental caries treated with different topical fluoride regimes: an in situ study. J Dent 2008; 36(6): 396
36. Fure S, Lingström P. Evaluation of different fluoride treatments of initial root caries lesions in vivo. Oral Health Prev Dent 2009; 7(2): 147-154.
37. Fontana M, Gonzales-Cabezas C, Haider A, Stookey GK. Inhibition of secondary caries lesion progression using fluoride varnish. Caries Res 2002; 36(2): 129-135.
38. Lin R, Hildebrand T, Donly KJ. In vitro remineralization associated with a bioerodible fluoridated resin and a fluoride varnish. Am J Dent 2009; 22(4): 203-205.
39. Castellano JB, Donly KJ. Potential remineralization of demineralized enamel after application of fluoride varnish. Am J Dent 2004; 17(6): 462-464.
40. Iijima Y, Cai F, Shen P, Walker G, Reynolds C, Reynolds EC. Acid resistance of enamel subsurface lesions remineralized by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. Caries Res 2004; 38(6): 551- 556.
41. Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC. Remineralization of enamel subsurface lesions by sugar-free chewing gum containing phosphopeptide-amorphous calcium phosphate. J Dent Res 2002; 81(4): 228.
42. Reynolds EC, Cain CJ, Webber FL, Black CL, Riley PF, Johnson IH, Perich JW. Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res 1995; 74(6): 1272-1279.
43. Reynolds EC. Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review. Spec Care Dentist 1998; 18(1): 8-16.
44. Mathew M, Takagi S. Structures of biological minerals in dental research. J Res Natl Inst Stand Technol 2001; 106(6): 1035-1044.
45. Reynolds EC, Black CL, Cai F. Advances in enamel remineralization: anticariogenic casein phosphopeptide-amorphous calcium phosphate. J Clin Dent 1999; 10(2): 86-88.
46. Walker GD, Cai F, Shen P, Bailey DL, Yuan Y, Cochrane NJ, Reynolds C, Reynolds EC. Consumption of milk with added casein phosphopeptide-amorphous calcium phosphate remineralizes enamel subsurface lesions in situ. Aust Dent J 2009; 54(3): 245-249.
47. Llena C, Forner L, Baca P. Anticariogenicity of casein phosphopeptide-amorphous calcium phosphate: a review of the literature. J Contemp Dent Pract 2009; 10(3): 1-9.
48. Willershausen B, Schulz-Dobrick B, Gleissner C. In vitro evaluation of enamel remineralization by a casein phosphopeptide-amorphous calcium phosphate paste. Oral Health Prev Dent 2009; 7(1): 13-21.
49. Reynolds EC, Cain CJ, Webber FL. Anticariogenity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res 1995; 74(6): 1272-1279.
50. Walker GD, Cai F, Shen P, Adams GG, Reynolds C, Reynolds EC. Casein phosphopeptide-amorphous calcium phosphate incorporated into sugar confections inhibits the progression of enamel subsurface lesions in situ. Caries Res 2010; 44(1):
51. Bailey DL, Adams GG, Tsao CE, Hyslop A, Escobar K, Manton DJ, Reynolds EC, Morgan MV. Regression of post-orthodontic lesions by a remineralizing cream. J Dent Res 2009; 88(12): 1148-1153.
52. Elsayad I, Sakr A, Badr Y. Combining casein phosphopeptide-amorphous calcium phosphate with fluoride: synergistic remineralization potential of artificially demineralized enamel or not? J Biomed Opt 2009; 14(4): 4439-4456.
53. Fu H, Liang R, Xiao Y, Zhang XJ. Efficacy of Tooth Mousse in reducing enamel demineralization and promoting remineralization. Hua Xi Kou Qiang Yi Xue Za Zhi 2008; 26(3): 301-305.
54. Schirrmeister JF, Seger RK, Altenburger MJ, Lussi A, Hellwig E. Effects of various forms of calcium added to chewing gum on initial enamel caries lesions in situ. Caries Res 2007; 41(2): 108-114.
55. Cai F, Shen P, Morgan MV, Reynold EC. Remineralization of enamel subsurface lesions in situ by sugar-free lozenges containing casein phosphopeptide amorphous calcium phosphate. Aust Dent J 2003; 48(4): 240-243.
56. Steiner-Oliveira C, Rodrigues LK, Soares LE, Martin AA, Zezell DM, Nobre-dos-Santos M. Chemical, morphological and thermal effects of 10.6-micron CO2 demineralization. Dent Mater J 2006; 25(3): 455
57. Klein AL, Rodrigues LK, Eduardo CP, Nobre dos Santos M, Cury JA. Caries inhibition around composite restorations by pulsed carbon dioxide laser application. Eur J Oral Sci 2005; 113(3): 239- 244.
58. Esteves-Oliveira M, Zezell DM, Meister J, Franzen R, Stanzel S, Lampert F, Eduardo CP, Apel C. CO2 laser (10.6 micron) parameters for caries prevention in dental enamel. Caries Res 2009; 43(4): 261-268.
59. Steiner-Oliveira C, Rodrigues LK, Lima EB, Nobre- dos-Santos M. Effect of the CO2 laser combined with fluoridated products on the inhibition of enamel demineralization. J Contemp Dent Pract 2008; 9(2): 113-121.
60. Rodrigues LK, Nobre Dos Santos M, Featherstone JD. In situ mineral loss inhibition by CO2 laser and fluoride. J Dent Res 2006; 85(7): 617-621.
61. Schmidlin PR, Dörig I, Lussi A, Roos M, Imfeld T. CO2 laser-irradiation through topically applied fluoride increases acid resistance of demineralized human enamel in vitro. Oral Health Prev Dent 2007; 5(3): 201-208.
62. Chen CC, Huang ST. The effects of lasers and fluoride on the acid resistance of decalcified human enamel. Photomed Laser Surg 2009; 27(3): 447-452.
63. Santaella MR, Braun A, Matson E, Frentzen M. Effect of diode laser and fluoride varnish on initial surface demineralization of primary dentition enamel: an in vitro study. Int J Pediatr Dent 2004; 14(3): 199-203.
64. ten Cate JM, Larsen MJ, Pearce EIF, Fejerskov O. Chemical interaction between the tooth and oral fluids. In: Fejerskov O, Kidd E, eds. Dental Caries: The Disease and its Clinical Management. Oxford: Blackwell Munksgaard, 2003. p.49-68.
65. Goepferd SJ, Olberding P. The effect of sealing white spot lesions on lesion progression in vitro. Pediatr Dent 1989; 11(1): 14-16.
66. Mueller J, Meyer-Leuckel H, Paris S, Hopfenmuller W, Kielbassa AM. Inhibition of lesion progression by the penetration of resins in vitro: influence of the application procedure. Oper Dent 2006; 31(3): 338-345.
67. Robinson C, Brooks SJ, Kirkham J, Woods SR, Shore RC. In vitro studies of the penetration of adhesive resins into artificial caries -like lesions. Caries Res 2001; 35(2): 136-141.
68. Paris S, Meyer-Lueckel H, Mueller J, Hummel M, Kielbassa AM. Progression of sealed initial bovine enamel lesions under demineralizing conditions in vitro. Caries Res 2006; 40(2): 124-129.
69. Meyer-Lueckel H, Paris S, Mueller J, Colfen H, Kielbassa AM. Influence of the application time on the penetration of different dental adhesives and a fissure sealant into artificial subsurface lesions in bovine enamel. Dent Mater 2006; 22(1): 22-28.
70. Meyer-Lueckel H, Paris S. Progression of artificial enamel caries lesions after infiltration with experimental light curing resins. Caries Res 2008; 42(2): 117-124.
71. Gray GB, Shellis P. Infiltration of resin into white spot caries-like lesions of enamel: an in vitro study. Eur J Proshodont Restor Dent 2002; 10(1): 27-32.
72. Paris S, Meyer-Lueckel H Masking of labial enamel white spot lesions by resin infiltration--a clinical report. Quintessence Int 2009; 40(9): 713-718.
73. Paris S, Meyer-Lueckel H. Inhibition of caries progression by resin infiltration in situ. Caries Res 2010; 44(1): 47-54.
74. Paris S, Meyer-Lueckel H, Cölfen H, Kielbassa AM. Penetration coefficients of commercially available and experimental composites intended to infiltrate enamel carious lesions. Dent Mater 2007; 23(6): 742-748.
75. Meyer-Lueckel H, Paris S. Progression of artificial enamel caries lesions after infiltration with experimental light curing resins. Caries Res 2008; 42(2): 117-124.
76. Meyer-Lueckel H, Paris S. Improved resin infiltration of natural caries lesions. J Dent Res 2008; 87(12): 1112-1116.
77. Paris S, Dörfer CE, Meyer-Lueckel H. Surface conditioning of natural enamel caries lesions in deciduous teeth in preparation for resin infiltration. J Dent 2010; 38(1): 65-71.
78. Meyer-Lueckel H, Paris S, Kielbassa AM. Surface layer erosion of natural caries lesions with phosphoric and hydrochloric acid gels in preparation for resin infiltration. Caries Res 2007; 41(3): 223-230.
79. DMG: Icon: Available from: www.drilling-no- thanks.com/us/upload/files/download//z_download s_2_H2_Icon_USA_091575_2009_09_V11_LAY.pdf (erişim tarihi: 03.05.2010).