Prisheechny caries – carious process with localization in pridesnevy area, that is in a tooth neck. Depending on a stage prisheechny caries can be shown by tooth enamel darkening in okolodesnevy area; hypersensibility of tooth on temperature, chemical and mechanical irritants; formation of a carious cavity of various depth, pain syndrome. Prisheechny caries is diagnosed during dental survey and a X-ray analysis of tooth. Treatment of prisheechny caries is carried out taking into account a stage of carious damage of tooth and does not differ from caries, that at other types.
Prisheechny caries – the kind of caries which is characterized by destruction of solid fabrics on border of a crown and a fang near a gum. According to the classification accepted in stomatology depending on localization allocate fissurny, prisheechny (tservikalny), contact (aproksimalny) and ring (circular) caries. Prisheechny caries the lip, shchechny, lingual surfaces of side and frontal teeth can be surprised. Prisheechny caries arises at aged people of 30-60 years more often. Prisheechny caries is among the most dangerous types of caries affecting tooth in the most weak spot and promoting it to bystry destruction.
Reasons of prisheechny caries
In general caries of prisheechny area develops owing to the same reasons and mechanisms, as carious processes of other localizations. At the same time, developing of prisheechny caries is favored by the special conditions which are available in pridesnevy area. First of all, it is inaccessibility of this zone for high-quality hygienic leaving, and, therefore, the raised congestion of a dental plaque and formation of a scale in prisheechny area. Direct link between prisheechny caries and gingivity is traced.
Besides, in a tooth neck thickness of enamel makes only 0,1 mm whereas in the field of hillocks - 1,7 mm, and in fissures - 0,6-0,7 mm. The thin layer of enamel is rather easily damaged when toothbrushing by abrasive pastes, tooth-powders, rigid brushes.
Among other factors, development of prisheechny caries can be promoted by frequent consumption of sour products and reception of the medicines increasing porosity of enamel, pregnancy. At defeat by prisheechny caries at the same time of several teeth, most likely, it is necessary to think of endocrine dysfunction (diabetes, diseases of a thyroid gland).
Symptoms of prisheechny caries
Prisheechny caries passes the same stages, as any other carious defeat in the development: stage of a spot, superficial, average and deep caries. In an initial stage enamel in a neck of tooth loses gloss and becomes opaque; on it there is a light (pretty) or pigmented spot with a smooth surface; clinical manifestations are absent.
Further the surface of a spot becomes rough that demonstrates the begun enamel destruction; subjective feelings are characterized by short-term painful reaction to chemical, mechanical and temperature irritants. It demonstrates transition of prisheechny caries to the following kliniko-morphological stage - superficial.
Weakness of enamel in a neck of tooth promotes rather bystry progressing of prisheechny caries in a stage of average and deep caries which are clinically shown by formation of a carious cavity, jamming of food, painful reaction at a conversation, meal, toothbrushing. Deep caries can be followed by considerable destruction of tooth and be complicated by development of a pulpitis. Prisheechny caries is usually localized on the lip or shchechny surface of teeth; sometimes defeat covers all radical neck of tooth as circular caries.
Diagnosis of prisheechny caries
The skilled stomatologist can distinguish prisheechny caries at a stage of a pretty spot. As well as in other cases, inspection of an oral cavity, sounding, assessment of a hygienic index is performed. Additional methods of diagnosis of prisheechny caries can include thermotest, vital coloring, an elektroodontodiagnostika, transillumination, a tooth X-ray analysis, radioviziografichesky inspection.
In the course of diagnostics prisheechny caries should be distinguished from wedge-shaped defect, an erosion of enamel, a flyuoroz. If it is found in the patient several teeth affected with prisheechny caries it it is necessary to direct to consultation to the endocrinologist for an exception of pathology of endocrine system.
Treatment of prisheechny caries
Methods of treatment of prisheechny caries depend on a stage of the address to the expert. At early stages (a spot stage) performing the remineralizing therapy – a course of applications of fluorinated medicines, deep fluoration of enamel is expedient.
At formation of a cavity process of treatment of prisheechny caries has to include the following main stages: local anesthesia, removal of tooth deposits, preparation of defect and processing of a cavity, imposing of the medical and isolating laying (at treatment of average and deep caries), statement of a seal of light polymerization, grinding and polishing of a seal.
Forecast and prevention of prisheechny caries
It is necessary to remember that prisheechny caries progresses very quickly therefore at detection of the slightest changes in area of a neck of tooth it is necessary to address the stomatologist. In uncomplicated stages by means of modern methods of treatment it is possible to restore completely an esthetics and functional mission of tooth. As complications of deep prisheechny caries often serve also pulpitises, periodontitis, gingivita. The started prisheechny caries can lead to destruction and loss of tooth which restoration will require prosthetics or dental implantation.
Prevention of prisheechny caries includes regular and careful care of teeth by means of individually picked up means (toothpastes, conditioners, tooth thread), observance of the correct technology of toothbrushing, professional hygiene of an oral cavity, the prevention of diseases of gums and endocrine violations.