《牙体牙髓病学》课程教学资源（教案）二、clinical manifestations and diagnosis of Caries

该页由授课教师填写，并在授课前两周交教研室主任审核。 周次第周，第1次课2010年10月12日授课教师周智 职称副教授 章节第三章龋病临床特征和诊断 备注 名称 Pathologic process of caries Manifestaion and classification of caries. Diagnosis and Differentiation Diagnosis of caries 授课 方式 理论课（√）实践课()实习() 教学时数2学时 Review the pathology of dental caries. 学 Know the pathological process of caries and the relation between clinical manifestation and pathological changes. 及要 Be familiar with the classification of caries Master the diagnostic techniques and clinical manifestation of dental caries 教学主要内容 时间 分配 1.pathologic process of caries (1)Enamel Caries the lesion can be devided into 4 zones (②)Dentine caries 4 pulp-dentine complex tubular sclerosis within the dentine reactionary dentine the lesion n be divided into5 layes (3)Cemental Caries 4 4)Demineralization and remineralization the enamel rods are surrounded by the organic compositions the acidic ions could spread through the organic matrix into the enamel the hydroxyapatite(HA)crystals in the enamel can be dissolved by acids. 2.Manifestaion and classification of caries Clinically,dental caries may be classified according to the rate of attack,the location of the lesion on the toothand the severity of the lesion. Drampant or acute caries 2slowly progressive or chronic caries 3arrested caries.do not progress secondary caries:occur in the tooth tissue adjacent to the filling material cause- (Ipit or fissure caries ②undermined caries smooth surface caries

该页由授课教师填写，并在授课前两周交教研室主任审核。 周次 第 周，第 1 次课 2010 年 10 月 12 日 授课教师 周智 职称 副教授 章 节 名 称 第三章 龋病临床特征和诊断 Pathologic process of caries Manifestaion and classification of caries. Diagnosis and Differentiation Diagnosis of caries 备 注 授 课 方 式 理论课（√ ）；实践课（）；实习（ ） 教学时数 2 学时 教 学 目 的 及 要 求 Review the pathology of dental caries. Know the pathological process of caries and the relation between clinical manifestation and pathological changes. Be familiar with the classification of caries Master the diagnostic techniques and clinical manifestation of dental caries. 教 学 主 要 内 容 时 间 分 配 1.pathologic process of caries ⑴ Enamel Caries the lesion can be devided into 4 zones the progression process: ⑵ Dentine caries pulp-dentine complex tubular sclerosis within the dentine reactionary dentine the lesion can be divided into 5 layes ⑶ Cemental Caries ⑷ Demineralization and remineralization the enamel rods are surrounded by the organic compositions the acidic ions could spread through the organic matrix into the enamel the hydroxyapatite(HA) crystals in the enamel can be dissolved by acids. 2.Manifestaion and classification of caries Clinically, dental caries may be classified according to the rate of attack, the location of the lesion on the tooth, and the severity of the lesion. ⑴Classification by rate of attack ① rampant or acute caries ② slowly progressive or chronic caries ③ arrested caries: do not progress ④ secondary caries : occur in the tooth tissue adjacent to the filling material ⑤ cause: ⑵classification by site of attack ①pit or fissure caries ②undermined caries ③smooth surface caries 4 4 4 8 2 7 8

④root caries linear enamel caries usually occur at the neo-natal line on the labial surfac of upper anterior deciduous teeth 3)classification by depth of the lesion ①superficial caries ②moderate caries ③deep caries 3.Diagnosis and Differentiation Diagnosis (1)the prerequisites for caries diagnosis: good lighting clean teeth sharp eyes with vision aided by magnification, reproducible bitewing radiographs. (2).Diagnosis methods ①Visual inspection Characteristics changes in and translusency oftooth structure exploratory inspection ④thermal test 5 radiographic examination ⑥transmitted light (3)diagnostic criteria:clinically based ordingtothe verity of the lesion 12 ①superficial caries differenciatial diagnosis enamel hypoplasia dental fluorosis ③deep caries pulpitis: Review the pathology of dental caries. 教学重 Know the pathological process of caries and the relation between clinical manifestation and pathological changes. Be familiar with the classification of caries Master the diagnostic techniques and clinical manifestation of dental caries pulp-dentine complex,tubular sclerosis within the dentine,reactionary dentine,superficial caries,differeniatial diagnosis,exploratory inspection,Cemental Caries 理论讲授结合病例分析

④root caries ⑤linear enamel caries. usually occur at the neo-natal line on the labial surface of upper anterior deciduous teeth ⑶classification by depth of the lesion ①superficial caries ②moderate caries ③deep caries 3. Diagnosis and Differentiation Diagnosis ⑴ the prerequisites for caries diagnosis : good lighting clean teeth a three-in-one syringe so that teeth can be viewed both wet and dry sharp eyes with vision aided by magnification, reproducible bitewing radiographs. ⑵.Diagnosis methods ① Visual inspection ② Characteristics changes in the color and translusency of tooth structure ③ exploratory inspection ④ thermal test ⑤ radiographic examination ⑥ transmitted light ⑶ diagnostic criteria: clinically, the diagnostic criteria is based on classification according to the severity of the lesion: ① superficial caries differenciatial diagnosis enamel hypoplasia dental fluorosis ② moderate caries: ③ deep caries pulpitis: 8 15 8 12 教 学 重 点 与 难 点 Review the pathology of dental caries. Know the pathological process of caries and the relation between clinical manifestation and pathological changes. Be familiar with the classification of caries Master the diagnostic techniques and clinical manifestation of dental caries 外 语 要 求 pulp-dentine complex，tubular sclerosis within the dentine，reactionary dentine，superficial caries，differeniatial diagnosis，exploratory inspection，Cemental Caries 教 理论讲授结合病例分析

手段 《.Dental Caries》 Ole Fejerskov and Edwina A.M.Kidd 2003,Blackwell Munksgaard Are We Ready to Move from Operative to Non-Operative/Preventive Treatment of Dental 考 Caries in Clinical Practice?Caries Res 2004:38:294-304 The Best Methods For Management Of Precarious Coronal Lesions 资 Pit and Fissure Sealants in High Caries Risk Ede.65(10:1084-109200 Caries-Diagnosis.Risk Assessment and Non-Invasive Treatment,A Systematic Review The use of pit and fissure sealants in preventing caries in the permanent dentition of childrenA guide to prevention in dentistry,P41-P46 Profcsionalyaplicdtopnicdnuo dentistry,P47-P50 Pathologic process of caries Manifestaion and classification of caries. Diagnosis and Differentiation Diagnosis of cari 室主任意见

学 手 段 参 考 资 料 《.Dental Caries》 Ole Fejerskov and Edwina A.M. Kidd 2003, Blackwell Munksgaard Are We Ready to Move from Operative to Non-Operative/Preventive Treatment of Dental Caries in Clinical Practice? Caries Res 2004;38:294–304 The Best Methods For Management Of Precarious Coronal Lesions Pit and Fissure Sealants in High Caries Risk Individuals, J Dent Educ. 65(10): 1084-1090 2001 Caries – Diagnosis, Risk Assessment and Non-Invasive Treatment，A Systematic Review The use of pit and fissure sealants in preventing caries in the permanent dentition of children A guide to prevention in dentistry,P41-P46 Professionally applied topical fluorides for caries prevention. A guide to prevention in dentistry,P47-P50 课 后 要 求 Pathologic process of caries Manifestaion and classification of caries. Diagnosis and Differentiation Diagnosis of caries 教 研 室 主 任 意 见