Differential diagnostics.

Date: 2015-10-07; view: 462.

The differential diagnostics of the acute caries must be performed with the acute initial and medial caries, enamel hypoplasia and the erosive form of a fluorosis. The difference between an acute primary and primary superficial caries is that the superficial proceeds at complete destruction of the superficial layer and deep development of a pathological process into the enamel. Unlike the acute medial caries, acute superficial caries is characterized by the retention of integrity of the enamel-dentine junction which is always destroyed at medial caries. In case of the medial caries probing of the enamel-dentine junction is painful.

The enamel hypoplasia is different from the primary caries for the multiplicity of defects and their symmetry of disposition. There is no hyperesthesia. The floor of the hypoplastic defects is smooth and glistening. This floor is formed with a thin layer of the enamel or a sclerosised dentine.

Medial cariesis diagnosed most frequently and it is characterized by the impaired integrity of the enamel- dentine junction and localization of a defect within the dentine. Complaints: about dental pain caused by cold at acute caries development, presence of a cavity. The carious cavity is characterized with a small, narrow orifice with white dentine (at acute development) or with broad orifice with brown dentine (at chronic development). Objectively: The carious cavity is situated within the dentine. The floor and walls are covered with a softened dentine which is easily removed in layers ( at acute development), the dentine on the floor and walls of the carious cavity is quite hard (at chronic development). Probing of the carious cavity walls in the area of the enamel-dentine junction is painful (at acute development). The percussion is painless, at acute development of caries we may observe pain after the drinking cold water which disappears after the stimulus has been removed.