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       Caries Management— Science and Clinical Practice

      Univ.-Prof.

      Dr. Hendrik Meyer-Lueckel, MPH

      Department of Operative Dentistry,

      Periodontology, and Preventive Dentistry

      Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen

      Aachen, Germany

      Priv.-Doz. Dr. Sebastian Paris, DDS

      Clinic for Operative Dentistry

      and Periodontology

      Christian-Albrechts-Universität zu Kiel

      Kiel, Germany

      Assoc. Prof. Kim R. Ekstrand, DDS, PhD

      Vice Dean and Chair

      Section for Cariology, Endodontics,

      Pediatric Dentistry, and Clinical Genetics

      Department of Odontology

      Faculty of Health and Medical Sciences

      University of Copenhagen

      Copenhagen, Denmark

      Managing Editor:

      Dr. Susanne Effenberger

      Manager Clinical Research

      DMG Dental-Material Gesellschaft mbH

      Hamburg, Germany

      With contributions by

      Mohammad Alkilzy, Bennett T. Amaechi, Uwe Blunck, Wolfgang Buchalla, Brian H. Clarkson, Agata Czajka-Jakubowska, Christof Doerfer, Hafsteinn Eggertsson, Roland Frankenberger, Rainer Haak, Leandro Augusto Hilgert, Soraya Coelho Leal, Stefania Martignon, Vera Mendes Soviero, David Nigel James Ricketts, Ulrich Schiffner, Christian Andres Schneider, R. Peter Shellis, Christian H. Splieth, Svante Twetman, Martin J. Tyas, Cornelis van Loveren, Bart Van Meerbeek, Michael Jochen Wicht, Yasuhiro Yoshida, Domenick T. Zero

      409 illustrations

      Thieme

      Stuttgart · New York

      Library of Congress Cataloging-in-Publication Data is available from the publisher.

      Illustrators: Christine Lackner, Ittlingen, Germany; Eva M. Reinwald, Copenhagen, Denmark (portraits in preface)

      © 2013 Georg Thieme Verlag KG

      Rüdigerstrasse 14, 70469 Stuttgart,

      Germany

      http://www.thieme.de Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA http://www.thieme.com

      Cover design: Thieme Publishing Group

      Translation: Dolphin Translations, Stuttgart, Germany

      Typesetting by primustype Robert Hurler GmbH, Notzingen,

      Germany

      Printed in Italy by L.E.G.O., Vincenza

      ISBN 978-3-13-154711-8

      eISBN 978-3-13-169381-5

      Important note: Medicine is an ever-changing science undergoing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy. Insofar as this book mentions any dosage or application, readers may rest assured that the authors, editors, and publishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of production of the book.

      Nevertheless, this does not involve, imply, or express any guarantee or responsibility on the part of the publishers in respect to any dosage instructions and forms of applications stated in the book. Every user is requested to examine carefully the manufacturers’ leaflets accompanying each drug and to check, if necessary in consultation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications stated by the manufacturers differ from the statements made in the present book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the user's own risk and responsibility. The authors and publishers request every user to report to the publishers any discrepancies or inaccuracies noticed. If errors in this work are found after publication, errata will be posted at www.thieme.com on the product description page.

      Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain.

      This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation, without the publisher's consent, is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing, preparation of microfilms, and electronic data processing and storage.

      Preface

      Dental caries is still one of the most common diseases in human beings, causing smaller or larger problems to millions of people around the world every day. As dental professionals we have to help people to understand the disease to enable them to prevent caries by themselves (self-management). When more severe decay is diagnosed, we, together with the patient, should manage the caries disease in a minimally interventional way.

      This introductory chapter will present some general thoughts about caries and where we come from in cariology. Moreover, we will explain why we think it is important to have another book about cariology and will describe the concept of the book, which is presented in two main parts: science and practice.

       Caries—Important but Preventable

      Dental caries is the term used for pathoanatomical changes of the dental hard tissues. These changes are caused by acids that are created in the dental plaque (biofilm) covering the affected tooth surface, when certain microorganisms ferment sugars, which in turn demineralize the dental hard tissues. Thus, the disease, which professionals perceive as changes of the dental hard tissues, in fact reflects activities within the overlying dental biofilm. If these unfavorable biofilm activities are occurring frequently, the signs of the caries process on the dental hard tissues will become more easily detectable. Nonetheless, the caries “scar” starts with signs that are only visible with high magnification in the laboratory but end up with clinically visible alterations of the tooth surface integrity. Thus, caries is a term which actually covers changes in the dental hard tissue from the time the first mineral ion leaves the tissue to when no mineral is left. This development СКАЧАТЬ