Bjørndal Lars
Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark.
J Endod. 2008 Jul;34(7 Suppl):S2-5. doi: 10.1016/j.joen.2008.02.037.
The understanding of the caries process and its effect on the pulp is presented in the context that caries does develop in various rates of progression. Early in the caries process, the pulp reflects changes within lesion activity. Thus, the early pulp response is reversible. Later, the rate of caries progression is reflected by the quality of the tertiary dentin. Slowly progressing lesions create tertiary dentin resembling normal tubular dentin. Rapidly progressing lesions lead to the production of atubular dentin or complete absence of tertiary dentin, as well as pulp necrosis and apical pathology. Finally, the nature of the untreated deep carious lesion is an ecosystem that might undergo significant changes. The untreated lesion is temporarily converted from an active and closed lesion environment into one that is open and slowly progressing. The analysis of untreated carious lesions has transformed the treatment philosophy of deep carious lesions.
对龋病过程及其对牙髓影响的理解是在龋病以不同进展速度发展的背景下呈现的。在龋病过程早期，牙髓会反映病变活动中的变化。因此，早期牙髓反应是可逆的。后来，龋病进展速度由第三期牙本质的质量反映出来。进展缓慢的病变会形成类似于正常管状牙本质的第三期牙本质。进展迅速的病变会导致无管牙本质的产生或完全没有第三期牙本质，以及牙髓坏死和根尖病变。最后，未经治疗的深龋病变的性质是一个可能会发生显著变化的生态系统。未经治疗的病变会暂时从活跃且封闭的病变环境转变为开放且进展缓慢的环境。对未经治疗的龋病病变的分析改变了深龋病变的治疗理念。
