Kidd E A
Department of Conservative Dentistry, Guy's Hospital Dental School, England.
Adv Dent Res. 1990 Jun;4:10-3. doi: 10.1177/08959374900040010101.
Secondary caries is the most common reason given by dentists for the replacement of restorations, and yet this is a diagnosis that is difficult to make with confidence. This paper attempts to define some of the problems in the diagnosis of caries in restored teeth. The histology of the secondary carious lesion shows that it may be considered in two parts: an outer lesion adjacent to the filling, and a wall lesion which will occur only if there is leakage between the filling and the tooth. The specific diagnostic difficulties addressed are the difficulty of seeing this wall lesion, whether a defective margin indicates secondary caries, and the difficulties of differentiating secondary from residual caries and active from arrested disease. Since further research is needed to solve many of these problems, the paper ends by discussing the consequences of these difficulties for clinicians, epidemiologists, teachers, and research workers.
继发龋是牙医更换修复体最常见的原因，但这是一种难以确诊的疾病。本文试图明确修复牙龋齿诊断中的一些问题。继发龋损的组织学表明，它可分为两部分：与充填物相邻的外层龋损，以及仅在充填物与牙齿之间存在渗漏时才会出现的壁龋。文中讨论的具体诊断难点包括：难以观察到壁龋、缺损边缘是否提示继发龋、区分继发龋与残留龋以及区分活动龋与静止龋的困难。由于需要进一步研究来解决其中许多问题，本文最后讨论了这些难点对临床医生、流行病学家、教师和研究人员的影响。
