Ultrastructure of the intact surface zone of white spot and brown spot carious lesions in human enamel.

Electron microscopy of the intact surface zone of white spot and brown spot carious lesions showed that in general their ultrastructure was similar. Their outermost crystalline surface consisted of small crystals similar to those in healthy enamel, crystals with central core dissolution, and rounded crystals. Below this, surface demineralization of enamel was observed as the enlargement of micropores, the central core dissolution of crystals, the formation of channels and the enlargement of spaces at prism boundaries. Remineralization of enamel was observed as the partial occlusion of voids, the rounding and enlargement of crystals, and some new needle-shaped crystals. Some other features indicated combined demineralization and remineralization. The occlusion of spaces at prism boundaries was a more common feature in brown spot lesions, whereas the pockets of rounded crystals were more common in white spot lesions. A relatively uniform distribution of needle-shaped crystals throughout the intact surface zone was a feature of some brown spot lesions only.