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      Evaluacion del riesgo De La Caries Dental Como Un Proceso Infeccioso: Propuesta De Un Modelo Para Historia Clinica

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          Abstract

          En éste artículo se hace un llamado al profesional de la odontología a generar cambios conductuales (tanto diagnósticos como terapéuticos) en cuanto al manejo de la caries dental, bajo el entendido de la mismacomo un proceso infeccioso que debe atacarse antes de que se produzcan las manifestaciones clínicas. El objetivo de éste artículo, es presentar una herramienta guia consistente en una historia clínica, expresamente diseñada para detectar el riesgo de la caries

          Translated abstract

          This paper is calling the dentist for to do benavioral changes (terapeutics and diagnosis) in dental caries management.The dental caries is an infections process which we have to handle before clinics manifestations.The objetive of this article is to give us a tool that is a dental record which was designed for to detecting the risk of caries

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          Most cited references23

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          Salivary parameters of relevance for assessing caries activity in individuals and populations.

          A review of the non-microbial salivary parameters with respect to their possible association with caries activity is presented. The parameters are limited to those which already are or at least in the near future will obviously be simple enough, also for clinical purposes. Salivary flow rate is undoubtedly the most important single parameter since the cariostatic activity or efficacy of practically all other salivary parameters depends on the flow rate. Flow rate as such has no linear association with dental caries but there seems to exist an individual "threshold" limit which is decisive for enhanced caries activity. This threshold limit varies among different individuals and therefore the so-called normal values for unstimulated or stimulated flow rate are more reliable on a population level than among individuals for screening purposes. In any individual a regular and longitudinal follow-up of the flow rate is of higher clinical value than only a single cross-sectional measurement. Salivary buffer effect has only a weak negative association with caries activity and again, this effect is of greater clinical significance on a population level. Since the decisive processes in caries attack occur within or under the dental plaque, the buffering effect of saliva is limited and obviously more important to screen for erosion-than caries-prone individuals. Although important for dental health, none of the salivary antimicrobial agents as such has shown any strong association with caries activity. The only ones with some evidence of a regulatory role are secretory IgA antibodies, hypothiocyanite ions, and agglutinins. However, the data are controversial and it seems that instead of measuring individual parameters, the assessment of saliva's functional properties (such as the ability to aggregate bacteria, prevent their adhesion to hydroxyapatite or sugar metabolism etc.) is more important for clinical purposes. Of the parameters involved in de- and remineralization process, only salivary fluoride content has some association with caries susceptibility but its diagnostic or predictive value is questionable.
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            Reproducibility and Accuracy of Three Methods for Assessment of Demineralization Depth on the Occlusal Surface: An in vitro Examination

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              Assessing the stage of caries lesion activity on the basis of clinical and microbiological examination.

              The dynamic nature of caries lesion progression may require that classification of caries lesions makes distinctions in activity status. The aim of the present review was to compile and discuss the literature which pertains to clinical assessment of caries lesion activity, and to examine whether recent developments in microbiological research may justify the use of microbiological methods for evaluation of caries activity. Clinical observations suggest that caries lesion progression can be arrested at any stage of lesion development, provided that clinically plaque-free conditions are obtained. However, there is no universal level of oral hygiene to be recommended. The diagnoses "active" and "inactive/arrested" caries have been validated by a range of histological and chemical methods which have supported a separation into distinct clinical categories. Simple microbiological methods have so far not been useful in differentiating between active and inactive caries lesions. Very few studies have evaluated the inter- and intraexaminer reliability of caries diagnostic criteria based on assessment of the activity state of lesions, but recent data indicate that active and inactive caries lesions can be diagnosed with a high degree of reliability. A decision-making tree for dental caries is presented by means of which it is possible to associate the assessment of caries lesion activity with an appropriate treatment modality. It is concluded that research into better methods of assessing caries lesion activity clinically should be stimulated.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                aov
                Acta Odontológica Venezolana
                Acta odontol. venez
                Facultad de Odontología -UCV (Caracas )
                0001-6365
                December 1999
                : 37
                : 3
                : 106-111
                Affiliations
                [1 ] UCV
                Article
                S0001-63651999000300021
                26237917-0ab1-4672-85b4-afa0d8da2a6a

                http://creativecommons.org/licenses/by/4.0/

                History
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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0001-6365&lng=en
                Categories
                DENTISTRY, ORAL SURGERY & MEDICINE

                Dentistry
                Caries Risk,Caries,Infections Process,Dental Record,caries - riesgo,caries - proceso infeccioso,historia clínica

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