[New aspects for the caries of deep cavities].

Abstract

This article refers to the contemporary aspects about the carious lesions in the deepest parts of a cavity near the pulp. In these situations the problem that arises is to how deeply this carious dentine should be excavated without the risk of destroying the pulp. On this question there have been expressed two divergent opinions based also on two divergent theories. The one theory supports that during the carious process the microorganisms proceed the decalcification of the dentin, whereas the other theory supports the opposite view. According to the new aspects, in acute carious lesions the decalcification proceeds the bacteria, while in chronic caries the microorganisms, the discoloration and the bacterial invasion are closer to each other. This article also refers to the microflora of deep carious lesions and to the fate of bacteria that remain under the fillings. From this paper we come to the following conclusions: 1) In certain clearly defined conditions some carious dentine should be left at the base of a cavity in order to avoid the pulp exposure. But the periphery of the cavity must be unquestionably caries-free. 2) Few microbes always remain after the excavation of the carious cavities. 3) These microbes under well-fitting restorations do not proliferate and gradually die. 4) The defensive properties of the pulp play also a significant role, because pulp immunoglobulins are able to react upon invasive bacteria. 5) Finally, it must be emphasized that the clinical dentist must not underestimate the microbial role and action.