title: Is the morphology and activity of the occlusal carious lesion related to the lesion progression stage?
abstract: OBJECTIVE
  To investigate the relationship between degree of dentin demineralization with both lesion activity and morphology of the occlusal carious cavity.
  
  
  METHODS
  Occlusal sites (n=138) were identified by visual examination (Nyvad's scores 0-6) in 67 extracted teeth which were scanned in a high energy micro-CT. After 3D reconstruction, each stack was resliced in the mesio-distal direction and tooth mineral density (MD) was measured along a path from enamel to the deepest part of dentin in the slice showing the most severe carious involvement. Each site was classified in "open" or "closed" (if cavitated) depending on the morphology of the surrounding enamel walls as measured using micro-CT and as active or inactive in enamel or dentin by a clinical scoring system.
  
  
  RESULTS
  Lesions showing dentin cavitation presented higher demineralization degree compared to non-cavitated, or enamel cavitated lesions. Inactive lesions presented lower demineralization degree compared to active lesions, although with a low effect size. According to the morphological aspect of the carious cavity, open enamel lesions showed lower dentin demineralization degree than closed lesion environments.
  
  
  CONCLUSIONS
  Active lesions showed higher dentin demineralization degree than inactive ones, while lesions showing closed cavitation resulted in higher dentin demineralization degree only for enamel lesions. Including those parameters in treatment decisions may help to improve prognosis and increase effectiveness of the caries diagnostic systems in the clinical setting.
authors.affiliation: Departamento de Odontopediatria e Ortodontia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. Electronic address: alineves@ufrj.br.
authors.forename: Aline Almeida
authors.initials: AA
authors.lastname: Neves
authors.affiliation: Departamento de Odontopediatria e Ortodontia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
authors.forename: Daniel Otero Amaral
authors.initials: DOA
authors.lastname: Vargas
authors.affiliation: Escola Politécnica da UFRJ, Laboratório de Instrumentação Nuclear, Rio de Janeiro, RJ, Brazil.
authors.forename: Thais Maria Pires
authors.initials: TMP
authors.lastname: Santos
authors.affiliation: Escola Politécnica da UFRJ, Laboratório de Instrumentação Nuclear, Rio de Janeiro, RJ, Brazil.
authors.forename: Ricardo Tadeu
authors.initials: RT
authors.lastname: Lopes
authors.affiliation: Departamento de Morfologia, Universidade Federal da Paraíba (UFPB), João Pessoa, Brasil, Brazil.
authors.forename: Frederico Barbosa
authors.initials: FB
authors.lastname: Sousa
mesh_terms: D003731:Dental Caries / Q000000981:diagnostic imaging / Q000473:pathology*; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000473:pathology; D003804:Dentin / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D066298:In Vitro Techniques; D008964:Molar, Third; D017001:Tooth Demineralization / Q000000981:diagnostic imaging / Q000473:pathology; D055114:X-Ray Microtomography
keywords: Caries lesion activity; Caries morphology; Cavitation; Dentin demineralization; Micro-CT