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Classification System for Root-Surface Quality

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16/07/2012 at 5:27 pm #15732
Anonymous

 



Figure 1  This patient presented with generalized gingival recession of the mandibular anterior teeth. There were no changes in the root surfaces that would indicate the beginning of the demineralization process. Although no surface demineralization process had occurred, these root surfaces would respond to remineralization therapy. The positive changes may include: hard, shiny root surfaces and a reduction in dentinal hypersensitivity.

Figure 1

Figure 2  The root surface cervical to the crown margin appears darker than healthy cementum. In addition, the surface appears dull. When palpated with the side of an explorer, the clinician can expect to feel a root surface that resists the explorer over its surface.

Figure 2

Figure 3  This root surface has a dull surface and is discolored. This indicates the progression of the demineralization/caries process. No cavitation has occurred due to this process. This root surface will feel slightly tacky and softened when exploring with the side of the explorer.

Figure 3

Figure 4  This root surface is black and cavitated. When exploring with the side of the explorer, this root surface will feel soft and sticky, and it may be possible to remove soft debris from this lesion.

Figure 4

Figure 5  The root surface on the maxillary left first molar has responded to remineralization therapy and appears shiny. This caries-resistant surface will feel hard, smooth, and glass-like when palpated with the side of an explorer. These patients often notice a marked reduction in dentinal hypersensitivity.

Figure 5

Figure 6  Although discolored, the root surface on the mandibular left first premolar is shiny and will feel hard, smooth, and glass-like when palpated with the side of the explorer. No restoration is necessary.

Figure 6

Figure 7  The root surfaces on the mandibular incisors range in color from dark yellow to orange to dark brown. Although cavitated, the root surfaces are remineralized. When palpated with the side of an explorer, the cavitation is obvious, but the surface of the root is hard and shiny.

Figure 7

Figure 8  Notice the island of active caries surrounded by hard, remineralized root structure. The caries that was too extensive to respond to remineralization therapy must be removed and the lost tooth structure must be restored. However, in non-esthetic areas, the remineralized root structure can remain while only the active caries is removed. This provides the most minimally invasive approach to the tooth.

Figure 8

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Table 1