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**17** 

*Turkey* 

Cafer Türkmen\*

**Filling Materials for the Caries** 

*Marmara University, Dentistry Faculty, Depertment of Restorative Dentistry, Istanbul,* 

Caries is a dynamic process in which mineral is removed during times of high acid production by bacterial plaque (demineralization) and replaced during periods of neutral pH (remineralization). Remineralization is the process by which mineral is deposited into tooth structure from salivary calcium and phosphate during periods of neutral pH. The remineralization process is facilitated by fluoride and can arrest carious demineralization by

Dentinal caries is similar to enamel caries, except that dentin demineralization begins at a higher pH (6.4 compared to 5.5) and proceeds about twice as rapidly since dentin has only half the mineral content. Low fluoride levels are insufficient to initiate dentin remineralization but are adequate to facilitate enamel remineralization. In enamel, at fluoride levels around 3 parts per million (ppm), the balance of mineral uptake and loss is shifted from net demineralization to net remineralization. Because dentin composes most root structure and because root surface caries lesions require significantly greater amounts of fluoride than enamel caries lesions to promote remineralization, restorative materials that release fluoride are often recommended for root surfaces [1]. Root caries appears as a softening and/or cavitation in the root surface with no initial involvement of the adjacent enamel. These lesions generally begin at or slightly occlusal to the free gingival margin but can extend into the gingival sulcus and/or undermine the coronal enamel as the caries progresses. Lesions also begin at the margins of restorations that have their cervical

Traditional caries management has consisted of the detection of carious lesions followed by immediate restoration. In other words, caries was managed primarily by restorative dentistry. However, when the dentist takes the bur in hand, an irreversible process begins. Placing a restoration does not guarantee a sound future for the tooth; on the contrary, it may be the start of a restorative cycle in which the restoration will be replaced several times. The decision to initiate invasive treatment should be preceded by a number of questions: Is caries present and if so, how far does it extend? I a restoration required, or could the process be arrested by preventive treatment? Sometimes the decision to restore may be based on

**1. Introduction** 

the formation of a hard outer surface [16].

interfaces on root structure [19].

questionable diagnostic criteria.

Corresponding Author

 \*

