Demineralization and Remineralization of Root Surface Caries

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Abstract
Although enamel, cementum and dentin all develop carious lesions in roughly the same manner there are significant differences between enamel and the other two tissues. While early enamel lesions are white, root surface lesions in cementum or dentin are light brown or yellow. The color probably arises from extrinsic stain materials, and it is possible that very early, actively forming lesions are colorless. Cementum and dentin often acquire a hypermineralized surface when first exposed to the oral environment. When caries begins to form, this layer can enlarge or disappear. Therefore, it is possible to have lesions with hypermineralized surface layers, hypomineralized surface layers, or no surface layer. Hypermineralization can also occur deeply within a lesion, probably as a result of remineralization. When this occurs the lumen of the tubules fill with mineral and the crystals within the lesion body become larger. Fluoride is readily taken up by carious root tissues and contributes to remineralization. Remineralization of artificial root surfaces after treatment with monofluorophosphate has been shown. In these lesions much of the newly acquired mineral was found near the surface but some was also found in the lesion body.