Features of Mineralization of Hard Tissues of the Tooth in Carious and Non-Carious Lesions

Relevance: Rehabilitation of patients undergoing orthodontic treatment with subsequent detection of foci of enamel demineralization is one of the leading problems of modern orthodontics. Materials and methods: 90 patients were monitored, divided into 6 groups: 1 – patients with intact teeth, 2 – with enamel demineralization after removal of braces, 3 – with wedge-shaped defects, 4 – with dental fluorosis, 5 – with pathological erasure, 6 – patients with enamel hypoplasia. Mineralization indicators were determined both at the intact point (the object of comparison) and in the area of its violation (the object of observation). Results: In patients of group 1, mineralization indices were 60.5-62.1 relative units, group 2- 60.5 intact area-53 demineralization area after removal of braces, group 3 – 84.5 intact -72 relative units in the area of demineralization of the wedge-shaped defect, group 4 – 113.6 -113.7 relative units, group 5 -199.1 intact site-72.6 relative units with pathological erasure, group 6-84,1 intact-66.7 areas of hypoplasia. 60-90 patients with demineralization of hard tooth tissues with initial caries, enamel hypoplasia, wedge-shaped defects, foci of fluorosis and increased erasure using the digital method of raman-fluorescence diagnostics revealed a statistically significant decrease in mineralization by 10-300% relative to intact tooth areas, with indicators: for intact teeth 60.5-62.1 relative units, for initial caries 60.5-53 relative units, for a wedge-shaped defect 84.5-72 relative units, for foci of fluorosis 111.6-113 relative units, for teeth with increased abrasion, 199.1-72.6 relative units in the foci. The decrease was in all cases except for teeth with fluorosis, where it was almost 2 times higher than in intact teeth and 3 times higher for teeth with increased abrasion. Based on the results obtained, a clinical algorithm for assessing the mineralization of dental hard tissues using the method of Raman-fluorescence diagnostics has been developed. Conclusion: A statistically significant decrease in the mineralization of the hard tissues of the tooth in their non-carious lesions was revealed by 10-300% in relation to intact teeth. The decrease in indicators was in all cases except for teeth with fluorosis, where it was initially 2 times higher than the indicators of intact teeth and 3 times higher for teeth with increased abrasion. The developed digital medical technology is a promising medical technique for assessing the condition of hard dental tissues in normal and non-carious conditions, which will contribute to an effective and controlled rehabilitation process for patients with demineralization foci of various etiologies.