Why Do Odontogenic Keratocysts Recur? A Clinical Insight

Why Do Odontogenic Keratocysts Recur? A Clinical Insight

Question. Write a short essay on the caries activity test.
Or
Write a short note on the caries activity test.

Answer. Several caries activity tests have evolved, which are as follows:

Snyder Test

• This test measures the ability of salivary microorganisms to produce organic acids from carbohydrate metabolism.
• Glucose agar media containing an indicator dye, i.e,. Bromocresol gree n is useful.
• The indicator dye changes from green to yellow the in range of pH between 5.4 to 3.8
• Paraffin-stimulated saliva is added into the medium,  change of the medium from green to yellow is indicative of the degree of caries activity.

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Salivary Reductase Test

• It measures the activity of the Reductase enzyme present in salivary bacteria.
• Paraff-stimulated saliva is collected in the plastic container and an indicator dye “Diazoresorcinol” is added to it which colors the saliva blue.
• The reductase enzyme liberated by the cariogenic bacteria causes color changes in the medium from blue to other colors, which indicates the caries “conductiveness” of the patients.

Microbiological Test

• Microbiological test helps to measure the number of Streptococcus mutAns and Lactobacillus acidophilus.
• Two samples of paraffin-stimulated saliva is collected and diluted 10 times and each is cultivated in two diffrent special media.
• Rogosa’s SL agar medium for Lactobacillus.
• MIT’s Salivarius agar medium for S. mutans.
• After incubation,, thnumberrs of colonies that develop in two separate media are counted and then multiplied by 10 to estimate the number of bacteria in 1 ml of saliva.
• Result: If count is more than 10, 00,000 S. mutAns and more than 1,00,000 L. acidophilus, than the caries susceptibility of individual is very high.

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Alban’s Test

It is the modification of synder test. It uses less agar, i.e. 5ml per tube. The saliva is drooled directly into the tubes and the tubes are incubated for 4 days at 37°C.
The color change is noted from bluish-green to yellow and the depth to which the change has occurred is noted.

Strip Test For S.MutAns Level In Saliva

Saliva/plaque samples are obtained by using tongue blades and toothpicks (after air drying the tooth for plaque samples) and are transferred to the S. mutants strip, which is incubated in M.S.B.
agar (Mitis Salivarius Bacitracin agar).

The number of S. mutAns colonies is used to estimate the caries activity ,and more than 105 colonies per mL of saliva is indicative of high caries activity.

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Buffer Capacity Test

10 mL of stimulated saliva is collected at least one hour after eating and stored under paraffin oil to prevent the loss of volatile bicarbonate ions, 4 mL of this is measured in a beaker.

After correcting the pH meter to room temperature the pH of the saliva is adjusted to 7.0 by addition of acid or base.

The level of lactic acid in the graduated cylinder is then again recorded.

Lactic acid is then added to the sample until a pH of 6.0 is reached. The amount of lactic acid needed to reduce pH from 7.0 to 6.0 is the measure of the buffer capacity.

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Fosdick Calcium Dissolution Test

25 mL of gum-stimulated saliva is collected. Part of this is analyzed for calcium content.

The rest is placed in an 8-inch sterile test tube with about 0.1g of powdered human enamel.

The tube is sealed and shaken for four hours at body temperature, after which it is again analyzed for calcium content.

If paraffin is used, a concentration of about 5% glucose is added. The amount of enamel dissolution increases as the caries activity increases.

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Dewar test

This test is similar to the Fosdick calcium dissolution test, except that the final pH after four hours is measured instead of the
calcium dissolved.

Swab Test

The swab test involves sampling of the oral flora by swabbing buccal tooth surfaces and placing it in the Snyder media.

This is incubated for 48 hours, and the pH changes are read and correlated with the caries activity.

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Interpretation

pH 4.1 and less than 4.1—Marked caries activity
pH 4.2–4.6—Active
pH 4.5–4.6—Slightly active
pH greater than 4.6—Caries active.