New Data on Clinical and Therapeutic Management of Occlusal Caries. (i)

Dental caries is a transmissible pathologic infectious process in which a cariogenic biofilm, in the presence of a more pathological than protective oral status leads to demineralization of the hard dental tissues. The occlusal surface of posterior teeth represents, due to its anatomy, the most exposed place to dental caries. Even if the global ratio of such disease decreased in industrialized countries, the situation is different for occlusal caries. Nowadays, one of the main reasons for a lower ratio in the control of occlusal caries is represented by the fact that, in the so-called ”post-fluorization” generation, fluoride has better controlled the caries from the smooth than from the occlusal surfaces. The term of fissural caries has been previously employed for describing the carious lesions occurring in pits and fossae. The definition was bsed on the assumption that the high incidence of carious lesions in the pits and fossae of molars was directly related to the low accessibility of these zones to the usual hygiene measures. Two factors are evaluated as to plaque accumulation and caries initiation on occlusal surfaces: the stage of dental eruption or the functional utilization of the occlusal surface and the specific surface anatomy. The scope of this review study is to synthesize the existing knowledge on the evolution of occlusal caries and the available methods of control and treatment.