Enamel secondary caries

Several different types of dental caries have been described by clinicians. Specifically these are smooth-surface caries, pit and fissure caries, enamel caries, dentinal caries, secondary caries, early childhood caries and root caries [12], All occur by the same essential mechanism, as described above, and all arise as a consequence of a disturbance to the demineralization-remineralization balance. Attack by organic acids produced by bacteria in the plaque favours demineralization, but the natural remineralization processes of the mouth can reverse this. Certain dietary and hygiene behaviours as well as clinical treatments can enhance this natural remineralization provided they occur early enough in the demineralization part of the process. For example, complexes of casein phosphopeptide with amorphous calcium phosphate have been shown in various studies to be capable of enhancing the remineralization step under certain conditions and in specific groups of individuals [16,17]. These are now available commercially as an anticaries treatment for patients. 

Due to the high frequency of recurrent caries after restorative treatments, much attention has been given to the therapeutic effects manifested by direct restorative materials. Restorative composites have demonstrated to accumulate more biofilm over time, when compared to enamel and other restorative materials, thus favoring the development of recurrent caries around these restorations [54]. Therefore, in an attempt to control or even prevent secondary caries, alternative clinical methods for caries prevention have been proposed including the search for new restorative materials with antibacterial activity. 

---