Caries de Superficies Radiculares: Etiología, diagnóstico y manejo clínico


  • Gustavo Parodi Estellano Universidad Católica del Uruguay


Palabras clave:

caries radiculares, geriatría, remineralización, flúor, clorhexidina, diaminofluoruro de plata


Como todas las lesiones de caries, la caries de superficies radiculares (CSR) refleja un cambio tisular continuo. Es esencial diagnosticar los síntomas antes que esas lesiones lleguen a estar cavitadas. Por la misma razón, y para poder decidir entre modalidades invasivas y no-invasivas, deberá ser perfectamente comprendida la dinámica de la formación de la lesión cariosa. Este artículo revisa la etiología, los criterios de diagnóstico y los factores de riesgo en caries de superficies radiculares, y también discute la prevención y la terapéutica, haciendo un especial énfasis en procedimientos de remineralización y en un enfoque no- invasivo de este problema. 


Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Gustavo Parodi Estellano, Universidad Católica del Uruguay

Profesor de Cariología, Facultad  de Odontología, Universidad Católica del Uruguay


Aas JA, Griffen AL, Dardis SR, Lee AM, Olsen I, Dewhirst FE, Leys EJ, Paster BJ. (2008) Bacteria of dental caries in primary and permanent teeth in children and young adults. J Clin Microbiol; 46: 1407–1417.

Amer RS, Kolker JL. (2013) Restoration of root surface caries in vulnerable elderly patients: a review of the literature. Spec Care Dentist; 33: 141–149.

Arends J, Ruben J. (1993) Chlorhexidine CHX release by dentin after varnish treatment (abstract 88). Caries Res; 27: 231-232.

Banting DW, Papas A, Clark DC, Proskin HM, Schultz M, Perry R. (2000) The effectiveness of 10% chlorhexideine varnish treatment on dental caries incidence in adults with dry mouth. Gerodontology; 17: 67-76.

Bardow A, Nyvad B, Nauntofte B. (2001) Relationships between medication intakes, complaints of dry mouth, salivary flow rate and composition and the rate of tooth demineralization in situ. Arch Oral Biol; 46: 413-423.

Baysan A, Lynch E, Ellwood R, Davies R, Petersson L, Borsboom P. (2001) Reversal of primary root caries using dentifrices containing 5.000 and 1.100 ppm fluoride. Caries Res; 35: 41-46.

Beighton D, Lynch E, Heath MR. (1993) A microbiological study of primary root-caries lesions with different treatment needs. J Dent Res; 72: 623-629.

Ben-Aryeh H, Miron D, Szargel R, Gutman D. (1984) Whole saliva secretion rates in old and young healthy subjects. J Dent Res; 63: 1147-48.

Bengochea J, Cabella W, Calvo J, Fernández Soto M, Koolhaas M, Nathan M, Pardo I, Pellegrino A, Varela Petito C. (2013) Detrás de los tres millones. La población uruguaya luego del censo 2011. UR. FCS-UM. Programa de Población : Brecha.

Billings RJ, Brown LR, Kaster AG. (1985) Contemporary treatment strategies for root surface dental caries. Gerodontics; 1: 20-27.

Birkhed D. (1994) Cariologic aspects of Xilitol and its use in chewing gum: a review. Acta Odontol Scand; 52: 116-127.

Black GV. (1955) Black's Operative Dentistry, 9th ed. South Milwaukee: Medico-Dental Publishing.

Brailsford SR, Shah B, Simons D, Gilbert S, Clark D, Ines I, Adams SE, Allison C, Beighton D. (2001) The predominant aciduric microflora of root-caries lesions. J Dent Res; 80: 1828-33.

Bratthall D. (1996) Dental caries: intervened-interrupted-interpreted. Concluding remarks and Cariography. Eur J Oral Sci; 104: 486-491.

Ekstrand KR, Poulsen JE, Hede B, Twetman S, Qvist V, Ellwood RP. (2013) A randomized clinical trial of the anti-caries efficacy of 5,000 compared to 1,450 ppm fluoridated toothpaste on root caries lesions in elderly disabled nursing home residents. Caries Res. 47(5):391–398.

Emilson CG, Ravald N, Birkhed D. (1993) Effects of a 12-month prophylactic programme on selected oral bacterial population on root surfaces with active and inactive carious lesions. Caries Res; 27: 195-200.

Enns CW, Goldman JD, Cook A. (1997) Trends in food and nutrient intakes by adults: NFCS 1977-78, CSFII 1989-91, and CSFII 1994-95. Family Economics & Nutrition Review; 10(4): 2-15.

Ettinger RE. (1996) Review: xerostomia: a symptom which acts like a disease. Age Ageing; 25: 409-412.

Featherstone S. (1994) Fluoride, remineralization and root caries. Am J Dent; 7: 271-274.

Fejerskov 0. ( 1994) Recent advancements in the treatment of root surface caries. Int Dent J; 44: 139-44.

Frencken JE. (2014) The atraumatic restorative treatment (ART) approach can improve oral health for the elderly; myth or reality? Gerontology; 31: 81 –82.

Cedillo Valencia JJ, Herrera Almanza A, Cedillo Félix VM. (2017) Equia Forte: innovación del futuro en obturación de cavidades. Rev RODYB [internet]. [citado 2017 Mayo 20]; 6(1): 1-11. Disponible en:

Cruz Gonzales AC, Marín Zuluaga DJ. (2016) Clinical outcome of root caries restorations using ART and rotary techniques in institutionalized elders. Braz Oral Res; 30(1):1-8.

Grogono AL, Mayo JA. (1994) Prevention of root caries with dentin adhesives. Am J Dent; 7: 89-90.

Hahn P, Schaller HG, Gernhardt C, Hellwig E. (1999) Influence of two dentin bonding systems on the demineralization of the root surface. Oper Dent; 24: 344-350.

Heifetz SB. (1994) Fluorides for the elderly. J Calif Dent Assoc; 22: 49-54.

Hoppenbrouwers PM, Driessens FC, Borggreven JM. (1987) The mineral solubility of human tooth roots. Arch Oral Biol; 32:319–22.

Huizinga ED, Ruben J, Arends J. (1990) Effect of an antimicrobial varnish on root demineralization in situ. Caries Res; 24: 130-132.

Jette AM, Feldman HA, Tennstedt SL. (1993) Tobacco use: a modifiable risk factor for dental disease among the elderly. Am J Publ Health; 83: 1271-1276.

Johansen E, Papas A, Fong W, Olsen TO. (1987) Remineralization of carious lesions in elderly patients. Gerodontics; 3: 47-50.

Jonsson R, Moen K, Vestrheim D, Szodoray P. (2002) Current issues in Sjogren syndrome. Oral Dis; 8: 130-140.

Jordan HV, Sumney DL. (1973) Root surface caries: Review of the literature and significance of the problem. J Periodontol; 44: 158-63.

Katz RV. (1984) Development of an index for the prevalence of root caries. J Dent Res; 63 (Sp Iss): 814-819.

Keltjens H, Schaeken T, van der Hoeven H. (1993) Preventive aspects of root caries. Int Dent J; 43: 143-48.

Kidd E, Fejerskov O, Nyvad B. (2015) Infected dentine revisited. Dent Update;42: 802–806, 808-809.

Krall EA, Dawson-Hughes B, Garvey AJ, Garcia RI. (1997) Smoking, smoking cessation and tooth loss. J Dent Res; 76: 1653-1659.

Lynch E, Baysan A. (2001) Reversal of primary root caries using a dentifrice with a high Fluoride content. Caries Res; 35 (suppl 1): 60-64.

Lundgreen M, Birkhed D, Steen G, Emilson CG, Osterberg T, Steen B. (1997) Oral glucose clearance in nonagenarians in relation to functional capacity, medication and oral variables. Gerodontology; 14: 17-27.

Lia R, Lo EC, Liu BY, Wonga MC, Chu CH. (2016) Randomized clinical trial on arresting dental root caries through silver diammine fluoride applications in community-dwelling elders. J Dent; 51: 15–20.

McComb D. (1994) Operative dentistry considerations for the elderly. J Prosthet Dent; 72: 517-524.

McIntyre JM, Featherstone JD, Fu J. (2002) Studies of dental root surface caries. 2: The role of cementum in root surface caries. Aust Dent J; 45: 97-102.

Mount GJ. (1994) Glass ionomer cements and future research. In Exposed Root Interactions Symposium. Am J Dent; 7: 286-292.

Nyvad B, Fejerskov 0. (1982) Root surface caries, histopatho¬logical and microbiological features and clinical impli¬cations. Int Dent J; 32: 311-326.

Nyvad B, Fejerskov O. (1986) Active root surface caries converted into inactive caries as a response to oral hygiene. Scand JDent Res; 94: 281-284.

Parodi, G. (2002). Criterios actuales en el tratamiento de la caries de superficies radiculares (CSR). Mag Int Coll Dent; 10: 73-85.

Rahiotis C, Vougiouklakis G. (2007) Effect of a CPP-ACP agent on the demineralization and remineralization of dentine in vitro. J Dent.;35(8):695-698.

Ravald N, List T. (1998) Caries and periodontal conditions in patients with primary Sjogren syndrome. Swed Dent J; 22: 97-103.

Schachtele CF, Rosamond WD, Harlander SK. (1985) Diet and aging: Current concerns related to oral health. Gerodontics; 1: 117-124.

Schaeken MJ, De Haan P. (1989) Effects of sustained-release chlorhexidine acetate on the human dental plaque flora. J Dent Res; 68: 119-123.

Schaeken MJ, Keltjens HM, Van der Hoeven JS. (1991) Effects of fluoride and chlorhexidine on the microflora of dental root surfaces and progression of root surface caries. J Dent Res; 70: 150-153

Schüpbach P, Guggenheim B, Lutz F. (1990a) Histopatology of root surface caries. J Dent Res; 69: 1195-1204.

Schüpbach P, Guggenheim B, Lutz, F. (1990b) Human root ca¬ries. Histopathology of advanced lesions. Caries Res; 24: 145-158

Schüpbach P, Osterwalder V, Guggenheinm B. (1996) Human root caries: microbiota of a limited number of root caries lesions. Caries Res; 30: 52-64

Simons D, Kidd EAM, Beighton D, Jones B. (1997) The effect of chlorexidine/xilitol chewing-gum on cariogenic salivary microflora: a clinical trial in elderly patients. Caries Res; 31: 91-96.

Srinivasan M, Schimmel M, Riesen M, Ilgner A, Wicht MJ, Warncke M, Ellwood RP, Nitschke I, Müller F, Noack, MJ. (2014) High-fluoride toothpaste: a multicenter randomized controlled trial in adults. Community Dent Oral Epidemiol; 42: 333–340.

Steele JG, Sheiham A, Marcenes W, Fay N, Walls AW. (2001) Clinical and behavioural risk indicators for root caries in older people. Gerodontology; 18: 95-101

Swift El, Hammel SA, Perdigao J, Wefel JS. (1994) Prevention of root surface caries using a dental adhesive. J Am Dent Assoc; 125: 571-576.

Tajima K , Nikaido T , Inoue G , Ikeda M, Tagami J. (2009) Effects of coating root dentin surfaces with adhesive materials. Dent Mater J; 28(5): 578–586.

Takahashi N, Nyvad B.(2016) Ecological hypothesis of dentin and root caries. Caries Res; 50: 422-431.

Tomar SL, Asma S. (2001) Smoking-attributable periodontitis in the United States: findings from NHANES III. National Health and Nutritional Survey. J Periodontol; 71: 743-¬751.

U.S. Department of Agriculture, Human Nutrition Information Service. 1983. Food Intakes: Individuals in 48 States, Year 1977-78. Nationwide Food Consumption Survey 1977-78, Rep. 1-1. National Technical Information Service, 5285 Port Royal Road, Springfield, VA 22161; (703) 487-4650. Technical report: Accession no. PB91-103523INZ.

Van Loveren C, Buijs JF, Buijs MJ, ten Cate JM. (1996) Protection of bovine enamel and dentin by chlorexidine and fluoride varnishes in a bacterial demineralization model. Caries Res; 30: 45-51.

White SN, MacEntee MI, Cho G. (1994) Restorative treatment for geriatric root caries. J Calif Dent Assoc; 22(3): 55-60.

Wierichs RJ, Meyer-Lueckel H. (2015) Systematic review on noninvasive treatment of root caries lesions. JDent Res; 94(2): 261 –271.

Winn DM. (2001) Tobbaco use and oral disease. J Dent Educ; 65: 306-12.

Wright PS, Hellyer PH, Beighton D, Heath R, Lynch E. (1992) Relationship of removable partial denture use to root caries in an older population. Int J Prosthodont; 5: 39-46

Yamaga R, Nishino M, Yoshida S, Yokomizo I. (1972) Diammine silver fluoride and its clinical application. J Osaka Univ Dent Sch.; 12: 1-20

Zhang N, Melo MA, Chen C, Liu J, Weir MD, Bai Y, Xu HH. (2015) Development of a multifunctional adhesive system for prevention of root caries and secondary caries. Dent Mater; 31(9): 1119–1131.