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González-Gil D, Flores-Fraile J, Vera-Rodríguez V, Martín-Vacas A, López-Marcos J. Comparative Meta-Analysis of Minimally Invasive and Conventional Approaches for Caries Removal in Permanent Dentition. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:402. [PMID: 38541128 PMCID: PMC10971845 DOI: 10.3390/medicina60030402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 07/23/2024]
Abstract
Background and Objectives: Addressing deep carious lesions poses significant challenges in daily dental practice due to the inherent complexity of their treatment. Traditionally, complete removal of carious tissues has been the norm, potentially leading to pulp tissue exposure and subsequent pulpitis. In contemporary dentistry, there is a growing preference for minimally invasive techniques, such as selective removal, offering a more conservative approach with enhanced predictability and success rates. Materials and Methods: Our study commenced with a comprehensive systematic review. After that, we performed a meta-analysis focused exclusively on randomized controlled trials involving permanent dentition. Our investigation incorporated seven selected articles, which scrutinized success rates and the incidence of pulp exposure in minimally invasive techniques (MIT) versus conventional techniques (CT). Statistical analysis employed U Mann-Whitney and Wilcoxon tests to interpret the results. Results: Although the difference did not reach statistical significance, MIT demonstrated marginally superior success rates compared to CT. Furthermore, MIT exhibited a lower percentage of pulp exposure when contrasted with CT. However, due to the limited sample size, statistical significance for this difference could not be established. Conclusions: Minimally invasive techniques for caries removal emerge as a conservative and promising approach to safeguard pulp tissues in comparison to conventional techniques. The need for additional randomized controlled trials is emphasized to unequivocally establish the superior success rates of these procedures over their conventional counterparts.
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Affiliation(s)
- Diego González-Gil
- Dental Clinic Faculty of Medicine, Surgery Department, University of Salamanca, 37007 Salamanca, Spain; (D.G.-G.); (J.L.-M.)
| | - Javier Flores-Fraile
- Dental Clinic Faculty of Medicine, Surgery Department, University of Salamanca, 37007 Salamanca, Spain; (D.G.-G.); (J.L.-M.)
| | | | | | - Joaquín López-Marcos
- Dental Clinic Faculty of Medicine, Surgery Department, University of Salamanca, 37007 Salamanca, Spain; (D.G.-G.); (J.L.-M.)
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Ionescu AC, Hahnel S, Chiari MDS, König A, Delvecchio P, Braga RR, Zambelli V, Brambilla E. TEGDMA-Functionalized Dicalcium Phosphate Dihydrate Resin-Based Composites Prevent Secondary Caries in an In Vitro Biofilm Model. J Funct Biomater 2022; 13:jfb13040232. [PMID: 36412873 PMCID: PMC9680503 DOI: 10.3390/jfb13040232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022] Open
Abstract
This study evaluated the efficacy of experimental TEGDMA-functionalized dicalcium phosphate dihydrate (T-DCPD) filler-based resin-based composites (RBC) in preventing caries lesions around the restoration margins (secondary caries, SC). Standardized Class-II cavities were made in sound molars with the cervical margin in dentin. Cavities were filled with a commercial resin-modified glass-ionomer cement (RMGIC) or experimental RBCs containing a bisGMA-TEGDMA resin blend and one of the following inorganic fractions: 60 wt.% Ba glass (RBC-0); 40 wt.% Ba glass and 20 wt.% T-DCPD (RBC-20); or 20 wt.% Ba glass and 40 wt.% T-DCPD (RBC-40). An open-system bioreactor produced Streptococcus mutans biofilm-driven SC. Specimens were scanned using micro-CT to evaluate demineralization depths. Scanning electron microscopy and energy-dispersive X-ray spectroscopy characterized the specimen surfaces, and antimicrobial activity, buffering effect, and ion uptake by the biofilms were also evaluated. ANOVA and Tukey’s tests were applied at p < 0.05. RBC-0 and RBC-20 showed SC development in dentin, while RBC-40 and RMGIC significantly reduced the lesion depth at the restoration margin (p < 0.0001). Initial enamel demineralization could be observed only around the RBC-0 and RBC-20 restorations. Direct antibiofilm activity can explain SC reduction by RMGIC, whereas a buffering effect on the acidogenicity of biofilm can explain the behavior of RBC-40. Experimental RBC with CaP-releasing functionalized T-DCPD filler could prevent SC with the same efficacy as F-releasing materials.
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Affiliation(s)
- Andrei Cristian Ionescu
- Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Pascal, 36, 20133 Milan, Italy
- Correspondence:
| | - Sebastian Hahnel
- Clinic of Prosthodontics and Dental Materials Science, University of Leipzig, Liebigstraße 12, Haus 1, 04103 Leipzig, Germany
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93042 Regensburg, Germany
| | - Marina D. S. Chiari
- Department of Biomaterials and Oral Biology, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo 05508-900, SP, Brazil
| | - Andreas König
- Clinic of Prosthodontics and Dental Materials Science, University of Leipzig, Liebigstraße 12, Haus 1, 04103 Leipzig, Germany
| | - Paolo Delvecchio
- School of Medicine and Surgery, University of Milan-Bicocca, Via Cadore, 48, 20900 Monza, Italy
| | - Roberto Ruggiero Braga
- Department of Biomaterials and Oral Biology, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo 05508-900, SP, Brazil
| | - Vanessa Zambelli
- School of Medicine and Surgery, University of Milan-Bicocca, Via Cadore, 48, 20900 Monza, Italy
| | - Eugenio Brambilla
- Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Pascal, 36, 20133 Milan, Italy
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Cheng L, Zhang L, Yue L, Ling J, Fan M, Yang D, Huang Z, Niu Y, Liu J, Zhao J, Li Y, Guo B, Chen Z, Zhou X. Expert consensus on dental caries management. Int J Oral Sci 2022; 14:17. [PMID: 35361749 PMCID: PMC8971510 DOI: 10.1038/s41368-022-00167-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 02/05/2023] Open
Abstract
Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
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Affiliation(s)
- Lei Cheng
- State Key Laboratory of Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu, China
| | - Lu Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat‑Sen University, Guangzhou, Guangdong, China
| | - Mingwen Fan
- School of Medicine, Jianghan University, Wuhan, China
| | - Deqin Yang
- College of Stomathology, Chongqing Medical University, Chongqing, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Yumei Niu
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University & Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, China
| | - Jianguo Liu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Yanhong Li
- Affiliated Stomatological Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Bin Guo
- Department of Stomatology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu, China.
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Cascales ÁF, Moscardó AP, Toledano M, Banerjee A, Sauro S. An in-vitro investigation of the bond strength of experimental ion-releasing dental adhesives to caries-affected dentine after 1 year of water storage. J Dent 2022; 119:104075. [DOI: 10.1016/j.jdent.2022.104075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/12/2022] [Accepted: 02/22/2022] [Indexed: 11/15/2022] Open
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Rodrigues MDP, Cunha LSD, Vilela ABF, Schettini ACT, Bragança GFD, França R, Soares CJ. Selective carious tissue removal and glass ionomer liner reduction of pulp stress in bulk fill resin composite restorations. Braz Oral Res 2021; 35:e119. [PMID: 34878074 DOI: 10.1590/1807-3107bor-2021.vol35.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/10/2021] [Indexed: 11/21/2022] Open
Abstract
To evaluate the effect of selective or nonselective carious tissue removal and the use of a resin-modified glass ionomer (RMGIC) liner under bulk fill resin composite restoration on the stress at the pulp chamber, the elastic moduli of hard, firm, soft and intact dentin were calculated using nanoindentation. Post-gel shrinkage of the bulk fill resin composite and RMGIC were determined using the strain-gauge method. Six finite element models were created by using digital radiography with the combination of two study factors: a) carious tissue removal: selective removal or nonselective removal of carious tissue, and b) use of RMGIC liner: with or without 1.0 mm of RMGIC liner. The modified von Mises stresses (mvm) (MPa) were extracted on the nodes of the internal wall of the pulp ceiling chamber at 100 N occlusal loading. Data were analyzed descriptively and recorded quantitively. Both study factors influenced the stress distribution. The mvm stress during the restorative procedure was higher for nonselective carious tissue removal without RMGIC (25.9 MPa) and lower for selective carious tissue removal associated with RMGIC (13.5 MPa). The dentin elastic modulus increased from soft carious (3.6 ± 0.3 MPa) to firm carious (5.2 ± 1.0 MPa) to hard carious (10.9 ± 1.2 MPa) to intact dentin (22.7 ± 3.0 MPa). Molars with carious lesions showed high mvm stress at the pulp ceiling (89.6 MPa) and at fragilized coronal structure remaining. Selective carious tissue removal followed by restoration using a Vitrebond liner and Tetric N-Ceram Bulk fill reduced the stress at the pulp chamber ceiling.
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Affiliation(s)
- Monise de Paula Rodrigues
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Laryssa Silva da Cunha
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Andomar Bruno Fernandes Vilela
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Ana Cecília Teodoro Schettini
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Gabriel Felipe de Bragança
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Rodrigo França
- University of Manitoba, Faculty of Health Science, College of Dentistry, Department of Restorative Dentistry, Winnipeg, Canada
| | - Carlos José Soares
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
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Effect of conditioning and 1 year aging on the bond strength and interfacial morphology of glass-ionomer cement bonded to dentin. Dent Mater 2021; 37:106-112. [DOI: 10.1016/j.dental.2020.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/14/2020] [Accepted: 10/21/2020] [Indexed: 11/20/2022]
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