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Ahmed B, Wafaie RA, Hamama HH, Mahmoud SH. 3-year randomized clinical trial to evaluate the performance of posterior composite restorations lined with ion-releasing materials. Sci Rep 2024; 14:4942. [PMID: 38418863 PMCID: PMC10902344 DOI: 10.1038/s41598-024-55329-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
To evaluate the impact of using ion-releasing liners on the 3-year clinical performance of posterior resin composite restorations after selective caries excavation with polymer burs. 20 patients were enrolled in this trial. Each patient had two deep carious lesions, one on each side of the mouth. After selective caries removal using polymer bur (PolyBur P1, Komet, Brasseler GmbH Co. KG, Lemgo, Germany), cavities were lined with bioactive ionic resin composite (Activa Bioactive Base/Liner, Pulpdent, Watertown, MA, USA) or resin-modified glass ionomer liner (Riva Light Cure, SDI, Bayswater, Victoria, Australia). All cavities were then restored with nanofilled resin composite (Filtek Z350XT, 3M Oral Care, St. Paul, MN, USA). All the tested materials were placed according to the manufacturers' instructions. Clinical evaluation was accomplished using World Dental Federation (FDI) criteria at baseline and after 6 months, 1, 2, and 3 years. Data were analyzed using Mann-whitney U and Friedman tests (p < 0.05). The success rates were 100% for all resin composite restorations either lined with ion-releasing resin composite or resin-modified glass ionomer liner. Mann-whitney U test revealed that there were no statistically significant differences between both ion-releasing lining material groups for all criteria during the follow-up periods (p > 0.05). Resin composite restorations showed acceptable clinical performance over 3 years either lined with bioactive ionic or resin-modified glass ionomer liners after selective caries excavation preserving pulp vitality. After the 3-year follow-up period, Activa Bioactive and Riva Light Cure liners were clinically effective and they exhibited with the overlying composite restorations successful clinical performance.Trial registration number: NCT05470959. Date of registration: 22/7/2022. Retrospectively registered.
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Affiliation(s)
- Basma Ahmed
- Conservative Dentistry Department, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Gamasa, Egypt
| | - Ramy Ahmed Wafaie
- Conservative Dentistry Department, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Gamasa, Egypt
| | - Hamdi H Hamama
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.
- Faculty of Dentistry, New-Mansoura University, New-Mansoura, Egypt.
| | - Salah Hasab Mahmoud
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
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R R, Wani W, Sharma S, Kumar V, Chawla A, Kalaivani M, Logani A. Selective Removal to Soft Dentine versus Full Pulpotomy for Management of Proximal Deep Carious Lesions: A Randomized Controlled Non-Inferiority Trial. Caries Res 2023; 57:536-545. [PMID: 37552970 DOI: 10.1159/000530895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/25/2023] [Indexed: 08/10/2023] Open
Abstract
The management of the deep carious lesion with reversible pulpitis is a dilemma for the dentist. The current study compared selective removal to soft dentine (SRSD) and full pulpotomy (FP) for treating proximal deep carious lesions in teeth with reversible pulpitis. Visual-tactile examination and bitewing radiographs were used to determine the depth of carious lesion, and American Association of Endodontists recommendations were used to formulate pulp diagnosis. Sixty mandibular molar teeth from healthy patients between the ages of 16-35 years and a diagnosis of proximal deep carious lesion with reversible pulpitis were included. Teeth were randomly allocated to two study groups. SRSD group (n = 30): soft dentine was preserved over the pulpal aspect. A hard-setting calcium hydroxide cement liner and resin-modified glass ionomer cement base were applied over the remaining soft carious dentine. FP group (n = 30): complete caries removal followed by mineral trioxide aggregate FP was performed. The teeth in both groups were restored with composite resin restoration. The established criteria for outcome assessment of SRSD and pulpotomy were used. Accordingly, only asymptomatic teeth with no radiological evidence of periapical rarefaction were considered successful at the 12-month follow-up. Two-sample t test, Pearson χ2 test/Fisher's exact test, and percentage agreement were used for statistical evaluation. According to the per-protocol analysis, the success rate of both SRSD and FP treatment was 95.45% and 95.65%, respectively, and the actual difference between the two treatments was 1% (95% CI: [-10, 9]). The data suggests that both treatments (SRSD and FP) appear to have a good success rate (>95%) when used to manage permanent mandibular molar teeth with proximal deep carious lesion and reversible pulpitis. As SRSD is a noninvasive procedure, it should be favored over FP in these instances.
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Affiliation(s)
- Rechithra R
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Wasim Wani
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Sidhartha Sharma
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Faria LV, Antunes LS, Pio LRR, Dias JC, Pinheiro LHM, Reis CLB, Fontes KBFC, Cajazeira MRR, Antunes LAA. Evaluation of composite restorations in primary molars subjected to selective caries removal associated with antimicrobial photodynamic therapy: A randomized controlled trial. Int J Paediatr Dent 2022; 32:585-597. [PMID: 34783404 DOI: 10.1111/ipd.12937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 10/08/2021] [Accepted: 10/30/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) has been used as an adjunct treatment of deep caries lesions; however, studies on the effects of aPDT on the longevity of restorations are still limited. AIM To evaluate the clinical performance of composite restorations in primary molars subjected to selective caries removal (SCR) associated with aPDT. DESIGN A randomized clinical trial was designed. Primary molars of patients (mean age 6.15 years) with deep caries lesions without signs and symptoms of pulpal involvement were selected. A total of 64 teeth were randomly divided into groups G1 (SCR, 32 teeth) and G2 (SCR + aPDT, 32 teeth) for treatment, restored with composite, and evaluated after a week (T0 ), 6 months (T1 ), and 12 months (T2 ) according to the criteria of FDI. Groups were compared using the Rao-Scott chi-squared test and the logistic regression analysis for complex designs to account for multiple observations per subject (alpha = 0.05). RESULTS From all FDI criteria evaluated, the marginal adaptation for the SCR + aPDT group was significantly better in comparison with the SCR group at T0 and T2 in the logistic regression analysis (T0: OR = 0.151; 95% CI = 0.03-0.068, P = .015; and T2: OR = 0.201; 95% CI = 0.05-0.79, P = .022). CONCLUSION The marginal adaptation of primary molar resin restorations was positively affected by aPDT after 12 months of follow-up.
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Affiliation(s)
- Laís Veiga Faria
- Postgraduate Program in Dentistry of Niterói, Faculty of Dentistry, Federal Fluminense University, Niterói, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program in Dentistry of Niterói, Faculty of Dentistry, Federal Fluminense University, Niterói, Brazil.,Department of Specific Formation, Health Institute of Nova Friburgo, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
| | - Luciana Ribeiro Reis Pio
- Department of Specific Formation, Health Institute of Nova Friburgo, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
| | - Jessica Coelho Dias
- Department of Specific Formation, Health Institute of Nova Friburgo, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
| | - Liz Helena Moraes Pinheiro
- Postgraduate Program in Dentistry, Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, Brazil
| | | | - Karla Bianca Fernandes Costa Fontes
- Department of Specific Formation, Health Institute of Nova Friburgo, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
| | - Marlus Roberto Rodrigues Cajazeira
- Department of Specific Formation, Health Institute of Nova Friburgo, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
| | - Lívia Azeredo Alves Antunes
- Postgraduate Program in Dentistry of Niterói, Faculty of Dentistry, Federal Fluminense University, Niterói, Brazil.,Department of Specific Formation, Health Institute of Nova Friburgo, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil.,Postgraduate Program in Dentistry, Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, Brazil
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Scholz KJ, Sim W, Bopp S, Hiller KA, Galler KM, Buchalla W, Widbiller M. Impact of access cavity cleaning on the seal of postendodontic composite restorations in vitro. Int Endod J 2022; 55:950-963. [PMID: 35768890 DOI: 10.1111/iej.13792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Abstract
AIM To investigate the influence of cavity cleaning and conditioning on marginal integrity of directly placed postendodontic composite class-I-restorations in vitro. METHODOLOGY 168 fully intact teeth without caries or fillings received preendodontic composite restorations (class-II) after their extraction. Occlusal endodontic access-cavities were prepared, root-canals were instrumented and filled with guttapercha and an epoxy-resin based sealer. Prior to postendodontic class-I-restoration, access cavities were completely contaminated with sealer, cleaned with alcohol and pretreated as follows: Cleaner only (alcohol), glycine-polishing, Al2 O3 -sandblasting, carbide bur (immediate as well as delayed restoration). A positive control (not contaminated with sealer and adhesive used) and negative control (cleaner used but no adhesive) were established. Half of the teeth from each group were subjected to thermocycling and mechanical loading (TCML). Marginal integrity of postendodontic restoration was evaluated in oro-vestibular or mesio-distal sections after AgNO3 -dye-penetration (DP) by standardized photomacroscopic imaging and expressed in percent of margin length along all segments and separately for enamel, dentine and composite, respectively. Results were analyzed non-parametrically (α=0.05). RESULTS No restorations or teeth fractured or debonded completely. Without TCML, the median DP of all segments was significantly higher for the negative control compared to all other groups in oro-vestibular cutting direction (53%; P=0.002) and in mesio-distal cutting direction (51%; P≤0.041). The other groups without TCML revealed 16-24% DP (oro-vestibular) and 12-24% DP (mesio-distal). With TCML, the median DP in oro-vestibular cutting direction for all segments ranged between 48-62% for all groups, a significant difference was only observed between glycine-polishing and carbide bur (P=0.041). In mesio-distal cutting direction, the median DP in negative control was 69% with TCML and significantly higher compared to all other groups (P=0.002). For all other groups, the median DP of all segments ranged between 28% and 40% with TCML without significant differences. Error rates method (k=7) revealed a significant influence of TCML in general on penetration of all segments in both, oro-vestibular and mesio-distal cutting directions. CONCLUSION Additional access cavity pretreatment after alcohol cleaning did not improve the marginal integrity of postendodontic composite restorations. Thorough cleaning of the access cavity with alcohol seems to assure an acceptable marginal integrity to the tooth and restorative composite.
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Affiliation(s)
- Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Woocheol Sim
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Silvio Bopp
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Kerstin M Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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Widbiller M, Weiler R, Knüttel H, Galler KM, Buchalla W, Scholz KJ. Biology of selective caries removal: a systematic scoping review protocol. BMJ Open 2022; 12:e061119. [PMID: 35177469 PMCID: PMC8860079 DOI: 10.1136/bmjopen-2022-061119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Primary goal of restorative caries therapy is to preserve pulp vitality and the dentition. Whereas the conventional approach of complete caries removal aims at the elimination of all affected substances without regard to losses of hard tissue or pulp vitality, the innovative concept of selective caries removal (SCR) is characterised by a targeted and non-invasive excavation. It presents a lower risk of accidental pulp exposure, which reportedly has a positive effect on tooth survival. Although clinical data show the benefits of SCR, knowledge about the biological processes during this procedure in the pulp-dentine complex of permanent teeth is scarce. Hence, the aim of this work is to systematically scope the existing literature and map the existing evidence according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline. This protocol details the scoping review's methodological and analytical approaches. METHODS AND ANALYSIS First, a structure was established (phase I) as basis for a systematic scoping of literature (phase II). In the course of phase I, a total of 100 systematic reviews related to selective caries removal were searched in MEDLINE and information or theories on the biological processes were extracted. During the entire procedure, two reviewers independently screened the articles, and controversies were mediated by vote of a third reviewer. Eventually, it became apparent that different biological explanations can be organised into four categories: pulp response, cavity seal, remaining bacteria and cavity liner. Based on this structure, a search for original publications (phase II) will be performed and retrieved evidence will be assembled using a predefined conceptual framework. ETHICS AND DISSEMINATION As primary data will not be included in this study, ethical approval is not required. Findings will be disseminated through peer-reviewed publications, conference presentations and summaries for key stakeholders.
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Affiliation(s)
- Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Rita Weiler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, Regensburg, Germany
| | - Kerstin M Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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One-Year Clinical Aging of Low Stress Bulk-Fill Flowable Composite in Class II Restorations: A Case Report and Literature Review. COATINGS 2021. [DOI: 10.3390/coatings11050504] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bulk-fill flowable composites provide functional and aesthetic restorations while eliminating incremental composite layering and saving time. The degradation of the adhesive interface with subsequent gap formation is a concern when adhesively luted restorations are placed. Moreover, the number of adhesive interface failures increases when they are exposed to long-term water storage. The aim of the present study was to evaluate the morphological characteristics of the tooth-composite interface in class II cavities restored with a low stress bulk-fill flowable composite after aging in an oral environment. We describe a case of a patient with class II cavities in four premolars restored with a low stress bulk-fill flowable composite Surefil SDR (Dentsply DeTrey GmbH, Konstanz, Germany). The occlusal part was restored with nano-hybrid resin composite Ceram X Mono (Dentsply DeTrey GmbH). After one year of clinical function, the teeth were extracted and examined in a scanning electron microscope (SEM). It can be concluded that the application of bulk-fill covered with conventional composite seems to provide the homogeneous and stable bond to tooth structure after one year of aging in an oral environment. However, some defects within the dentin-resin composite interface were observed.
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