Masking and Penetration Ability of Various Sealants and ICON in Artificial Initial Caries Lesions In Vitro

Effect of sodium hypochlorite and EDTA pretreatment on the resin infiltration efficacy and acid resistance of enamel white spot lesions: an in vitro study

BACKGROUND

This in vitro study aimed to evaluate the effect of sodium hypochlorite (NaOCl) and ethylene diamine tetraacetic acid (EDTA) as pretreatments on the resin infiltration efficacy and acid resistance of enamel white spot lesions (WSLs).

METHODS

Enamel blocks prepared from the buccal surfaces of sound human premolars were placed in a demineralisation solution for 3 days to establish artificial enamel WSLs. All the blocks with WSLs were randomly divided into four groups (n = 40 per group): RI (Control): resin infiltration only. N/RI: 5.25% NaOCl pretreatment + resin infiltration; E/RI: 17% EDTA pretreatment + resin infiltration; NE/RI: combined pretreatment of 5.25% NaOCl with 17% EDTA + resin infiltration; Enamel pore exposure was measured by using SEM observation and Image J software in each group after pretreatment prior to resin infiltration (n = 8 per group). Resin penetration depth and enamel surface microhardness were assessed after resin infiltration (n = 8 per group for each test) by a confocal laser scanning microscope and a Vickers' microhardness test respectively. The remaining specimens were subjected 7 days of pH cycling after which surface enamel roughness and microhardness were assessed by an atomic force microscope and a microhardness test respectively.

RESULTS

Compared to the control group, the enamel surface pore exposure (p = 0.007), resin penetration depth (p = 0.011) and enamel surface microhardness (p < 0.001) were all significantly increased after the pretreatment of 5.25% NaOCl alone or combined with 17% EDTA by one-way ANOVA. After pH cycling, no significant differences were found in enamel surface roughness or microhardness among the four groups (p = 0.55) by two-way ANOVA.

CONCLUSIONS

Enamel surface pretreatment of 5.25% NaOCl or combined with 17% EDTA improved the efficacy of the resin infiltration of WSLs, but might be useless in enhancing the acid resistance of resin-infiltrated WSLs.

Noninvasive Proximal Adhesive Restoration in the Treatment of Non-cavitated Interproximal Incipient Carious Lesions: A Case Report

The noninvasive proximal adhesive restoration (NIPAR) technique is a noninvasive approach that utilizes a one-component universal adhesive for infiltration and a filled flowable resin for impermeable sealing. This technique offers several benefits. The noninvasive treatment approach is particularly significant in restorative dentistry, as it entails identifying and managing caries in their initial phases. The efficacy of the noninvasive proximal adhesive restoration technique is limited to non-cavitated lesions. In this case report, a 24-year-old male patient with no relevant medical conditions with a history of dental extractions and restorations visited the University of Geneva Dental School for a complete dental check-up. Orthopantomogram (OPG) and bitewing radiographs revealed multiple initial proximal caries in teeth # 37 (mesial), # 36 (mesial & distal), and # 35 (distal). In addition, DIAGNOcam (KaVo) was used as a diagnostic tool to establish proximal caries' progression. After discussing treatment options with the patient, a decision was made to treat the lesions at the enamel level using NIPAR.

Using Resin Infiltration Technique and Direct Composite Restorations for the Treatment of Carious Lesions with Different Depths

Minimally invasive treatment methods are of special interest in restorative dental practice, with numerous methods emerging in the last decade. Such methods are being developed to encompass various applications, an important one being the detection and treatment of caries in the early stages. White spot lesions are the earliest visible stage of the caries process. These lesions have a chalky, opaque appearance, which results in esthetic dissatisfaction. In contrast to the principles of minimally invasive dentistry, considerable amounts of sound tooth structure need to be sacrificed to get rid of these lesions. Therefore, caries infiltration has been introduced as an alternative treatment option for non-cavitated lesions. The resin infiltration technique only works in non-cavitated lesions. Replacement of lost dental tissue with resin composites remains the mainstay therapy in cases with cavity formation. This case report describes a case of caries with lesions of varying depths. In such cases, a combination of treatment methods may be used to provide satisfying esthetics with a minimally invasive approach.

Penetration ability and microhardness of infiltrant resin and two pit and fissure sealants in primary teeth with early enamel lesions

To determine the penetration depth and enamel microhardness (EMH) of an infiltrant resin and two fissure sealants in primary teeth with early enamel lesions. We randomly divided 174 sound teeth into six groups (n = 29): (1) phosphoric acid (PA) + Clinpro, (2) PA + Aegis, (3) Icon, (4) hydrochloric acid (HCl) + Clinpro, (5) HCl + Aegis, and (6) control. Percentage penetration (%PP) was analyzed by confocal laser scanning microscopy (n = 15). EMH was measured (n = 12), and the percentage of EMH recovery (%REMH) was calculated. Twelve samples were examined under a scanning electron microscope (SEM). All data were analyzed with the Kruskal–Wallis and one-way ANOVA tests (p < 0.05). Groups 3 and 4 showed the highest %PP (all, p < 0.05). Icon application led to significantly higher %REMH compared to the others (p < 0.05). Groups 2 and 5 showed the lowest reduction in %REMH after pH-cycling. Application of Icon and Clinpro with HCl pretreatment showed the greatest %PP. pH-cycling led to a decrease in %REMH for all of the materials, although this effect was lower in teeth treated with Aegis.

Effect of Resin Infiltration on Enamel: A Systematic Review and Meta-Analysis

Subsurface enamel demineralization beneath an intact surface layer or white spots lesions (WSL) can and should be treated with non-invasive procedures to impede the development of a cavitated lesion. We aim to analyze if infiltrative resin improves enamel roughness, microhardness, shear bond strength, and penetration depth. MEDLINE [via Pubmed], Cochrane Central Register of Controlled Trials, Embase, Web of Science, Scholar, and LILACS were searched until May 2021. Methodological quality was assessed using the Joanna Briggs Institute Clinical Appraisal Checklist for Experimental Studies. Pairwise ratio of means (ROM) meta-analyses were carried out to compare the enamel properties after treatment with infiltrative resin on sound enamel and WSLs. From a total of 1604 articles, 48 studies were included. Enamel surface roughness decreased 35% in sound enamel (95%CI: 0.49–0.85, I² = 98.2%) and 54% in WSLs (95%CI: 0.29–0.74, I² = 98.5%). Microhardness reduced 24% in sound enamel (95%CI: 0.73–0.80, I² = 99.1%) and increased by 68% in WSLs (95%CI: 1.51; 1.86, I² = 99.8%). Shear bond strength reduced of 25% in sound enamel (95%CI: 0.60; 0.95, I² = 96.9%) and increased by 89% in WSLs (95%CI: 1.28–2.79, I² = 99.8%). Penetration depth was 65.39% of the WSLs (95%CI: 56.11–74.66, I² = 100%). Infiltrative resins effectively promote evident changes in enamel properties in sound and WSLs. Future studies with long-term follow-ups are necessary to corroborate these results from experimental studies.