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01-06-2006 | Original Article

The monitoring of deep caries lesions after incomplete dentine caries removal: results after 14–18 months

Authors: E. F. Oliveira, G. Carminatti, V. Fontanella, M. Maltz

Published in: Clinical Oral Investigations | Issue 2/2006

Abstract

This paper aims to assess radiographic changes after incomplete carious dentine removal and tooth sealing. Thirty-two teeth with deep caries lesions were studied. The treatment consisted of incomplete excavation, application of a Ca(OH)₂ layer, sealing temporarily for a 6- to 7-month period and then restoration. Standardised bitewing radiographs were taken immediately after the temporary sealing and at 6- to 7- and 14- to 18-month intervals. The digitised images were analysed blind by image subtraction. The quantitative analyses subtractions were performed in the radiolucent zone (RZ) beneath the restoration and in two adjacent control areas (CA). Two cases were lost during the 6- to 7-month period (one pulp necrosis and one pulp exposure during removal of the provisional sealing). No difference (p>0.05) was observed in the radiographic density of the CA and the RZ in the two experimental periods. The mean and standard deviation (grey tonalities scale) were 129.42±5.83 and 127.65±4.67 (control areas) and 132.96±7.41 and 132.90±5.99 (RZ) for the first and second experimental periods, respectively. The radiographic density of the CA differed from the RZ (Tukey test, p<0.001). Interference in environmental conditions by partial dentine caries removal and tooth sealing arrests lesion progression, suggesting that complete dentine caries removal is not essential to control caries progression.

Al-Zayer MA, Straffon LH, Feigal RJ, Welch KB (2003) Indirect pulp treatment of primary posterior teeth: a retrospective study. Pediatr Dent 25:29–36PubMed

Anderson BG (1938) Clinical study of arresting dental caries. J Dent Res 17:443–452

Aponte A, Hartsook J, Crowley M (1966) Indirect pulp capping success verified. J Dent Child 33:164–166PubMed

Backer Dirks O (1966) Posteruptive changes in dental enamel. J Dent Res 45:503–511

Besic FC (1943) The fate of bacteria sealed in dental cavities. J Dent Res 22:349–354

Bjørndal L, Larsen T, Thylstrup A (1997) A clinical and microbiological study of deep carious lesions during stepwise excavation using long treatment intervals. Caries Res 31:411–417PubMed

Bjørndal L, Thylstrup A (1998) A practice-based study on stepwise excavation of deep carious lesions in permanent teeth: a 1-year follow-up study. Community Dent Oral Epidemiol 26:122–128PubMedCrossRef

Bjørndal L (2002) Dentin caries: progression and clinical management. Oper Dent 27:211–217PubMed

Brägger U, Hämmerle CHF, Mombelli A, Bürgin W, Lang NP (1992) Remodelling of periodontal tissues adjacent to sites treated according to the principles of guided tissue regeneration (GTR). J Clin Periodontol 19:615–624CrossRefPubMed

10.

Carvalho JC, Ekstrand KR, Thylstrup A (1989) Dental plaque and caries on occlusal surfaces of first permanent molars in relation to stage of eruption. J Dent Res 68:773–779PubMed

11.

Christgau M, Hiller K-A, Schmalz G, Kolbeck C, Wenzel A (1998) Accuracy of quantitative digital subtraction radiography for determining changes in calcium mass in mandibular bone: an in vitro study. J Periodontal Res 33:138–149PubMedCrossRef

12.

Eberhard J, Hartman B, Lenhard M, Mayer T, Kocher T, Eickholz P (2000) Digital subtraction radiography for monitoring dental demineralization. An in vitro study. Caries Res 34:219–224CrossRefPubMed

13.

Eidelman E, Finn SB, Koulourides T (1965) Remineralization of carious dentin treated with calcium hydroxide. J Dent Child 32:218–225PubMed

14.

Elwood RP, Davies RM, Worthington HV (1997) Evaluation of a dental subtraction radiography system. J Periodontal Res 32:241–248PubMedCrossRef

15.

Falster CA, Araujo FB, Straffon LH, Nor JE (2002) Indirect pulp treatment: in vivo outcomes of an adhesive resin system vs calcium hydroxide for protection of the dentin–pulp complex. Pediatr Dent 24:241–248PubMed

16.

Formousis I, Brägger U, Bürgin W, Tonetti M, Lang NP (1994) Digital image processing. I. Evaluation of gray level correction methods in vitro. Clin Oral Implants Res 5:37–47CrossRefPubMed

17.

Handellman SL, Leverett DH, Solomon ES, Brenner SM (1981) Use of adhesive sealants over occlusal carious lesions: radiographic evaluation. Community Dent Oral Epidemiol 9:256–259PubMedCrossRef

18.

Held-Wydler E (1964) “Natural” (indirect) pulp capping. J Dent Child 31:107–113

19.

Holmen L, Thylstrup A, Artun J (1987) Clinical and histological features observed during arrestment of active enamel carious lesions in vivo. Caries Res 21:546–554PubMedCrossRef

20.

Jaeger RG (1988) Comportamento biológico da dentina cariada humana após o capeamento pulpar indireto. Estudo morfológico pela microscopia de luz e eletrônica. Thesis, University of São Paulo, Brazil

21.

Jeffcoat MK, Reddy MS, Webber RL, Williams RC, Ruttimann UE (1987) Extraoral control of geometry for digital subtraction radiography. J Periodontal Res 22:396–402PubMedCrossRef

22.

Jordan RE, Suzuki M (1971) Conservative treatment of deep carious lesions. J Can Dent Assoc 37:337–342PubMed

23.

Kerkhov JR, Herman SC, Klein A, Macdonald RE (1967) A clinical and television densitometric evaluation of the indirect pulp capping technique. J Dent Child 34:193–201

24.

Khademi JA (1996) Digital images & sound. J Dent Educ 60:41–46PubMed

25.

Kidd EAM, Joyston-Bechal S, Beighton D (1993) The use of a caries detector dye during cavity preparation: a microbiological assessment. Br Dent J 174:245–248CrossRefPubMed

26.

Kidd EAM (2004) How “clean” must a cavity be before restoration? Caries Res 38:305–313CrossRefPubMed

27.

King JB, Crawford JJ, Lindall RL, Hill C (1965) Indirect pulp capping: a bacteriologic study of deep carious dentine in human teeth. Oral Surg Oral Med Oral Pathol 20:663–671CrossRefPubMed

28.

Kuwabara R, Massler M (1966) Pulpal reactions to active and arrested carious lesions. J Dent Child 33:190–204PubMed

29.

Leksell E, Ridell K, Cvek ME, Mejare I (1996) Pulp exposure after stepwise versus direct complete excavation of deep carious lesions in young posterior permanent teeth. Endod Dent Traumatol 12:192–196CrossRefPubMed

30.

Maltz M, Oliveira EF, Fontanella V, Bianchi R (2002) A clinical, microbiologic, and radiographic study of deep caries lesions after incomplete caries removal. Quintessence Int 33:151–159PubMed

31.

Massara MLA, Alves JB, Brandão PRG (2002) Atraumatic restorative treatment: clinical, ultrastructural and chemical analysis. Caries Res 36:430–436CrossRefPubMed

32.

Massler M (1978) Treatment of profound caries to prevent pulpal damage. J Pedod 2:99–105PubMed

33.

Mertz-Fairhurst EJ, Curtis Jr, Ergle JW, Rueggeberg FA, Adair SM (1998) Ultraconservative and cariostatic sealed restorations: results at year 10. J Am Dent Assoc 129:55–66PubMed

34.

Mjör IA, Moorhead JE, Dahl JE (2000) Reasons for replacement of restorations in permanent teeth in general dental practice. Int Dent J 50:361–366PubMed

35.

Murray PE, Hafez AA, Windsor LJ, Smith AJ, Cox CF (2002) Comparison of pulp responses following restoration of exposed and non-exposed cavities. J Dent 30:213–222CrossRefPubMed

36.

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

37.

Pashley EL, Talman R, Horner JA, Pashley DH (1991) Permeability of normal versus carious dentin. Endod Dent Traumatol 7:207–211CrossRefPubMed

38.

Ribeiro CC, Baratieri LN, Perdigão J et al (1999) A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth. Quintessence Int 30:591–599PubMed

39.

Ruttimann EU, Webber RL, Schmidt E (1986) A robust digital method for film contrast correction in subtraction radiography. J Periodontal Res 21:486–495PubMedCrossRef

40.

Sarnat H, Massler M (1965) Microstructure of active and arrested dentinal caries. J Dent Res 44:1389–1401

41.

Shovelton DS (1968) A study of deep carious dentine. Int Dent J 18:392–405PubMed

42.

Tziafas D, Smith AJ, Lesot H (2000) Designing new treatment strategies in vital pulp therapy. J Dent 28:77–92CrossRefPubMed

43.

Vandre RH, Webber RL (1995) Future trends in dental radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 80:471–478CrossRefPubMed

44.

Weerheijm KL, Kreulen CM, de Soet JJ, Groen HJ, van Amerongen WE (1999) Bacterial counts in carious dentine under restorations: 2-year in vivo effects. Caries Res 33:130–134CrossRefPubMed

45.

Wenzel A, Anthonisen PN, Juul MB (2000) Reproducibility in the assessment of caries lesion behaviour: a comparison between conventional film and subtraction radiography. Caries Res 34:214–218CrossRefPubMed

Title: The monitoring of deep caries lesions after incomplete dentine caries removal: results after 14–18 months
Authors: E. F. Oliveira
G. Carminatti
V. Fontanella
M. Maltz
Publication date: 01-06-2006
Publisher: Springer-Verlag
Published in: Clinical Oral Investigations / Issue 2/2006
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-006-0033-8

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The monitoring of deep caries lesions after incomplete dentine caries removal: results after 14–18 months

Abstract

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