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

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.