The influence of the lining material on the repair of the infected dentin in young permanent molars after restoration: A randomized clinical trial

Abstract

Aim: This study evaluated the impact of liner material on the fluorescence, morphological and mineral characteristics of permanent carious dentin after cavity sealing.

Methods: Thirty children (11.0 ± 2.7 years old) presenting at least one active deep carious lesion in permanent molars were selected. Fragments of carious dentin were removed from teeth before lining the cavity (baseline samples) with high-viscosity glass ionomer cement (G1) or an inert material (wax - G2). Cavities were restored with composite resin and reopened 60 days later, and other fragments were removed (60-day sample). The laser fluorescence (LF) readings and morphological and mineral changes of both groups were compared.

Results: After 60 days, forty teeth were available for evaluation. Lower LF means were obtained (Wilcoxon signed-rank test; P < 0.05), and enhanced calcium and phosphorus levels were detected for both groups (t-test, P < 0.05). An uptake of fluorine was observed only in G1 (t-test; P < 0.05). Regardless of the group, baseline samples exhibited clear signs of bacterial invasion, and the collagen fibers were exposed; the 60-day samples showed a better-organized tissue with a more compact intertubular dentin.

Conclusion: Caries arrestment with dentin reorganization occurs regardless of the lining material placed in contact with the infected dentin.

Keywords: Deep carious lesions; dental pulp capping; glass ionomer cement.

Figure 1

Bacterial aggregates were seen at baseline for both groups (arrows). After restoration, we observed some dentinal tubules without microorganisms (arrows) for G1 and G2, and a decrease in the bacterial contamination is evident although some microorganisms can still be seen in the intertubular dentin (pointer)

Figure 2

The demineralized dentin tissue with exposed collagen fibers was observed at baseline for both groups. The 60-day samples exhibited a more compact tissue, particularly on G1. However, the remineralization process also occurred on G2 in peri- and inter-tubular dentin (arrows)