Is Cavity Lining Really Necessary After Selective Caries Removal in Primary Teeth?
Keywords:
Dental Caries, Tooth, Deciduous, Dental Pulp Capping, Pediatric DentistryAbstract
Objective: To evaluate the clinical and radiographic response of pulp-dentin complex after selective caries removal with or without pulp lining in primary teeth. Material and Methods: Twenty-four primary molars with deep occlusal caries lesions and without pulpal alterations were selected from children, both genders, aged between 5 and 9 years old. After selective caries removal, the teeth were divided into three groups: without cavity liner (Group I), calcium hydroxide cement – CH (Group II), and Mineral trioxide aggregate – MTA (Group III). The final restoration was performed with resin-modified glass ionomer cement. Clinical and radiographic assessments were conducted at 6-month follow-up. The Kappa test determined intraexaminer reliability. Fisher's exact test evaluated intergroup comparisons (p<0.05). Results: All teeth showed clinical and radiographic success at the 6-month follow-up without statistically significant differences (p>0.05). Conclusion: Selective caries removal without cavity lining was acceptable for deep caries lesions in primary teeth.References
Elhennawy K, Finke C, Paris S, Reda S, Jost-Brinkmann P-G, Schwendicke F. Selective vs stepwise removal of deep carious lesions in primary molars: 24 months follow-up from a randomized controlled trial. Clin Oral Investig 2021; 25(2):645-652. https://doi.org/10.1007/s00784-020-03536-6
Zain S, Davis GR, Hill R, Anderson P, Baysan A. Mineral exchange within restorative materials following incomplete carious lesion removal using 3D non-destructive XMT subtraction methodology. J Dent 2020; 99:103389. https://doi.org/10.1016/j.jdent.2020.103389
Stafuzza TC, Vitor LLR, Lourenço Neto N, Rios D, Cruvinel T, Sakai VT, et al. Pulp liner materials in selective caries removal: Study protocol for a randomised controlled trial. BMJ Open 2021; 11(1):e029612. https://doi.org/10.1136/bmjopen-2019-029612
Stafuzza TC, Vitor LLR, Rios D, Cruvinel T, Loureço Neto N, Sakai VT, et al. A randomized clinical trial of cavity liners after selective caries removal: One-year follow-up. J Appl Oral Sci 2019; 27:e20180700. https://doi.org/10.1590/1678-7757-2018-0700
Kaul S, Kumar A, Jasrotia A, Gorkha K, Kumari S, Jeri SY. Comparative analysis of biodentine, calcium hydroxide, and 2% chlorhexidine with resin-modified glass ionomer cement as indirect pulp capping materials in young permanent molars. J Contemp Dent Pract 2021; 22(5):511-516. https://doi.org/10.5005/jp-journals-10024-3084
Dhar V, Marghalani AA, Crystal YO, Kumar A, Ritwik P, Tulunoglu O, et al. Use of vital pulp therapies in primary teeth with deep caries lesions. Pediatr Dent 2017; 39(5):146E-159E.
da Rosa WLO, Lima VP, Moraes RR, Piva E, da Silva AF. Is a calcium hydroxide liner necessary in the treatment of deep caries lesions? A systematic review and meta-analysis. Int Endod J 2019; 52(5):588-603. https://doi.org/10.1111/iej.13034
Bressani AEL, Mariath AAS, Haas AN, Garcia-Godoy F, de Araujo FB. Incomplete caries removal and indirect pulp capping in primary molars: A randomized controlled trial. Am J Dent 2013; 26(4):196-200.
Trairatvorakul C, Sastararuji T. Indirect pulp treatment vs antibiotic sterilization of deep caries in mandibular primary molars. Int J Paediatr Dent 2014; 24(1):23-31. https://doi.org/10.1111/ipd.12022
Lula ECO, Monteiro-Neto V, Alves CMC, Ribeiro CCC. Microbiological analysis after complete or partial removal of carious dentin in primary teeth: A randomized clinical trial. Caries Res 2009; 43(5):354-358. https://doi.org/10.1159/000231572
Lourenço Neto N, Marques NC, Fernandes AP, Hungaro Duarte MA, Abdo RC, Machado MA, et al. Clinical and radiographic evaluation of Portland cement added to radiopacifying agents in primary molar pulpotomies. Eur Arch Paediatr Dent 2015; 16(5):377-382. https://doi.org/10.1007/s40368-015-0177-9
Oliveira TM, Moretti AB, Sakai VT, Lourenço Neto N, Santos CF, Machado MA, et al. Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human primary teeth. Eur Arch Paediatr Dent 2013; 14(2):65-71. https://doi.org/10.1007/s40368-013-0015-x
Gurcan AT, Seymen F. Clinical and radiographic evaluation of indirect pulp capping with three different materials: A 2-year follow-up study. Eur J Paediatr Dent 2019; 20(2):105-110. https://doi.org/10.23804/ejpd.2019.20.02.04
Schwendicke F, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing carious lesions: Consensus recommendations on carious tissue removal. Adv Dent Res 2016; 28(2):58-67. https://doi.org/10.1177/0022034516639271
Alkhalaf R, Neves A de A, Banerjee A, Hosey MT. Minimally invasive judgement calls: managing compromised first permanent molars in children. Br Dent J 2020; 229(7):459-465. https://doi.org/10.1038/s41415-020-2154-x
Splieth CH, Banerjee A, Bottenberg P, Breschi L, Campus G, Ekstrand KR, et al. How to intervene in the caries process in children: A joint ORCA and EFCD expert Delphi consensus statement. Caries Res 2020; 54(4):297-305. https://doi.org/10.1159/000507692
Duncan HF, Cooper PR, Smith AJ. Dissecting dentine-pulp injury and wound healing responses: Consequences for regenerative endodontics. Int Endod J 2019; 52(3):261-266. https://doi.org/10.1111/iej.13064
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(2):e061119. https://doi.org/10.1136/bmjopen-2022-061119
BaniHani A, Santamaría RM, Hu S, Maden M, Albadri S. Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: An umbrella review. Eur Arch Paediatr Dent 2022; 23(5):667-693. https://doi.org/10.1007/s40368-021-00675-6
Massón M, Viteri-García A, Verdugo-Paiva F. Stepwise removal compared to complete removal for deep carious lesions. Medwave 2022; 22(1):e8227. https://doi.org/10.5867/medwave.2022.01.8226
Schwendicke F, Meyer-Lueckel H, Dörfer C, Paris S. Failure of incompletely excavated teeth--A systematic review. J Dent 2013; 41(7):569-580. https://doi.org/10.1016/j.jdent.2013.05.004
Jardim JJ, Mestrinho HD, Koppe B, de Paula LM, Alves LS, Yamaguti PM, et al. Restorations after selective caries removal: 5-Year randomized trial. J Dent 2020; 99:103416. https://doi.org/10.1016/j.jdent.2020.103416
Dalpian DM, Ardenghi TM, Demarco FF, Garcia-Godoy F, De Araujo FB, Casagrande L. Clinical and radiographic outcomes of partial caries removal restorations performed in primary teeth. Am J Dent 2014; 27(2):68-72.
Dos Santos NM, Leal SC, Gouvea DB, Sarti CS, Toniolo J, Neves M, et al. Sealing of cavitated occlusal carious lesions in the dentine of deciduous molars: A two-year randomised controlled clinical trial. Clin Oral Investig 2022; 26(1):1017-1024. https://doi.org/10.1007/s00784-021-04085-2
Gibbison R, Crozier R. Are RMGIC restorations as effective with or without selective caries removal in primary molars? Evid Based Dent 2021; 22(4):132-133. https://doi.org/10.1038/s41432-021-0218-7
Alves FBT, Hesse D, Lenzi TL, Guglielmi CDAB, Reis A, Loguercio AD, et al. The bonding of glass ionomer cements to caries-affected primary tooth dentin. Pediatr Dent 2013; 35(4):320-324.
Santos PS dos, Pedrotti D, Braga MM, Rocha R de O, Lenzi TL. Materials used for indirect pulp treatment in primary teeth: A mixed treatment comparisons meta-analysis. Braz Oral Res 2017; 31:e101. https://doi.org/10.1590/1807-3107/2017.vol31.0101
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