An in vitro Study of Affected Dentin as a Risk Factor for the Development of Secondary Caries

Abstract

The objective of the study was to investigate the association between the presence of residual caries (inner affected dentin) on the cavity walls of cavity preparations and the further development of secondary caries lesions. Two 2 × 5 × 2 mm cavities, one in the apical portion (A) and one in the cervical portion (C) of the root, were prepared on both the lingual (L) and buccal (B) surfaces of 18 extracted human roots. The apical cavities (AB and AL) were artificially demineralized for 30 min using a decalcifying solution, followed by staining with a caries detector dye and then excavation of irreversibly demineralized dentin, leaving behind a layer of inner carious dentin. The cervical cavities (CB and CL) remained intact with sound dentin on the cavity walls. All cavities were then restored with composite resin. Following restoration, lingual specimens (AL and CL) were completely covered by an acid-resistant varnish to prevent further demineralization. All specimens were then incubated in an in vitro microbial artificial mouth model for 3 days in order to develop secondary carious lesions. At the end of the study all specimens were processed for energy-dispersive X-ray analysis of Ca concentration adjacent to the border between dentin and restoration. Statistical analysis of Ca concentrations revealed that the presence of affected inner dentin does not increase the susceptibility to secondary caries. Therefore, it was concluded that conservative cavity preparations leaving behind affected dentin do not increase the risk of secondary caries development.

A New in vitro Model to Study the Relationship of Gap Size and Secondary Caries

“…They often utilized conventional methods of cavity preparation and restorations before incubating tooth specimens with chemical solutions or bacterial cultures [Kidd, 1976;Gilmour et al, 1990;Donly and Gomez, 1994;Sepet et al, 1995;Dionysopoulos et al, 1996;Fontana et al, 1996a;Matharu et al, 2001;Lobo et al, 2005;Seemann et al, 2005;Borczyk et al, 2006]. The in vitro model developed for this study provided further standardization of the gap size and specimens (i.e.…”

Liners and bases in general dentistry

“…Ricketts et al suggest that there is insufficient evidence to know whether it is necessary to re‐enter after a period of time and excavate further, but studies that have not re‐entered do not report adverse consequences. It has also been shown that the presence of affected dentine did not increase the susceptibility to secondary caries 70 …”

A Comparative Evaluation of DIAGNOdent and Caries Detector Dye in Detection of Residual Caries in Prepared Cavities

“…In contrast, Bjorndal 25 indicated that if an excellent marginal adaptation is maintained, the presence of little remaining caries in the depth of the cavity may not cause a problem for short-term success of the restoration. Borczyk et al 26 reported that the presence of affected dentin did not predispose tooth tissue to secondary caries formation. Although, complete removal of all decayed dentin had been advocated in the past during cavity preparation, a more conservative approach is to remove any demineralization in the external cavity walls (mesial, distal, gingival, buccal and lingual) during excavation, but leave softened affected dentin in pulpal and axial surfaces in order to prevent pulpal exposure.…”