Clinical study of cervical caries treatment the effectiveness by assessing composite restorations condition

Abstract

Background. Cervical caries is a fairly common teeth pathology and its treatment is carried out in complicated clinical conditions. Therefore, increasing the term of functioning of composite restorations is an urgent task. Aim. Identification of the effectiveness of a differential approach to dissection of hard dental tissues depending on the depth of enamel microcracks and implementation of professional hygiene in the treatment of cervical caries in the short- and long-term periods. Materials & Methods. The study involved 50 people (average age [23.28±5.52] years) in whom cervical caries was treated in 72 teeth. All patients were divided into three equal groups based on the number of restorations according to the selected dissection technique and the chara­cteristics of professional hygiene. The dissection technique depended on the depth of the enamel microcracks in Main Group I (MG I), the dissection was carried out within the limits of clinically intact hard dental tissues in Control Group (CG) and Main Group II (MG II). The dental biofilm was removed from the vestibular surface of the teeth by the method of air-abrasive cleaning using the erythritol-based powder in MG I and MG II, the vestibular surface of the tooth was cleaned of dental deposits with a polishing paste without fluoride in CG. The quality of restorations was assessed based on the United States Public Health Service (USPHS) criteria on the day of restoration, 6 and 12 months later. The effectiveness of the prescribed treatment was identified by the dynamic indicators of the dental pulp electroexcitability and the electrical conductivity of the enamel. Results. There were no partial or completely destroyed restorations in all terms of the observation period. Composite restorations were preserved according to the criteria of "anatomical shape" and "color matching". One year later restoration defects were absent in 61 teeth (84.72%): in MG I – in 22 (91.67%), in CG – in 19 (79.17%), in MG II – in 20 (83.33%). Recurrent caries and symptoms of hypersensitivity were not identified in MG I. A slightly greater effectiveness of the treatment was noted in MG II group in comparison with CG (by 4.16%) that confirms the importance of removing the dental biofilm before restoration by the method of air-abrasive clea­ning using erythritol. Conclusions. The analysis of the state of restorations in the long-term period showed that the dissection technique and the features of professional hygiene affected their quality before restoration. The number of high-quality composite restorations was by 10.42% more on average in MG I than in the other groups. The obtained results make it possible to recommend the proposed method for using in practical dentistry. Keywords: electroodontology, electroodontometry, microcracks.