Influence of selective caries excavation on marginal penetration of class II composite restorations in vitro

Abstract

Selective caries excavation may support pulp preservation. This in vitro study investigated the influence of selective removal of demineralized dentin on marginal integrity of composite restorations as determined by dye penetration. Dentinal caries‐like lesions were produced in the approximal surfaces of 40 extracted human molars (ethylenediaminetetraacetate, 0.5 M, 96 h). The following test procedures were established: complete excavation, selective excavation, and caries‐free control. Two class II cavities with enamel at the cervical margins were prepared per tooth and demineralization volume was determined by micro‐computed tomography for the purpose of a stratified distribution to receive complete excavation or selective excavation. After complete or selective excavation (30 cavities each), adhesive composite restorations were placed. Cavities without demineralized dentin (20 cavities) served as control. The marginal integrity of restorations was evaluated by dye penetration with and without thermocycling or mechanical loading. Results were analyzed by non‐parametrical statistical tests (Mann‐Whitney U Test) with an α = 0.05 level of significance. Dye penetration did not differ significantly among completely excavated, selectively excavated, or undemineralized teeth, but was increased by thermocycling and mechanical loading in all experimental groups. Selective caries removal did not increase marginal penetration in class II restorations. The presence of remaining demineralized dentin surrounded by sound dentin did not impair marginal integrity of restorations with margins placed in sound enamel.

One-Year Clinical Aging of Low Stress Bulk-Fill Flowable Composite in Class II Restorations: A Case Report and Literature Review

“…The gap observed in only one specimen may be a consequence of specimen preparation, including sectioning procedures and drying steps [89]. Further studies could be performed with an accurate, safe, and non-destructive method such as dye penetration [90] or non-invasive OCT (optical coherence tomography) instead of SEM [91]. Last, some tubule walls could be dissolved during demineralization; thus, tubule-covering sheaths persisted which may otherwise denote the so-called lamina limitans-in other words, the inner sheath of the peritubular dentin matrix containing glucosaminoglycans.…”

Evaluation of composite restorations in primary molars subjected to selective caries removal associated with antimicrobial photodynamic therapy: A randomized controlled trial

“…5 It, however, seems to be reasonable to consider that composite restorations could lose marginal seal over time but without relevant clinical consequences. 32 The increase in the time of care subsequent to aPDT application can be a limitation of this technique. It is unfavorable for uncooperative patients during dental care and a limitation for the indication of aPDT use as an adjunct in the treatment of deep caries dentin.…”

“…Despite the presence of bacteria in the caries‐affected dentin, once the sealing of the cavity margins is maintained, bacterial access to the nutrients from the oral environment is interrupted, causing a reduction in the metabolic activity of these microorganisms 5 . It, however, seems to be reasonable to consider that composite restorations could lose marginal seal over time but without relevant clinical consequences 32 …”

Impact of access cavity cleaning on the seal of postendodontic composite restorations in vitro

“…Half of the samples from each group (six upper and six lower molars) were randomly assigned to thermocycling and mechanical loading (5000 thermo-cycles of 30 s at 5 and 55°C and 500 000 mechanical cycles at 72.5 N load and 1.6 Hz) established in other studies (Krifka et al, 2009(Krifka et al, , 2011Schenke et al, 2008;Scholz et al, 2020), whereas the other samples were stored in deionized water (21°C). Teeth were loaded centrally with a hemispherical metal stop simulating the opposing cusp (Naumann et al, 2009;Scholz et al, 2020). This stop was placed in the occlusal surface of the postendodontic composite restoration without contact to the restoration margins.…”