2017 Clinical oral investigations

Glass hybrid, but not calcium hydroxide, remineralized artificial residual caries lesions in vitro.

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Clinical oral investigations Vol. 21 (1) : 389-396 • Jan 2017

OBJECTIVES: For deep carious lesions, less invasive carious tissue removal is recommended. The resulting residual carious lesions might benefit from remineralization by lining or restoration materials. We aimed to compare mineral gains in artificial residual lesions provided by calcium hydroxide and glass hybrid materials in combination with pulpal fluid simulation. METHODS: On the coronal aspect of human dentin discs (n = 20), artificial carious lesions were induced using acetic acid. Median mineral loss DeltaZ [25th/75th percentiles] of resulting lesions was 1643 [1301/1858] vol% mum. One third of each disc served as baseline sample. The remaining disc was divided into four groups, each being covered with one experimental material (n = 20/group): flowable composite (control (CO)), setting or non-setting calcium hydroxide liner plus flowable composite (CH-S, CH-NS), and glass hybrid (GH). Samples were mounted in a dual-chamber device. Pulpal surfaces were exposed to simulated pulpal fluid at 2.94 kPa. Coronal surfaces were exposed to artificial saliva and rinsed with 200 ppm NaF every 2 weeks. After 12 weeks, mineral loss differences (DeltaDeltaZ) were assessed using transverse microradiography. Electron probe microscopic analysis was used to measure fluoride and strontium concentrations. RESULTS: Mineral gains were not significantly different between CO (DeltaDeltaZ = 372 [115/501] vol% mum), CH-S (DeltaDeltaZ = 317 [229/919] vol% mum), or CH-NS (DeltaDeltaZ = 292 [130/579] vol% mum; p > 0.05/Wilcoxon test) but significantly increased in GH (DeltaDeltaZ = 1044 [751/1264] vol% mum, p < 0.001). Samples in GH showed fluoride and strontium enrichment deep into the dentin. Such enrichment was not found in CO. CONCLUSIONS: Within the limitations of this study, GH, but not calcium hydroxide, provided coronal remineralization of residual carious lesions. CLINICAL RELEVANCE: Glass hybrids might provide additional remineralization of residual carious lesions. The functional implications of this mineral gain need to be evaluated.

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