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A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in
C C Ribeiro1, L N Baratieri, J Perdigão
1Department of Pedodontics, Federal University of Maranhão, School of Dentistry, São Luís, Brazil.
Objective:
The purpose of this project was to evaluate the performance of a dentin adhesive system on carious and noncarious primary dentin in vivo.
Method And Materials:
Forty-eight primary molars with carious lesions were randomly assigned to 2 different treatments: group 1 (control, n = 24)--All identifiable, irreversibly infected dentin was removed prior to the application of the bonding agent and restorative material; group 2 (experimental, n = 24)--Irreversibly infected dentin was partially removed prior to the application of the bonding agent and restorative material. The control and experimental teeth were clinically monitored every 3 months and evaluated 12 months after restoration. The teeth were extracted around the time of exfoliation and processed for scanning electron microscopy.
Results:
Retention rate, marginal integrity, and pulpal symptoms were identical in both groups. Radiographically, the radiolucent area associated with the experimental restorations did not increase with time in 75% of the cases. For the control group, the adhesive system formed a hybrid layer. In the experimental group, there was morphologic evidence of the formation of an acid-resistant "altered hybrid layer." An acid-resistant tissue, resulting from the interdiffusion of adhesive resin within the area of carious dentin, was observed adjacent to and under the altered hybrid layer.
Conclusion:
Application of an adhesive restorative system to irreversibly infected dentin did not affect the clinical performance of the restoration.