An in vitro study of affected dentin as a risk factor for the development of secondary caries

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 x 5 x 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.