Performance of four dentine excavation methods in deciduous teeth

Area of Science:

• Dentistry
• Pediatric Dentistry
• Dental Materials Science

Background:

• Effective caries removal is crucial for preserving tooth structure in pediatric dentistry.
• Evaluating novel and conventional dentine excavation methods is essential for optimizing clinical outcomes.
• Deciduous teeth present unique challenges for caries management due to their smaller size and thinner dentine.

Purpose of the Study:

• To compare the speed and effectiveness of four dentine excavation methods: steel bur, Er:YAG laser, hand excavator, and polymer bur.
• To assess the extent of caries removal, over-preparation, and under-preparation for each method.
• To determine the most suitable method for carious dentine excavation in deciduous teeth.

Main Methods:

• An in vitro study involving 80 deciduous molars with induced caries.
• Longitudinal sectioning of teeth, imaging for caries assessment using light microscopy and confocal laser scanning microscopy (CLSM).
• Excavation using steel bur, Er:YAG laser, hand excavator, or polymer bur, followed by post-excavation imaging and comparative analysis.

Main Results:

• Steel bur was the fastest excavation method, followed by polymer bur, hand excavator, and laser.
• Steel bur resulted in the largest over-preparation area, while polymer bur led to the largest under-preparation area.
• Hand excavator showed the longest coincidence line between caries and preparation limits, indicating precise removal.

Conclusions:

• The hand excavator appears to be the most suitable method for carious dentine excavation in deciduous teeth.
• It offers a favorable combination of efficient excavation time and effective caries removal.
• This finding supports the continued use of traditional methods when balanced with modern techniques.