Bacteria beneath composite restorations--a culturing and histobacteriological study

The occurrence, viability and identification of the microbial flora under composite fillings using an anaerobic technique were studied. Class V cavities were prepared on clinically healthy buccal surfaces of 7 contralateral pairs of premolars in children 11--15 years of age. After preparation, rubber dam was applied and one cavity in each pair of teeth was washed with water blasted dry with air and filled with Adaptic. The other cavity was washed with a cavity cleaner (Tubulicid) and a cavity liner (Tubulitec) was applicated prior to filling with Adaptic. The teeth were extracted after 4--6 weeks. Under anerobic conditions the tooth crown was split. From one half samples were taken from the pulpal wall under the filling and cultured on blood agar and in broth medium. The other half was examined with histobacteriological technique. No growth occurred in cultures from lined cavities but in 6 of the 7 unlined cavities. Full agreement was observed between the findings from the culturing and histobacteriological examinations concerning presence or absence of microorganisms at the pulpal wall in all 14 teeth. The flora was mixed. Gram-positive bacteria, mainly Streptococcus and Actinomyces, dominated over gram-negative bacteria including Veillonella, Fusobacterium, Campylobacter and Selenomonas. The composition of the flora was more similar to that observed in dental plaque than that found in carious dentin or in saliva in other studies.