Histological and ultrastructural evaluation of remaining dentin after selective caries removal in primary molars: Ex-vivo study

Edite Novais Borges Pinchemel¹ image, Kelly Maria Silva Moreira2 image, Ana Flávia Bissoto Calvo3 image, Thaís Gimenez Cóvos4 image, Tamara Kerber Tedesco5 image, Victor Cavallaro Bottesini6 image, Danilo Antônio Duarte7 image, José Carlos Petorossi Imparato8 image

 

Highlights

Mineralization characteristics were apparent in dentin after selective removal, demonstrating effective remineralization.

Both low-cost and high-cost glass ionomer cements (GICs) showed satisfactory performance with selective caries removal.

No progression of the carious lesion was observed, confirming the effectiveness of selective removal technique.

Abstract

Aim: In this study, ultrastructural, chemical, and histological analyses of extracted deciduous teeth were performed to analyze the effect of two different types of glass ionomer cements used in association with selective caries removal in deep lesions of deciduous teeth. Methods: A clinical, ex vivo, longitudinal study was conducted. A total of 19 deciduous molars from 9 volunteer patients were used. The teeth were randomly restored with one of two types of glass ionomer cement following the selective caries removal technique. The groups were divided into a control group, which used Fuji IX (GC- Europe, Leuven, Belgium), and a test group, which used Maxxion R (FGM- Joinville, Santa Catarina, Brazil). After exfoliation, the teeth were stored at 4°C and subjected to scanning electron microscopy (SEM), optical microscopy (OM), and energy dispersive spectrometry (EDS). Results: EDS analysis revealed that calcium (Ca) and phosphorus (P) were present in 100% of the specimens in both the control and test groups. Fluoride was found in 60% of the control group specimens and 63% of the test group specimens. OM images showed areas of mineralized dentin in both treatment groups. Conclusions: Selective caries removal for deep lesions in deciduous teeth was shown to be a safe therapeutic protocol, demonstrating signs of dentin mineralization and control of disease progression.

Keywords: Carious, Dental Caries Removal; Glass Ionomer Cement; Scanning Electron Microscopy

Author Affiliations

  1. Doctoral Student, Department of Pediatric Dentistry, São Leopoldo Mandic College, Brazil (Correspondence:editenbpinchemel@gmail.com)
  2. PhD, Department of Pediatric Dentistry, University of Campinas, Brazil
  3. PhD, Department of Pediatric Dentistry; University of São Paulo,Brazil
  4. PhD, Department of Pediatric Dentistry, University of São Paulo (USP); Professor, Master’s Program in Health and Environment, UNIMES, Brazil
  5. PhD, Department of Pediatric Dentistry; University of São Paulo (USP); Professor, Postgraduated Program in Cruzeiro do Sul University, Brazil
  6. Doctoral Student, Department of Restorative Dentistry, São Paulo State University, Brazil
  7. PhD, Department of Pediatric Dentistry, São Leopoldo Mandic College, Brazil
  8. PhD, Department of Pediatric Dentistry; University of São Paulo, Brazil
  1. BaniHani A, Santamaría RM, Hu S, Maden M, Albadri S. Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. Eur Arch Pediatr Dent 2022;23:667-693
  2. Dawett B, Deery C, Banerjee A, Papaioannou D, Marshman Z. A scoping literature review on minimum intervention dentistry for children with dental caries. Br Dent J 2022. https://doi.org/10.1038/s41415-022-4038-8
  3. Souza TF de, Martins ML, Jural LA, Maciel IP, Magno MB, Coqueiro R da S, et al. Did the use of minimum interventions for caries management change during the COVID-19 pandemic? A cross-sectional study. Caries Res 2023;57:459-469
  4. Bitello-Firmino L, Soares VK, Damé-Teixeira N, Parolo CCF, Maltz M. Microbial Load After Selective and Complete Caries Removal in Permanent Molars: A Randomized Clinical Trial. Braz Dent J 2018;29:290–295
  5. Jardim JJ, Mestrinho HD, Koppe B, de Paula LM, Alves LS, Yamaguti PM, et al. Restorations after selective caries removal: 5-Year randomized trial. J Dent 2020;99:103416
  6. Lim ZE, Duncan HF, Moorthy A, McReynolds D. Minimally invasive selective caries removal: a clinical guide. Br Dent J 2023;234:233–240
  7. Ricketts D, Lamont T, Innes NP, Kidd E, Clarkson JE. Operative caries management in adults and children. Cochrane Database of Systematic Reviews. 2013;28:CD003808
  8. BaniHani A, Deery C, Toumba J, Munyombwe T, Duggal M. The impact of dental caries and its treatment by conventional or biological approaches on the oral health‐related quality of life of children and carers. Int J Paediatr Dent 2018;28:266–276
  9. Aravinda VSS, Kandregula CR, Y M, M MK, BS N, Sree BM. Minimal Extension for Maximal Results – Review on Minimal Intervention Paediatric Dentistry. Acta Sci Dent Sci 2022;1:102–114
  10. Stafuzza TC, Vitor LLR, Rios D, Cruvinel Silva T, Machado MAAM, Oliveira TM. Clinical and Radiographic Success of Selective Caries Removal to Firm Dentin in Primary Teeth: 18-Month Follow-Up. Case Rep Dent 2018;2018
  11. Casagrande L, Seminario AT, Correa MB, Werle SB, Maltz M, Demarco FF, et al. Longevity and associated risk factors in adhesive restorations of young permanent teeth after complete and selective caries removal: a retrospective study. Clin Oral Investig 2017;21:847–855
  12. Ali AH, Koller G, Foschi F, Andiappan M, Bruce KD, Banerjee A, et al. Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial. J Dent Res 2018;97:1207–1213
  13. Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, et al. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 2007;35:170–178
  14. Schwendicke F, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing Carious Lesions. Adv Dent Res 2016;28:58–67
  15. Jain N, Dutt U, Radenkov I, Jain S. WHO’s global oral health status report 2022: Actions, discussion and implementation. Oral Diseases. John Wiley and Sons Inc; 2023.
  16. Innes NPT, Chu CH, Fontana M, Lo ECM, Thomson WM, Uribe S, et al. A Century of Change towards Prevention and Minimal Intervention in Cariology. J Dent Res 2019;98:611–617
  17. Leal SC, Dame-Teixeira N, Barbosa CDB, Kominami PAA, Raposo F, Nakagawa EMT, et al. Minimum intervention oral care: defining the future of caries management. Braz Oral Res 2022;36:e135
  18. Chiu HHC, Lam PPY, Yiu CKY. The Impact of Minimal Intervention Dentistry on Patient-Reported and Observation-Based Outcomes in the Pediatric Population: A Systematic Review and Meta-Analysis. Healthcare 2023;11:2241
  19. Sarna-Boś K, Skic K, Boguta P, Adamczuk A, Vodanovic M, Chałas R. Elemental mapping of human teeth enamel, dentine and cementum in view of their microstructure. Micron 2023;172:103485
  20. Zain S, Davis GR, Hill R, Anderson P, Baysan A. Mineral exchange within restorative materials following incomplete carious lesion removal using 3D non-destructive XMT subtraction methodology. J Dent 2020;99:103389
  21. Arnold WH, Konopka S, Kriwalsky MS, Gaengler P. Morphological analysis and chemical content of natural dentin carious lesion zones. Annals of Anatomy – Anatomischer Anzeiger. 2003;185:419–424
  22. Calvo AFB, Kicuti A, Tedesco TK, Braga MM, Raggio DP. Evaluation of the relationship between the cost and properties of glass ionomer cements indicated for atraumatic restorative treatment. Braz Oral Res 2016;30: S1806-83242016000100201
  23. Rocha MFED, Fujimaki M, Pascotto RC, Mendes LLC, Lacerda CM, Pereira OC, et al. Survival analysis of ART restorations in primary molars of preschool children: 1 year follow-up. Rev Odontol UNESP 2018;47:112–118
  24. Olegário IC, Pacheco AL de B, de Araújo MP, Ladewig N de M, Bonifácio CC, Imparato JCP, et al. Low-cost GICs reduce survival rate in occlusal ART restorations in primary molars after one year: A RCT. J Dent 2017;57:45–50
  25. Moura MS, Sousa GP, Brito MHSF, Silva MCC, Lima MDM, Moura LFAD, et al. Does low-cost GIC have the same survival rate as high-viscosity GIC in atraumatic restorative treatments? A RCT. Braz Oral Res 2019;33: e125
  26. Singhal D, Acharya S, Thakur A. Microbiological analysis after complete or partial removal of carious dentin using two different techniques in primary teeth: A randomized clinical trial. Dent Res J (Isfahan). 2016;13:30-40

Article Info

Contemp Pediatr Dent 2024:5(1):34-42

Received: 09 February 2024

Accepted: 29 April 2024

Online First: 30 April 2024

DOI: 10.51463/cpd.2024.5

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					Edite Novais Borges Pinchemel, Kelly Maria Silva Moreira, Ana Flávia Bissoto Calvo, Thaís Gimenez Cóvos, Tamara Kerber Tedesco, Victor Cavallaro Bottesini, Danilo Antônio Duarte, José Carlos Petorossi Imparato. Histological and ultrastructural evaluation of remaining dentin after selective caries removal in primary molars: Ex-Vivo Study. Contemp Pediatr Dent 2024:5(1):34-42.

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