Objectives: To analyze the relationship between the cavity depth and liners with postoperative sensitivity of resin composite restorations. Methods: A clinical follow-up was conducted on 319 resin composite restorations made in the ®nal year of an undergraduate program over a 3-year period. Along with the analyses of cavity type, cavity depth, type of pulpal protection and the materials used, the postoperative sensitivity was also examined on each restoration.Results: Thirty-nine percent of the restorations had no protective layer (Group 1). As the depth of the prepared cavities increased, the restorations received one of the three pulpal protection methods; a calcium hydroxide base (Group 2), glass ionomer cement (Group 3), or protection with a calcium hydroxide base in combination with glass ionomer cement (Group 4). The incidence of postoperative sensitivity showed no signi®cant difference among Groups 1, 2 and 3, but was signi®cantly lower in Group 1 than in Group 4. The restorations made in shallow and medium depth cavities demonstrated signi®cantly less-postoperative sensitivity than those made in deep cavities. The newer generation dentine-bonding agents showed a signi®cantly lower incidence of postoperative sensitivity than the early generation group.Conclusions: Postoperative sensitivity in resin composite restorations was not related to the absence of protective layers but increased with the depth of cavities restored with the resin composite. The type of dentine-bonding agents could also be responsible for postoperative sensitivity. q

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Objectives: In 2002, FDI (World Dental Federation) published a policy advocating that caries be treated by minimal intervention (MI). This MI policy has been accepted worldwide and is taught in universities. But acceptance in general dental practice has been slower, especially in Japan where healthcare payment and practice favor drilling and filling. To help disseminate this MI policy into general practice, the Japanese Society of Conservative Dentistry developed an evidence-based clinical Guideline for restoring carious permanent teeth in adult patients. Methods:The Guideline was developed by a committee of nine university clinicians and a librarian. The committee selected the most frequent clinical questions in treating caries and used electronic databases to search and assess the best scientific evidence for each. Members then added their clinical experience and used the Delphi Method to discuss and reach consensus on each question on treating caries with MI policy. Graded recommendations and guidance were made for each clinical question. The provisional Guideline was strengthened after review and discussion with university researchers and general practitioners. Results:The Guideline addresses the 16 most frequent clinical questions in treating adult caries, including restorative methods and how to tackle root caries. Recommendations for treatment using MI policy were developed using the best scientific evidence and consensus of experienced clinicians.Clinical Significance: The Guideline offers a practical expert view of treating caries with the MI policy that incorporates the best scientific evidence, the latest techniques, the most preferable materials and the general consensus of expert clinicians. / 262

While mutans streptococci have long been assumed to be the specific pathogen responsible for human dental caries, the concept of a complex dental caries-associated microbiota has received significant attention in recent years. Molecular analyses revealed the complexity of the microbiota with the predominance of Lactobacillus and Prevotella in carious dentine lesions. However, characterization of the dentin caries-associated microbiota has not been extensively explored in different ethnicities and races. In the present study, the bacterial communities in the carious dentin of Japanese subjects were analyzed comprehensively with molecular approaches using the16S rRNA gene. Carious dentin lesion samples were collected from 32 subjects aged 4–76 years, and the 16S rRNA genes, amplified from the extracted DNA with universal primers, were sequenced with a pyrosequencer. The bacterial composition was classified into clusters I, II, and III according to the relative abundance (high, middle, low) of Lactobacillus. The bacterial composition in cluster II was composed of relatively high proportions of Olsenella and Propionibacterium or subdominated by heterogeneous genera. The bacterial communities in cluster III were characterized by the predominance of Atopobium, Prevotella, or Propionibacterium with Streptococcus or Actinomyces. Some samples in clusters II and III, mainly related to Atopobium and Propionibacterium, were novel combinations of microbiota in carious dentin lesions and may be characteristic of the Japanese population. Clone library analysis revealed that Atopobium sp. HOT-416 and P. acidifaciens were specific species associated with dentinal caries among these genera in a Japanese population. We summarized the bacterial composition of dentinal carious lesions in a Japanese population using next-generation sequencing and found typical Japanese types with Atopobium or Propionibacterium predominating.