Effect of Different Liners on Pulpal Outcome after Partial Caries Removal: A Preliminary 12 Months Randomised Controlled Trial

Abstract

Aim: The aim of this double-blinded parallel randomised controlled trial was to compare the effect of different liners on 12-month pulp health outcomes after partial caries removal (PCR) with composite restorations in permanent molars. Methods: The study was registered at clinicaltrials.gov with registration No. NCT0328695 and conducted in the Department of Conservative dentistry and Endodontics, Post Graduate Institute of Dental Sciences Rohtak with no external financial support. One hundred and ninety-eight participants (116 males, 82 females and age 14–54 years) with vital permanent mature mandibular molars having deep caries involving two-thirds or more of dentin were randomised to calcium hydroxide (CH), resin-modified GIC (RMGIC) and no liner (DC) groups after PCR. After a follow-up time of 12 months, success was defined as positive response to pulp sensibility and absence of periapical alterations. Results: Categorical variables were compared using chi-square test. Two analytical approaches were used, such as intention-to-treat and per-protocol approach. Success rates in per-protocol approach were 96.8, 96.5, and 94.6% for CH, RMGIC and DC groups, respectively with no significant difference between 3 groups (p = 0.811). None of the baseline variables had any significant influence on the treatment success. Conclusion: Partial caries excavation has a high success rate to treat deep carious lesions in permanent teeth after 12 months of follow-up, indicating that the retention of carious dentin does not interfere with pulp vitality or restoration survival. Also, the success of the treatment is independent of the lining material used over the demineralized dentin.

Monomer Conversion, Dimensional Stability, Biaxial Flexural Strength, Ion Release, and Cytotoxicity of Resin-Modified Glass Ionomer Cements Containing Methacrylate-Functionalized Polyacids and Spherical Pre-Reacted Glass Fillers

“…Pulp protection or base/liner materials can be applied over the remaining demineralized dentin to promote the repair of carious dentin [ 4 ]. A clinical trial demonstrated that the use of liners was not directly associated with treatment success at 12 months [ 5 ]. However, clinicians who perform selective caries removal techniques still prefer to apply pulp protection materials over the remaining carious dentin [ 6 , 7 ].…”

Século XXI: A filosofia de uma Odontologia minimamente invasiva, o que mudou do diagnóstico ao tratamento da cárie dental?

“…Os aspectos referentes à remoção do tecido cariado têm sido ressaltados em alguns estudos, que demonstram haver diferenças significativas entre as técnicas de remoção total, parcial e stepwise (Quadro 2). Tanto a remoção total quanto a remoção em dois passos clínicos do tecido cariado aumentam as chances de injúria e/ou comunicação pulpar (Maltz et al, 2012;Manton, 2013;Mattos et al, 2014;Hoefler et al, 2016;Villat et al, 2016;Zhang , 2017;Bjørndal et al, 2017;Maltz et al, 2018;Khokhar e Tewari, 2018;Giacaman et al, 2018;Singh et al, 2019;Ricketts et al, 2019;Pozos-guillén et al, 2021) Além disso, estudos também evidenciam que não há diferença estatisticamente diferentes quando do uso de materiais forradores ou inertes no selamento de cavidades profundas (Corralo e Maltz, 2013;Giacaman et al, 2018).…”

An Evaluation on Deep Caries Removal Method and Management Performed by Undergraduate Dental Students: A Malaysia Experience

“… 20 About 88.1% of the respondents selected Ca(OH) 2 and GIC as the preferred materials used in pulpal lining that are in line with the recommendation and results showed from other studies. 21 22 23 Pulpotomy is a routinely performed clinical procedure with high clinical success to eliminate bacteria followed by the placement of a suitable material or medicament within the pulp chamber complex to maintain vitality of primary teeth until exfoliation to prevent the need of pulpectomy. 24 Approximately two-third of the respondents (74.9%) selected Ca(OH) 2 and ferric sulfate as the material of choice that is parallel with the current literature advocating material selection for pulpotomy.…”