Pulp survival after composite resin restoration of caries lesions in adults

Abstract

Minimal intervention is generally achieved by using direct composite resin (CR) restorations. However, deep caries lesions may lead to pulpal complications. This study evaluated the risk of endodontic complications after CR restoration in relation to depth of caries lesions. Data on 507 teeth from 316 adults treated with CR were analyzed. Caries depth was expressed as a percentage of the distance between the outer edge of the dental enamel and the pulp base on preoperative radiographs. The interval between CR restoration and follow-up root canal treatment was obtained from electronic treatment records for a period of 24 months. A Cox proportional hazards model was used to investigate the association between risk of endodontic complications and caries depth. Sixteen teeth (3.2%) required root canal treatment within 24 months. No root canal treatment was required after CR treatment for caries affecting <50% of the outer edge of enamel and pulp. As compared with CR treatment of caries lesions with a size of <80%, there was a significantly higher risk of root canal treatment for caries lesions with a size of 80% to 89% (hazard ratio, [95%

Endodontisk diagnostik

“…Med tanke på de få och svaga bevisen för det diagnostiska värdet av symtom och tecken kan ett lämpligt tillvägagångssätt vara att basera den endodontiska diagnosen på den bekräftade eller förmodade lokalisationen för bakterierna som orsakar inflammationen i pulpan eller de periapikala vävnaderna. Studier tyder på att denna faktor är den bästa prediktorn för vävnadens tillstånd [37][38][39][40] och för prognosen för pulpaöverlevnad [41][42]. Nyligen har nya klassificeringssystem för pulpit föreslagits, som baseras på symtom snarare än kariesskadans djup enligt röntgen och som indikerar att preoperativ smärta har prognostiskt värde [41,[43][44], men dessa har hittills inte fått bredare acceptans.…”

Evaluation of dental pulp stem cells response to flowable nano-hybrid dental composites: A comparative analysis

“…DPSCs can be damaged through various mechanisms. Common factors that can damage or compromise the viability and function of DPSCs include physical trauma, bacterial infection due to untreated or poorly managed dental caries, and chemical irritants resulting from dental materials [11][12][13]. These irritants can cause damage to the cell barrier, oxidative stress, inflammation, and even cell death if they can spread through dentinal tubules into the tooth pulp [14][15][16].…”

Update on Enamel Bonding Strategies

“…Adhesion largely determines the success or failure of composite resin (CR) restorations. Although various adhesive systems have been developed for reliable CR restorations (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), each product has unique characteristics that must be considered in clinical practice. Compared to dentin, adhesion to enamel was achieved at an early stage by etching the enamel surface with phosphoric acid (PA) (15).…”