Remineralization of carious dentin. II: In vivo microradiographic and chemical studies in human permanent teeth capped with calcium hydroxide

Abstract

The main aim of this in vivo study was to evaluate a possible remineralization of human carious dentin by means of chemical and microradiographic studies. Eighty-six samples of carious dentin were removed from 36 permanent teeth of 24 patients. These were divided into untreated (control) and chemically pure calcium hydroxide-capped (experimental) samples and analyzed at intervals varying from 10 to 120 days. They were classified according to depth of caries and degree of dentin softening and evaluated in relation to weight, phosphorus concentration, qualitative and quantitative microradiography and absolute values of total mineral content. One of two halves of each sample was selected for chemical studies and the other for total content of mineral salts. Experimental samples were examined with a light microscope and the results obtained showed a qualitative increase in radiopacity. Quantitatively, it was observed that, in the case of samples analyzed for phosphorus concentration, the average mean of differences in percentage increase after treatment was 9.6%, while for the samples evaluated microradiographically for total mineral content, it was 22.29%. In both cases, the differences were statistically significant.

An ex vivo study to evaluate the remineralizing and antimicrobial efficacy of silver diamine fluoride and glass ionomer cement type VII for their proposed use as indirect pulp capping materials - Part I

“…Significant difference was found, however, with GC VII which showed least amount of phosphorous deposition as compared to calcium hydroxide. This finding is consistent with that of Conrado[ 20 ] who showed an increase in phosphorus concentration from both vital and pulp-extirpated teeth, treated with chemically pure calcium hydroxide. He could not, however, explain the mechanism for this increased level in pulpless teeth.…”

Bond strength and adaptation of pulp capping materials to dentin

“…CH is the most commonly used lining material for direct and indirect PC. CH also has antibacterial properties and induces reactionary dentin formation (Conrado, ; Schwendicke, Meyer‐Lueckel, Dorfer, & Paris, ). However, it shows low compressive strength, dissolves over time, and forms tunnel defects in the dentin bridges, which leave voids prone to microleakage and bacterial recolonization (Gandolfi, Siboni, & Prati, ; Kitasako, Ikeda, & Tagami, ).…”

Glass hybrid, but not calcium hydroxide, remineralized artificial residual caries lesions in vitro

“…Similarly, the clinical efficacy of CH lining has not been convincingly demonstrated so far [42]. While there is some evidence supporting mineral gains after CH lining both clinically [23] and in vitro [22], such data are sparse. Our study found no additional benefit of CH compared with no lining.…”

“…On the other hand, cavity liners or remineralizing restorative materials have been thought to provide such mineral gain. For example, calcium hydroxide (CH) has been shown to provide remineralization in vitro [22] and clinically [23,24]. This and other potential advantages of CH (e.g., it is antibacterial and induces reactionary dentin development) could explain why this material is widely used in general dentistry [25][26][27].…”