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

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Abstract

Objectives

For deep carious lesions, less invasive carious tissue removal is recommended. The resulting residual carious lesions might benefit from remineralization by lining or restoration materials. We aimed to compare mineral gains in artificial residual lesions provided by calcium hydroxide and glass hybrid materials in combination with pulpal fluid simulation.

Methods

On the coronal aspect of human dentin discs (n = 20), artificial carious lesions were induced using acetic acid. Median mineral loss ΔZ [25th/75th percentiles] of resulting lesions was 1643 [1301/1858] vol% μm. One third of each disc served as baseline sample. The remaining disc was divided into four groups, each being covered with one experimental material (n = 20/group): flowable composite (control (CO)), setting or non-setting calcium hydroxide liner plus flowable composite (CH-S, CH-NS), and glass hybrid (GH). Samples were mounted in a dual-chamber device. Pulpal surfaces were exposed to simulated pulpal fluid at 2.94 kPa. Coronal surfaces were exposed to artificial saliva and rinsed with 200 ppm NaF every 2 weeks. After 12 weeks, mineral loss differences (ΔΔZ) were assessed using transverse microradiography. Electron probe microscopic analysis was used to measure fluoride and strontium concentrations.

Results

Mineral gains were not significantly different between CO (ΔΔZ = 372 [115/501] vol% μm), CH-S (ΔΔZ = 317 [229/919] vol% μm), or CH-NS (ΔΔZ = 292 [130/579] vol% μm; p > 0.05/Wilcoxon test) but significantly increased in GH (ΔΔZ = 1044 [751/1264] vol% μm, p < 0.001). Samples in GH showed fluoride and strontium enrichment deep into the dentin. Such enrichment was not found in CO.

Conclusions

Within the limitations of this study, GH, but not calcium hydroxide, provided coronal remineralization of residual carious lesions.

Clinical relevance

Glass hybrids might provide additional remineralization of residual carious lesions. The functional implications of this mineral gain need to be evaluated.

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Acknowledgments

We thank Dr. Jörg Nissen, Technical University Berlin, for EPMA analysis.

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Authors and Affiliations

  1. Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany

    Allam Al-Abdi, Sebastian Paris & Falk Schwendicke

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  1. Allam Al-Abdi
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  2. Sebastian Paris
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Correspondence to Falk Schwendicke.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Extracted human permanent molars were obtained with informed consent based on an ethics approved protocol (EA4/102/14).

Conflict of interest

Experimental determination of remineralization effects by GH was funded by GC Europe, Leuven, Belgium. The funders had no role in design, conduct, evaluation or interpretation of the study, or writing the manuscript.

Funding

FS receives a grant from the German Research Foundation (SCHW 1766/2-1). This study was co-funded by GC Europe, Leuven, Belgium. The funders had no role in design, conduct, evaluation, or interpretation of the study or writing the manuscript.

Informed consent

Extracted human permanent molars were obtained with informed consent based on an ethics approved protocol (EA4/102/14).

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Al-Abdi, A., Paris, S. & Schwendicke, F. Glass hybrid, but not calcium hydroxide, remineralized artificial residual caries lesions in vitro . Clin Oral Invest 21, 389–396 (2017). https://doi.org/10.1007/s00784-016-1803-6

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