Abstract
ObjectivesAssess calcium silicate cement (Biodentine™) vs. glass ionomer cement (Fuji IX™, control) as indirect pulp capping (IPC) materials in patients with reversible pulpitis after a 2-year follow-up. Evaluate the integrity of the overlying resin composite restorations using modified USPHS criteria and FDI criteria. Investigate the sensitivity of the modified USPHS criteria compared to the FDI criteria in the assessment of the restorations.Materials and methodsSeventy-two restorations (36 Biodentine™, 36 Fuji IX™) were placed randomly in 53 patients. Periapical radiographs were taken at pre-treatment (T0), 12-month (T12), and 24-month (T24) review. Restorations were assessed using the modified USPHS and FDI criteria at T12 and T24.ResultsAt 24 months, 15 teeth had failed to maintain vitality (6 Biodentine™, 9 Fuji IX™). Clinical success rate of IPC for both materials was 72% and is related to the intensity of reversible pulpitis symptoms. No difference was found between T12 and T24 in the periapical (PA) radiographs and in the integrity of the resin composite restorations overlying Biodentine™ compared to Fuji IX™. There was no difference in the efficacy of the USPHS criteria compared to the FDI criteria in the assessment of the resin composite restorations.ConclusionsBiodentine™ and Fuji IX™ were clinically effective when used as IPC materials in teeth with reversible pulpitis at T24. Resin composite restorations overlying both materials performed well at T24. Using the USPHS or FDI criteria is equally efficient at T24; however, longer term follow-up is needed to establish whether there are sensitivity differences between these assessment criteria.Clinical significanceTeeth with deep carious lesions approaching the pulp and with signs of reversible pulpitis can be treated successfully by indirect pulp capping using either Biodentine™ or Fuji IX™. Using the USPHS or FDI criteria to assess restorations is equally effective at 2 years.Trial registrationNCT02201641
Highlights
Dental caries is the most prevalent chronic condition of people worldwide, with individuals being susceptible to this disease throughout their lifetime [1, 2]
There is no significant difference in the dentine-pulp response between BiodentineTM and Fuji IXTM when assessed clinically and radiographically after 24 months
There is no difference in the integrity of the resin composite restorations overlying BiodentineTM compared to Fuji IXTM using both the USPHS and FDI criteria
Summary
Dental caries is the most prevalent chronic condition of people worldwide, with individuals being susceptible to this disease throughout their lifetime [1, 2]. The treatment of dental caries has cost implications especially with deep carious lesions approaching the pulp [3, 4]. Cvar and Ryge [7] developed criteria for the clinical evaluation of dental restorative materials for use by the United States Public Health Service—commonly known as BRyge^ or BUSPHS^ criteria. These criteria, with their many modifications, quickly gained popularity due to their clarity and workability and have been used extensively in studies worldwide [8]. There certainly remains a need for studies comparing the FDI criteria with other existing restorative assessment criteria, i.e. the USPHS criteria to establish its validity and benefit in permanent teeth
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