Abstract
Objective: The aim of this study was to evaluate, ex vivo, bacterial coronal leakage with different antimicrobial agents applied to the dentine for indirect pulp treatment (IPT). Study Design: Sixty extracted teeth were prepared and randomly distributed into 5 groups (n=10): Group 1: no antimicrobial dentine treatment; group 2: 1% chlorhexidine (CHX)+1% thymol varnish (Cervitec®); group 3: 2 % CHX solution; group 4: 40% CHX varnish (EC40™) and group 5: Clearfil™ Protect Bond (CPB). Ten teeth served as controls. The teeth were restored using a resin-modified glass ionomer cement (GIC) and then mounted in a two-chamber device. The coronal access was exposed to Streptococcus mutans for 45 days. The appearance of turbidity in the BHI broth of the lower chamber was considered as specimen leakage. Results: Survival analysis, determined by non parametric Kaplan-Meier and log-rank tests, showed that the best results were for groups EC40™+GIC and GIC alone; yet there were not statistically significant differences between them. All specimens of CPB+GIC and 2% CHX+GIC, leaked at 45 days. Conclusions: In IPT the use of GIC without pretreatment of the dentine and pretreatment with 40% CHX varnish resulted in a significant delay of bacterial coronal leakage. Key words:Streptococcus mutans, bacterial leakage, resin-modified glass ionomer cement, indirect pulp treatment.
Highlights
The main objective of the management of the primary and young permanent dentition is to preserve the teeths vitality, while causing as little trauma as possible to the pulp [1,2]
A recent clinical prospective study conducted by Kotsanos et al [9] obtained a high rate of clinical success (96.5%) after a 32-months follow-up, using a single application of resin-modified glass ionomer cement (GIC) for indirect pulp treatment (IPT) in primary molars. These results suggest that resin-modified GICs helps isolate affected dentine from oral bacteria
The antibacterial effect of CHX is concentration-dependent [27] and its antimicrobial substantivity depends on the number of CHX molecules available to interact with the dentine [27]
Summary
The main objective of the management of the primary and young permanent dentition is to preserve the teeths vitality, while causing as little trauma as possible to the pulp [1,2]. In paediatric dentistry, resin-modified glass ionomer cements (resin-modified GICs) may act simultaneously as base and restorative material [7] given their ease of handling and mechanical advantages compared to conventional GICs, as well as their high success rates when used as IPT materials [6,8,9] Due to their biocompatibility, antibacterial capacity and good physical and mechanical properties, they provide good marginal sealing, little microleakage and a high retention rate [10,11]. A recent clinical prospective study conducted by Kotsanos et al [9] obtained a high rate of clinical success (96.5%) after a 32-months follow-up, using a single application (simultaneously, as base and final restoration) of resin-modified GIC for IPT in primary molars These results suggest that resin-modified GICs helps isolate affected dentine from oral bacteria. The purpose of this study was to evaluate, ex vivo, bacterial coronal leakage of different antimicrobial treatments, applied to the dentine in IPT
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