Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands.
Department of Pediatric Dentistry, School of Health Sciences, University of Brasília, Brasília, Brazil.
Caries Res. 2018;52(4):303-311. doi: 10.1159/000485983. Epub 2018 Feb 6.
The objectives of the study were to quantify the dentine mineral concentration (DMC) in teeth restored conventionally, according to the atraumatic restorative treatment (ART) and ultraconservative (UCT) protocols (open cavities and small ART restorations), and the DMC underneath the open cavities of teeth managed by UCT versus nontreated, open cavities. We studied 50 teeth with restorations/open cavities, 39 restored teeth (9 by conventional restorative treatment [CRT], 17 by ART, and 13 by UCT) and 16 teeth with open cavities. Each restoration/open cavity was scanned using microcomputed tomography, with 3 hydroxyapatite disks with respective densities of 1.24, 1.33, and 1.57 g/cm3 as a reference. Images were reconstructed and the greyscale images were converted into DMC values. For each restoration/open cavity, 15 measurements of dentine immediately underneath and from the corresponding area in sound dentine were taken. DMC was expressed as a percentage of the DMC of sound dentine. ANOVA and the Student t test were used for statistical analysis. The mean DMC underneath restorations of the ART protocol group (98.93%) was statistically significantly higher than that of the UCT protocol group (91.98%), but not of the CRT protocol group (91.33%). On multiple surfaces, mean DMC in the axial area (94.32%) was statistically significantly higher than in the gingival area (92.80%). The mean DMC of open cavities managed by UCT protocol (89.05%) was statistically significantly higher than in nontreated open cavities (83.90%). In conclusion, a dentine-hypermineralized area underneath ART restorations was observed. Managing open cavities with a toothbrush and fluoride toothpaste (the UCT protocol) resulted in higher mineralized dentine underneath the cavity than in nontreated open cavities.
本研究的目的是定量分析传统治疗(conventional restorative treatment,CRT)、微创治疗(atraumatic restorative treatment,ART)和超保守治疗(ultraconservative treatment,UCT)条件下牙齿修复(open cavities and small ART restorations)和未治疗开放窝洞(untreated,open cavities)牙本质矿物浓度(dentine mineral concentration,DMC)。我们研究了 50 颗有修复体/开放窝洞的牙齿,39 颗有修复体的牙齿(9 颗 CRT,17 颗 ART,13 颗 UCT)和 16 颗有开放窝洞的牙齿。使用 microcomputed tomography 扫描每颗修复体/开放窝洞,以 3 个羟磷灰石圆盘(密度分别为 1.24、1.33 和 1.57 g/cm3)作为参考。重建图像并将灰度图像转换为 DMC 值。对于每个修复体/开放窝洞,在相应的正常牙本质区域下和紧邻修复体下方的牙本质处进行 15 次测量。DMC 表示为正常牙本质 DMC 的百分比。采用方差分析和 Student t 检验进行统计学分析。ART 组修复体下方的平均 DMC(98.93%)明显高于 UCT 组(91.98%),但与 CRT 组(91.33%)无差异。在多个表面上,轴向区域的平均 DMC(94.32%)明显高于龈方区域(92.80%)。UCT 组管理的开放窝洞的平均 DMC(89.05%)明显高于未治疗的开放窝洞(83.90%)。总之,在 ART 修复体下方观察到牙本质高矿化区域。用牙刷和含氟牙膏(UCT 方案)处理开放窝洞,窝洞下方的牙本质矿化程度高于未治疗的开放窝洞。