Department of Restorative Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey.
Department of Restorative Dentistry, Faculty of Dentistry, Yeniyüzyıl University, Istanbul, Turkey.
Clin Oral Investig. 2021 Dec;25(12):6871-6880. doi: 10.1007/s00784-021-03976-8. Epub 2021 May 12.
To investigate the practicability of atraumatic restorative treatment (ART) in adults in terms of marginal adaptation of restorations and microbiological changes in residual carious dentin.
The occlusal dentin caries of 25 permanent molar teeth were removed with hand instruments. The total counts of bacteria (TCB) and the facultative anaerobic bacteria (FAB), mutans streptococci (MS), and Lactobacillus spp. (LB) counts in the affected dentin were evaluated quantitatively. The weights of the samples were measured with an electronic balance (Shimadzu, Type AX200, Japan). The cavities were restored with glass ionomer cement (Ketac Molar Easymix, ESPE Dental AG, Seefeld, Germany). Twenty replicas of randomly selected ART restorations were prepared and marginal adaptation was evaluated by scanning electron microscopy (SEM). After 6 months, the same protocols were repeated. Data were analyzed with paired sample t-tests, Wilcoxon t-tests, Pearson and Spearman correlations, and chi-square tests (p<0.05).
In the sixth month, restoration loss and pulpitis were not observed. The mean weight of samples removed from the cavity floor was less than the baseline (0.014±0.009 and 0.023±0.013 g, respectively) (p<0.01), and the counts of total bacteria, FAB, MS, and LB significantly decreased compared to baseline (p<0.01). The frequency of marginal gaps was increased (p< 0.01).
ART showed that the counts of microorganisms decreased after 6 months although the marginal gap rates of restorations increased.
ART can be a reliable treatment approach in adults for 6 months due to the decrease in microorganism counts, although gaps exist.
研究非创伤性修复治疗（ART）在成年人中的实用性，评估其对修复体边缘适合性及残馀龋坏牙本质中微生物变化的影响。
使用手动器械去除 25 颗恒磨牙的窝沟龋坏。定量评估受影响牙本质中的总细菌数（TCB）、兼性厌氧菌（FAB）、变形链球菌（MS）和乳酸杆菌（LB）。用电子天平（Shimadzu，AX200 型，日本）测量样本重量。用玻璃离子水门汀（Ketac Molar Easymix，ESPE Dental AG，德国）修复窝洞。随机选择 20 个 ART 修复体进行复制，用扫描电子显微镜（SEM）评估边缘适合性。6 个月后重复相同的方案。采用配对样本 t 检验、Wilcoxon t 检验、Pearson 和 Spearman 相关分析及卡方检验进行数据分析（p<0.05）。
在第六个月，未观察到修复体脱落和牙髓炎。与基线相比，从窝洞底部取出的样本平均重量减少（分别为 0.014±0.009 和 0.023±0.013 g）（p<0.01），总细菌数、FAB、MS 和 LB 计数明显低于基线（p<0.01）。边缘间隙的频率增加（p<0.01）。
ART 显示，尽管修复体边缘间隙率增加，但 6 个月后微生物计数减少。
由于微生物计数减少，ART 可作为成年人 6 个月内可靠的治疗方法，尽管存在间隙。
