Petta Thais de Mendonça, de Santana Adan Lucas Pantoja, Nunes Ana Karoline Oliveira, da Silva Rayka Nohara Furtado Gomes, Teles Giovana Monteiro, Pinheiro Helder Henrique Costa, Marques Marcia Martins, D'Almeida-Couto Roberta Souza
School of Dentistry, Federal University of Pará, Augusto Correa Avenue, no 1, Guamá, Belém, PA, 66075-110, Brazil.
School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
Clin Oral Investig. 2025 Mar 19;29(4):192. doi: 10.1007/s00784-025-06263-y.
This randomized clinical trial aimed to evaluate the effect of selective caries removal in deep cavities of posterior teeth associated or not by photobiomodulation (PBM) on postoperative sensitivity, pulp vitality, and dentin neoformation.
Twenty seven permanent molars with deep Class I cavities were allocated into three groups (n = 9): selective caries removal (Control), selective caries removal followed by infrared (IR; 810 nm) or red (R; 660 nm) laser irradiation. After the cavities were restored with a two-step self-etch adhesive and composite layers, the participants scored their tooth sensitivity perception on a visual analogue scale, as well as after 1, 3, and 6 months. Two teeth per group were randomly selected for cone beam computed tomography (CBCT) scanning upon restoration and after 6 months to evaluate the thickness, mineralization density, and area of neoformed dentin. The sensitivity scores among groups were statistically analyzed by the Friedman test (p < 0.05) while dentin neoformation aspects were descriptively compared.
All teeth remained vital, and the sensitivity mean scores were not significantly different among groups (p < 0.05). Most of the CBCT sections revealed dentin neoformation in all groups. The mineralization density of affected dentin and the remaining dentin area increased in all groups, albeit higher values were found in IR and R groups.
Selective removal of infected dentin followed by mild self-etch adhesive application and composite restoration was effective in maintaining pulp vitality, attenuating postoperative sensitivity, and dentin neoformation after 6 months. PBM therapy improved the mineralization density and area of neoformed dentin.
Selective caries removal in deep cavities is a regenerative, effective, safe, and simplified treatment that can be combined with photobiomodulation therapy to optimize dentin neoformation.
本随机临床试验旨在评估后牙深龋洞选择性去龋联合或不联合光生物调节（PBM）对术后敏感性、牙髓活力和牙本质新生的影响。
将27颗患有深I类洞的恒牙分为三组（n = 9）：选择性去龋（对照组）、选择性去龋后进行红外（IR；810nm）或红色（R；660nm）激光照射。在用两步自酸蚀粘合剂和复合层修复洞后，参与者在视觉模拟量表上对牙齿敏感性进行评分，分别在术后1个月、3个月和6个月进行评分。每组随机选择两颗牙齿在修复时和6个月后进行锥束计算机断层扫描（CBCT），以评估新形成牙本质的厚度、矿化密度和面积。组间敏感性评分采用Friedman检验进行统计学分析（p < 0.05），同时对牙本质新生方面进行描述性比较。
所有牙齿均保持活力，组间敏感性平均评分无显著差异（p < 0.05）。大多数CBCT切片显示所有组均有牙本质新生。所有组中，患牙本质的矿化密度和剩余牙本质面积均增加，尽管在IR组和R组中发现的值更高。
选择性去除感染牙本质，然后应用温和的自酸蚀粘合剂和复合修复，在维持牙髓活力、减轻术后敏感性和6个月后牙本质新生方面是有效的。PBM治疗改善了新形成牙本质的矿化密度和面积。
深龋洞的选择性去龋是一种再生、有效、安全且简化的治疗方法，可与光生物调节疗法联合使用以优化牙本质新生。
