Key Points
-
Partial caries removal in primary teeth, lining with BCC and restoration with GIC showed poor durability over a 2-year period.
-
Such restorations, however, demonstrated no significant progression in the carious process.
-
Partial caries removal and restoration with GIC demonstrated comparable durability with and effectiveness as, complete caries removal and restoration over a 2-year period.
-
Further research is required on partial caries removal and the use of cariostatic materials.
Abstract
Objective To determine the durability and effectiveness of a black copper cement (BCC) and a conventional glass ionomer cement (GIC) when used to restore primary molars following partial caries removal (PCR) and to compare these results with conventional cavity preparation and restoration.
Design Split-mouth randomised controlled clinical trial.
Setting Department of Paediatric Dentistry, Dundee Dental Hospital, Dundee, 1998–1999.
Subjects Patients with previously unrestored, matched carious cavities in non-pulpally involved primary molars.
Interventions Three treatment groups: (1) Partial caries removal followed by lining with BCC and restoration with GIC (PCR:BCC); (2) Partial caries removal and restoration with GIC alone (PCR:GIC), and (3) Complete caries removal and conventional restoration (CR). Restoration durability and effectiveness was assessed both clinically and radiographically over 24 months.
Main outcome measures Median survival time (MST) of restorations.
Results Forty-four patients (F: 31; M: 13), mean age 6.8 years (range: 3.7–9.5), had 120 restorations placed (PCR:GIC: 43; CR: 41; PCR:BCC: 36). Eighty-six molars (29 patients) (PCR:GIC: 30; CR: 29; PCR:BCC: 27) were reviewed at 24 months. The median survival times (MST) with 25% and 75% quartiles in parenthesis were as follows: PCR:BCC, MST = 24 months (6, 24); PCR:GIC, MST = 24 months (24, 24) and CR, MST = 24 months (24, 24). The MST for PCR:BCC restorations was significantly less than for PCR:GIC and CR restorations (W = 1163.5, P = 0.028 and W = 1081.0, P = 0.004 respectively).
Conclusion There were no differences in the proportions of restorations lost between restoration types, although PCR:BCC restorations did have significantly more abscess/sinus formation over the 24-month study period.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Tickle M, Milsom D, King D, et al. The fate of the carious primary teeth of children who regularly attend the general dental service. Br Dent J 2002; 192: 219–223.
Levine RS, Pitts NB, Nugent Z . The fate of 1,587 unrestored carious deciduous teeth: a retrospective general dental practice based study from northern England. Br Dent J 2002; 193:99–103.
Welbury RR, Walls AW, Murray JJ, et al. The 5-year results of a clinical trial comparing a glass polyalkenoate (ionomer) cement restoration with an amalgam restoration. Br Dent J 1991; 170: 177–181.
Roberts JF, Sherriff M . The fate and survival of amalgam and preformed crown molar restorations placed in a specialist paediatric dental practice. Br Dent J 1990; 169: 237–244.
Ostlund J, Moller K, Koch G . Amalgam, composite resin and glass ionomer cement in Class II restorations in primary molars — a three year clinical evaluation. Swed Dent J 1992; 16: 81–86.
Randall RC, Vrijhoef MM, Wilson NH . Efficacy of preformed metal crowns vs. amalgam restorations in primary molars: a systematic review. J Am Dent Assoc 2000; 131: 337–343.
Pitts NB, Nugent ZJ, Smith PA . Scottish Health Boards' Dental Epidemiological Programme. Report of the 1999-2000 survey of 5 year old children. Dundee: University of Dundee, 2000.
Bedi R, Sutcliffe P, Donnan PT, et al. The prevalence of dental anxiety in a group of 13- and 14-year-old Scottish children. Int J Paediatr Dent 1992; 2: 17–24.
Welbury RR, Shaw AJ, Murray JJ, et al. Clinical evaluation of paired compomer and glass ionomer restorations in primary molars: final results after 42 months. Br Dent J 2000; 189: 93–97.
Mertz-Fairhurst EJ, Schuster GS, Fairhurst CW . Arresting caries by sealants: results of a clinical study. J Am Dent Assoc 1986; 112: 194–197.
Jensen OE, Handelman SL . Effect of an autopolymerizing sealant on viability of microflora in occlusal dental caries. Scand J Dent Res 1980; 88: 382–388.
Kreulen CM, de Soet JJ, Weerheijm KL, et al. In vivo cariostatic effect of resin modified glass ionomer cement and amalgam on dentine. Caries Res 1997; 31: 384–389.
Going RE, Loesche WJ, Grainger DA, et al. The viability of microorganisms in carious lesions five years after covering with a fissure sealant. J Am Dent Assoc 1978; 97:455–462.
Handelman SL, Leverett DH, Solomon ES, et al. Use of adhesive sealants over occlusal carious lesions: radiographic evaluation. Community Dent Oral Epidemiol 1981;9: 256–259.
Weerheijm KL, Kreulen CM, de Soet JJ, et al. Bacterial counts in carious dentine under restorations: 2-year in vivo effects. Caries Res 1999; 33: 130–134.
Smirnow MR . Copper cements. Dent Cosmos 1915; 57: 1209.
Duguid R . Copper-inhibition of the growth of oral streptococci and actinomyces. Biomaterials 1983; 4: 225–227.
Grytten J, Aamdal Scheie A, Afseth J . Effect of a combination of copper and hexetidine on the acidogenicity and copper accumulation in dental plaque in vivo. Caries Res 1988; 22: 371–374.
Rosalen PL, Bowen WH, Pearson SK . Effect of copper co-crystallized with sugar on caries development in desalivated rats. Caries Res 1996; 30: 367–372.
Hintze J . NCSS and PASS. Number Cruncher Statistical Systems. 2001, Kaysville, Utah: USA.
Holland IS, Walls AW, Wallwork MA et al. The longevity of amalgam restorations in deciduous molars. Br Dent J 1986; 161: 255–258.
Dawson LR, Simon JF Jr, Taylor PP . Use of amalgam and stainless steel restorations for primary molars. ASDC J Dent Child 1981; 48: 420–422.
Wong FS, Day SJ . An investigation of factors influencing the longevity of restorations in primary molars. J Int Assoc Dent Child 1990; 20: 11–16.
Qvist V, Laurberg L, Poulsen A, et al.Longevity and cariostatic effects of everyday conventional glass- ionomer and amalgam restorations in primary teeth: three-year results. J Dent Res 1997; 76: 1387–1396.
Crowell WS . Physical Chemistry of Dental Cements. J Am Dent Assoc 1927; 1030–1048.
Foley J . Black copper phosphate cement: does it have a future? Eur J Pros Rest Dent 2001; 9: 67–71.
Sewerin I . Frequency and distribution of proximal overlappings on posterior bitewing radiographs. Community Dent Oral Epidemiol 1981; 9: 69–73.
Pitts NB . Systems for grading approximal carious lesions and overlaps diagnosed from bitewing radiographs. Proposals for future standardization. Community Dent Oral Epidemiol 1984; 12: 114–1122.
Mertz-Fairhurst EJ, Schuster GS, Williams JE, et al. Clinical progress of sealed and unsealed caries. Part I: Depth changes and bacterial counts. J Prosthet Dent 1979; 42: 521–526.
Mertz-Fairhurst EJ, Schuster GS, Williams JE, et al. Clinical progress of sealed and unsealed caries. Part II: Standardized radiographs and clinical observations. J Prosthet Dent 1979; 42: 633–637.
Handelman SL, Leverett DH, Espeland MA, et al. Clinical radiographic evaluation of sealed carious and sound tooth surfaces. J Am Dent Assoc 1986; 113: 751–754.
Handelman SL, Washburn F, Wopperer P . Two-year report of sealant effect on bacteria in dental caries. J Am Dent Assoc 1976; 93:967–970.
Grondahl HG . Some factors influencing observer performance in radiographic caries diagnosis. Swed Dent J 1979; 3: 157–172.
Pitts NB . The use of film holding, beam collimating and aiming devices in bitewing radiography. A suggested design for routine and research use. Dentomaxillofac Radiol 1983; 12: 77–82.
Handelman SL, Leverett DH, Espeland M . et al. Retention of sealants over carious and sound tooth surfaces. Community Dent Oral Epidemiol 1987; 15: 1–5.
Acknowledgements
This study was funded by a Tattersall Scholarship, University of Dundee and the Carnegie Trust for the Universities of Scotland. Professors Robin Prescott and David Stirrups are thanked for their assistance with this study.
Author information
Authors and Affiliations
Corresponding author
Additional information
Refereed Paper
Rights and permissions
About this article
Cite this article
Foley, J., Evans, D. & Blackwell, A. Partial caries removal and cariostatic materials in carious primary molar teeth: a randomised controlled clinical trial. Br Dent J 197, 697–701 (2004). https://doi.org/10.1038/sj.bdj.4811865
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.bdj.4811865
This article is cited by
-
Selective removal to soft dentine or selective removal to firm dentine for deep caries lesions ın permanent posterior teeth: a randomized controlled clinical trial up to 2 years
Clinical Oral Investigations (2022)
-
Restorative thresholds for carious lesions in primary molars: French dentist’s decisions
European Archives of Paediatric Dentistry (2021)
-
The effect of different liners on the bond strength of a compomer to primary teeth dentine: in vitro study
European Archives of Paediatric Dentistry (2021)
-
Selective Caries Removal in Permanent Teeth (SCRiPT) for the treatment of deep carious lesions: a randomised controlled clinical trial in primary care
BMC Oral Health (2021)
-
One-step partial or complete caries removal and bonding with antibacterial or traditional self-etch adhesives: study protocol for a randomized controlled trial
Trials (2016)
