The Microfloral Analysis of Secondary Caries Biofilm around Class I and Class II Composite and Amalgam Fillings

<p>Abstract</p> <p>Background</p> <p>Secondary caries is responsible for 60 percent of all replacement restorations in the typical dental practice. The diversity of the bacterial sources and the different types of filling materials could play a role in secondary caries. The aim of this study was to determine and compare the microbial spectrum of secondary caries biofilms around amalgam and composite resin restorations.</p> <p>Methods</p> <p>Clinical samples were collected from freshly extracted teeth diagnosed with clinical secondary caries. Samples were categorized into four groups according to the types of restoration materials and the classification of the cavity. Biofilms were harvested from the tooth-restoration interface using a dental explorer and after dilution were incubated on special agars. The bacteria were identified using the biochemical appraisal system. Statistical calculations were carried out using SPSS11.5 software to analyze the prevalence of the bacteria involved in secondary caries.</p> <p>Results</p> <p>Samples from a total of four groups were collected: two groups were collected from amalgam restorations, each had 21 samples from both Class I and Class II caries; and the other two groups were from composite resin restorations, each had 13 samples from both class I and class II caries. Our results showed: (1) Anaerobic species were dominant in both restoration materials. (2) In terms of the types of individual bacteria, no significant differences were found among the four groups according to the geometric mean of the detected bacteria (P > 0.05). However, there were significant differences among the detected bacteria within each group (P < 0.05). The composition of each bacterium had no statistical difference among the four groups (P > 0.05), but showed significant differences among the detected bacteria in each group (P < 0.05). (3) Among the four groups, there were no significant differences for the detection rate of each bacterium (P > 0.05), however, the detection rate of each bacterium within each group was statistically different among the detected bacteria (P < 0.05).</p> <p>Conclusions</p> <p>The proportion of obligatory anaerobic species was much greater than the facultative anaerobic species in the biofilm of secondary caries. Statistically, the materials of restoration and the location of secondary caries did not show any significant effects on the composition of the microflora.</p

Influence of the restoration quality on the success of pulpotomy treatment: a preliminary retrospective study Influência da qualidade da restauração sobre o sucesso da pulpotomia: estudo preliminar

The aim of this study was to evaluate the clinical status of pulpotomy treatment with calcium hydroxide and to correlate it with the quality of restoration of the treated teeth. Patients were retrieved from the files of the Operative Dentistry clinics (FOUFPel) between 1996 and 2000. Twenty-two patients were recalled, which had 23 teeth treated with pulpotomy due to exposure by caries. Seven anterior and 16 posterior teeth composed the evaluated group, being all restored with composite resin. The age varied from 15-50 years (mean 23.9) and the follow-up mean was 34.52 months. Clinical and radiographic examinations were performed to evaluate the clinical status of treatment. The criteria used, clinically favorable and failure, were based on the following clinical exams: pulp vitality; sensitivity; and periapical alterations. The quality of the restorations was based on the USPHS criteria. Pulpotomy treatment was ranked as clinically favorable in 10 teeth (43.5%), 4 in anterior and 6 in posterior teeth. Failure was verified in 13 teeth (56.5%), 4 anterior and 9 posterior. From the group clinically favorable, 90% of the restorations were ranked as clinically satisfactory, while only 10% were unsatisfactory. In the failure group, 77.8% of the restorations were classified was unsatisfactory and 22.2% were ranked as satisfactory. The statistical analysis (Fisher&acute;s exact test) demonstrated that there is a statistically significant association between the clinical status of pulpotomy and restoration quality (p<0.05). Within the limitation of the study, it was verified that the quality of restoration could influence the favorable clinical status of pulpotomized teeth. Randomized clinical trials are required to confirm these preliminary data.<br>O objetivo deste estudo foi avaliar a condição clínica de dentes submetidos à pulpotomia com hidróxido de cálcio, correlacionando com a qualidade das restaurações dos respectivos dentes. A partir dos prontuários da clínica de Odontologia Restauradora da FOUFPel, foram selecionados 22 pacientes (23 dentes) submetidos a pulpotomia entre 1996 e 2000. Ao todo, 23 dentes (7 anteriores e 16 posteriores) receberam o tratamento de pulpotomia, indicado devido à exposição por cáries, sendo que todas as restaurações foram confeccionadas com resina composta. A idade dos pacientes variou de 15-50 anos (média de 23,9 anos) e o tempo médio de acompanhamento das pulpotomias foi de 34,52 meses. Avaliações clínicas e radiográficas foram realizadas para a avaliação das pulpotomias. Ausência de hipersensibilidade, de alterações periapicais e teste de vitalidade pulpar positivo, eram as condições necessárias para que o tratamento fosse incluído no grupo "clinicamente favorável" utilizados para avaliar a condição clínica dos dentes tratados. Os critérios de avaliação clínica da USPHS foram utilizados para avaliar a qualidade das restaurações. Dez dentes (43,5%) receberam o escore clinicamente favorável, 4 anteriores e 6 dentes posteriores. O critério falha foi atribuído a 13 dentes (56,5%), 4 dentes anteriores e 9 posteriores. Entre os dentes do grupo clinicamente favorável, 90% das restaurações foram classificadas como clinicamente satisfatória, enquanto 10% estavam insatisfatórias. No grupo onde houve falha, 77,8% das restaurações foram classificadas como insatisfatória enquanto 22,2% foram classificadas como satisfatórias. A análise estatística (Teste exato de Fisher) demonstrou que existe uma associação estatisticamente significante entre a condição clínica da pulpotomia e a qualidade da restauração (p<0,05). Respeitando as limitações do estudo, é possível verificar que a qualidade da restauração pode ser um fator influente para uma condição clínica favorável de dentes tratados com pulpotomia. Estudos clínicos controlados são necessários para confirmar esses achados preliminares