Clinical evaluation of three caries removal approaches in primary teeth: a randomised controlled trial.

OBJECTIVE: To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques. BASIC RESEARCH DESIGN: Randomised clinical controlled trial. CLINICAL SETTING: Two standard dental clinics in 2 hospitals near Bangkok. PARTICIPANTS: A total of 276 children, aged 6-11, having dentinal caries on the occlusal and/or proximal surface extending at least one-third of dentine without signs and/or symptoms of irreversible pulpitis. INTERVENTION: Children were randomly allocated into 3 study groups with different caries removal techniques: Group 1, partial soft caries removal at enamel-dentine junction (EDJ) by spoon excavation; Group 2, complete soft caries removal by spoon excavation; and Group 3, conventional caries removal by steel burs. All cavity preparations were restored with GIC (Fuji IX, GC Corp., Japan). MAIN OUTCOME MEASURES: Clinical and radiographic evaluations were carried out at 6 and 12 months after restoration. RESULTS: After 12 months, 89, 89, and 88 restorations in Groups 1, 2 and 3 were evaluated. The cumulative survival rates of GIC restorations in Groups 1, 2 and 3 were 83%, 83%, and 89% while the cumulative survival rates of pulp were 99%, 100% and 98% respectively. There were no statistically significant differences in the survival of GIC restorations or pulp in the three groups (p > 0.05). CONCLUSION: The clinical and radiographic evaluations after 12 months indicated that partial soft caries removal at EDJ followed by GIC restoration was comparable to that of ART and conventional approaches.

The effect of different milk formulas on dental plaque pH.

OBJECTIVES: The purposes of this study were (1) to investigate the effect of different milk formulas on dental plaque pH after rinsing with these three categories, type of protein-based formulas (milk-based, soy-based, protein hydrolysate), type of sugar (only lactose, lactose and other sugars, only non-milk extrinsic sugars), and casein ratio (high and low casein), and (2) to observe organic acids formed by different milk formulas. METHODS: Baseline plaque pH and plaque pH at 2, 5, 10, 15, 20, 25, 30, and 60 min after rinsing with milk formulas were recorded by a combination electrode in 14 healthy subjects. Deionized water and 10% sucrose were used as a negative and positive control. The plaque sample was also analysed to identify and quantify the organic acids using a high-performance liquid chromatography. Parameters including minimum pH, maximum pH drop, and area under curve were compared by RMANOVA and paired t-test. RESULTS: The minimum pH was not significantly different among different protein-based formulas, whereas, the maximum plaque pH drop of soy-based and milk-based formula was significantly higher than that produced by protein hydrolysate formula (P=0.022 and 0.03, respectively). Area under curve produced by soy-based and milk-based formulas was significantly larger than that created by protein hydrolysate formula (P=0.025 and<0.001, respectively). Milk formulas containing only lactose caused significantly less plaque pH change in minimum pH (P<0.001), maximum pH drop (P=0.003), and area under curve (P<0.001) when compared with formulas containing lactose and other sugar but not with special formulas containing only non-milk extrinsic sugar. Similarly, special formulas containing non-milk extrinsic sugar produced significantly lower minimum pH and smaller area under curve than formulas containing lactose and other sugar did (P=0.044 and 0.009, respectively). No different results were found between high and low casein follow-on formulas. Lactic acid was produced more by rinsing with formulas containing lactose and other sugars than that produced by formulas containing only lactose. CONCLUSIONS: This study suggests that milk formulas containing added other sugars tend to cause a decrease in plaque pH.