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  • Title: Effect of open-sandwich vs. adhesive restorative techniques on enamel and dentine demineralization: an in situ study.
    Author: Kirsten GA, Rached RN, Mazur RF, Vieira S, Souza EM.
    Journal: J Dent; 2013 Oct; 41(10):872-80. PubMed ID: 23851134.
    Abstract:
    OBJECTIVES: To assess in situ the effect of different restorative techniques used with fluoride-releasing materials on enamel and dentine demineralization in the presence of a cariogenic challenge. METHODS: Thirty human molars were prepared for 60 Class V cavities, with enamel and dentine margins. The teeth were divided into four groups (n=15): L1 - open sandwich technique with a conventional glass ionomer cement (GIC), L2 - open sandwich technique with a resin-modified GIC, A1 - total-etch bonding with a fluoride-containing adhesive, A2 - total-etch bonding with a nonfluoride-containing adhesive. All the cavities were restored with a nanofilled composite. Fifteen volunteers used appliances containing one specimen from each group. The cariogenic challenge was carried out with a 20% sucrose solution 8×/day for 7 days. The specimens were sectioned for microhardness test and EDS analysis at different depths below the enamel and dentine margins (25, 50 and 100μm) and distances from the tooth-restoration interfaces (25 and 75μm). The data were analyzed by ANOVA and Games-Howell test (α=5%). RESULTS: Both GICs produced higher hardness in enamel at all depth-and-distance combinations, but only L1 produced higher hardness in dentine (p<0.05). L2 and A1 exhibited similar dentine hardness at 25μm distance for all depths (p>0.05). L1 demonstrated significantly higher amounts of calcium in dentine than the other groups, but had similar amounts in enamel to L2 and A1. CONCLUSIONS: The open sandwich technique using conventional GIC proved more effective in reducing enamel and dentine demineralization at depths of up to 100μm under a cariogenic challenge. CLINICAL SIGNIFICANCE: Conventional GICs should be considered the materials of choice for lining of cavities not having all margins in enamel, particularly using the open sandwich technique.
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