Non-invasive proximal adhesive restoration of natural non-cavitated proximal lesions.

PURPOSE: To investigate the infiltration potential of different self-etch adhesives into natural non-cavitated proximal lesions and the effect of dehydration protocol on the infiltration of a self-etch adhesive. METHODS: 29 extracted molars and premolars with natural proximal lesions (ICDAS 1-2) were sectioned through the lesion providing two samples from each lesion. To compare the different adhesives, three groups of eight lesions were abraded with fine metallic strips and then etched with 37% H3PO4 acid for 120 seconds. All teeth were stained with rhodamine isothiocyanate. After drying with compressed air and ethanol application, lesions were infiltrated with Scotchbond Universal, Clearfil SE Protect or OneCoat 7 Universal for 180 seconds and then coated with a thin layer of flowable composite (Tetric Flow). To compare the effect of dehydration protocol on infiltration, two groups of nine paired lesions were pretreated as described above. One group was dried using compressed air alone and the second group was dried using compressed air and ethanol, both groups were then infiltrated with Scotchbond Universal then coated with a thin film of flowable composite. After light curing, un-encapsulated dye was bleached by immersion in hydrogen peroxide. Remaining lesion pores were stained with sodium fluorescein solution. Thin cuts of the teeth were observed with confocal microscopy and computer image analysis was performed (ImageJ). RESULTS: ANOVA and Duncan post-hoc tests showed no significant differences of the infiltrated area between the three adhesives (P= 0.835), no significant difference was found between the group dried with air compared to the one dried with air and ethanol. It can be concluded that the tested adhesives may be used for infiltration of natural lesions following the described pretreatment. CLINICAL SIGNIFICANCE: Enamel pretreatment with metallic strip and 37% H3PO4 acid promotes the infiltration of different adhesives into natural non-cavitated caries lesions.

Non-invasive proximal adhesive restoration (NIPAR) compared to resin infiltration for treating initial proximal carious lesions.

PURPOSE: To compare a new technique of non-invasive proximal adhesive restoration (NIPAR) to the infiltration concept technique (ICON). METHODS: Extracted human posterior teeth with non-cavitated proximal carious lesions (ICDAS code 1-2) were cut vertically to obtain two symmetrical lesions. Group 1 (NIPAR):Half of the paired lesions surfaces (n=13) were abraded with metallic strips and etched with 37% H3PO4 for 120 seconds. Group 2 (ICON):The other half of the paired lesions' surfaces (n=13) were etched with 15% HCl gel for 120 seconds. All samples were then stained with rhodamine isothiocyanate (RITC). After ethanol drying and isolation of the cut surface, Group 1 samples were infiltrated with Scotchbond Universal for 180 seconds and coated with a thin film of Tetric flow. Group 2 samples were infiltrated with ICON infiltrant following manufacturer's instructions. After light curing, unbound rhodamine was bleached by immersion in 30% hydrogen peroxide for 12 hours. Remaining lesion pores were stained with sodium fluorescein solution. Samples were observed with confocal microscopy (CLSM) and the percentage of infiltration (area of resin infiltration/area of total demineralization ×100) was calculated using ImageJ. RESULTS: 11 samples out of 13 showed larger infiltrated area of the lesions in Group 1 (NIPAR) compared to Group 2 (ICON). Statistical analysis revealed a significant difference between the two groups (P< 0.05). Within the limitations of this study, NIPAR allowed for better infiltration of non-cavitated proximal carious lesions when compared to ICON. CLINICAL SIGNIFICANCE: The combination of infiltration and sealing using non-invasive proximal adhesive restoration (NIPAR) offers a suitable non-invasive treatment option for non-cavitated proximal lesions combining the advantages of sealing and infiltration.