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04.11.2019 | Original Article

Four-year clinical prospective follow-up of resin composite restoration after selective caries removal using Er:YAG laser

verfasst von: Rodrigo Alexandre Valério, Rodrigo Galo, Daniel Galafassi, Silmara Aparecida Milori Corona, Maria Cristina Borsatto

Erschienen in: Clinical Oral Investigations | Ausgabe 7/2020

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Abstract

Objectives

The aim of this study was to longitudinally evaluate, after a 4-year period, the clinical longevity of composite resin restoration compared to the baseline, after selective caries removal in permanent molars using Er:YAG laser or bur preparation with biomodification of dentin with the use of chlorhexidine.

Methods

Selective caries removal was performed on 80 teeth of 20 individuals who each had at least four active carious lesions. These lesions, located on occlusal surfaces of permanent molar counterparts, were removed using (i) Er:YAG laser biomodified with chlorhexidine, (ii) Er:YAG laser and application of deionized water, (iii) bur preparation biomodified with chlorhexidine, and (iv) bur preparation and application of deionized water. At the end of 4 years, 64 of the 80 restorations were evaluated in 16 individuals (n = 16). The restorations were evaluated, both clinically and photographically, using scanning electron microscopy (SEM) and pulp vitality analysis. The experimental data were statistically evaluated by kappa, Fisher’s, and chi-square tests, with a significance level of 5%. The Kaplan–Meier test and the Cox regression analysis were used to evaluate the survival of the restorations.

Results

After 4 years of follow-up, there was a statistically significant difference in marginal discoloration criteria for all of the groups evaluated. For marginal adaptation criteria, there was a statistically significant difference for the Er:YAG laser group biomodified with chlorhexine (p = 0.050). For clinical and radiographic evaluation of pulp vitality, there were no statistically significant differences among the groups (p = 0.806).

Conclusion

Er:YAG laser can be used for selective caries removal, regardless of dentin biomodification with chlorhexidine or application of deionized water, once it produced promising results in composite resin restorations after 4 years of follow-up, according to the criteria evaluated. The selective caries removal using Er:YAG laser or bur and the biomodification of dentin with the use of chlorhexidine did not influence the survival of composite resin restorations after the 4-year follow-up period.

Clinical relevance

Composite resin restorations applied after selective caries removal using Er:YAG laser or burs, regardless of dentin biomodification with the use of chlorhexidine or application of deionized water, showed adequate clinical behavior after 4 years of follow-up.

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Titel: Four-year clinical prospective follow-up of resin composite restoration after selective caries removal using Er:YAG laser
verfasst von: Rodrigo Alexandre Valério
Rodrigo Galo
Daniel Galafassi
Silmara Aparecida Milori Corona
Maria Cristina Borsatto
Publikationsdatum: 04.11.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 7/2020
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-03082-w

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Four-year clinical prospective follow-up of resin composite restoration after selective caries removal using Er:YAG laser