Clinical Evaluation of Three Different Caries Removals in Primary Teeth

Objectives: To evaluate the clinical performance and radiographic outcomes of glass ionomer cement in primary molars using three caries removal approaches. Methods: 273 students (344 teeth), aged 6-11 years were included. Subjects had 1 dentinal caries without sign and/or symptom of irreversible pulpitis. Radiographic examination and restoration were performed in the standard-equipped dental clinics. The selected teeth revealed dentinal caries on occlusal and/or proximal surface involved at least one-third of dentine but not exposed pulp with no any pathologic finding. The teeth were randomly divided into 3 study groups: group 1) partial soft caries removal only at DEJ by spoon excavation, group 2) all soft caries removal by spoon excavation (ART approach), and group 3) traditional caries removal by burs (control group). Cavity preparations were not extended to remove any adjacent intact fissures and were restored with glass ionomer cement (Fuji IX, GC Corp., Japan). Clinical and radiographic evaluations were carried out at 6 and 12 months after restorations. The restoration survivals were calculated by means of Kaplan-Meier and the Log Rank Test. Results: After 1 year, 87, 90, and 97 students in group 1, 2 and 3 were evaluated. The cumulative survival rate of GI restoration in group 1, 2 and 3 after 12 months were 83.5%, 80.7%, and 90.2% respectively, with no statistical significant (p=.148). The mean survival time of restoration in group 1, 2 and 3 were 11.38 (0.18), 11.45 (0.17) and 11.8 (0.11) months. Only one tooth with cracked GI restoration in group 1 revealed caries progression. Two teeth in group 3 presented pulp degeneration. No pathologic lesion was seen in group 2. Conclusion: Clinical and radiographic evaluation after 1-yr restoration showed that incomplete infected dentine removal only at DEJ followed by glass ionomer cement, fluoride releasing restoration, is comparable to ART and traditional approaches.