Purpose:

 This study's purpose was to describe the primary dentin reactions following restoration without complete removal of infected dentin.

 Methods:

 Fragments of carious dentin from 43 teeth with acute deep lesions were removed at baseline and compared to samples of carious dentin removed 60 days later, using scanning electron microscopy (SEM) photographs. At the follow-up periods (60 days 10-13 months), restorations were evaluated using US Public Health Service criteria and standardized radiographs. A postprocessing routine of radiographs was used to identify changes in radiographic density between periods.

 Results:

  At baseline, SEM photographs showed disorganized tissue and bacterial invasion. After 60 days, the dentin exhibited a better organization and signs of remineralization. Differences in restoration characteristics were detected for cavosurface discoloration (P=.008), wear (P<.001), and surface texture (P<.001) after 10 to 13 months. Digital subtraction radiographs showed that mean gray levels of carious and sound dentin increased after 10 to 13 months (P<.001). Differences in mean gray levels were detected between carious and sound dentin only for the 60-day images (P=.03).

 Conclusions:

  Removal of infected dentin wasn't fundamental for caries arrestment. Carious dentin tended to reorganize in a short period when properly sealed, and the remineralization process continued for longer periods. Correct diagnosis of pulp vitality seems fundamental for the success of this protocol.

 Source: Journal of American Academy of ‍ Pediatric Dentistry

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