Abstract

Minimal invasive procedures in management of deep carious lesions have been the focus of researchers in the recent years. Minimal invasive procedures and the use of calcium silicate cements can maintain vitality in the compromised vital pulps by caries and trauma by providing good seal and enhancing favourable response and healing potential of the pulp to the injury in order to avoid the detrimental effect of devitalisation of teeth. The effectiveness of an innovative minimally invasive indirect clinical pulp protection technique (including CarisolvTM gel chemo mechanical system and an operating microscope) compared to a control protocol (rotary burs with no magnification)  in preserving pulp vitality in symptomatic teeth in patients presenting with signs/symptoms of reversible pulpitis has been tested clinically over a period of one year follow up accompanied by a comprehensive detection of the microbiome associated with those deep carious dentine lesions. The excavation process alongside the restorative materials could have an influence on the infectivity and activity of the remaining bacteria in the dentine, by affecting their ecological stress factors like pH, oxygen and nutrients. A randomised controlled clinical trial was undertaken which involved recruiting patients with signs of reversible pulpitis. Standardised clinical and radiographic investigations involving CBCT and PA radiographs at baseline and one-year follow-up were used to assess pulp pathology (presence/absence of PA radiolucencies). Bacterial load and composition of the bacterial flora were assessed using non-culture-based DNA extraction, qPCR and sequencing of the 16S rRNA gene by using next-generation high throughput sequencing.

Keywords

CarisolvTM gel; Radiolucencies