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Microbiological and SEM assessment of atraumatic restorative treatment in adult dentition

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Abstract

Objectives

To investigate the practicability of atraumatic restorative treatment (ART) in adults in terms of marginal adaptation of restorations and microbiological changes in residual carious dentin.

Materials and methods

The occlusal dentin caries of 25 permanent molar teeth were removed with hand instruments. The total counts of bacteria (TCB) and the facultative anaerobic bacteria (FAB), mutans streptococci (MS), and Lactobacillus spp. (LB) counts in the affected dentin were evaluated quantitatively. The weights of the samples were measured with an electronic balance (Shimadzu, Type AX200, Japan). The cavities were restored with glass ionomer cement (KetacTM Molar Easymix, ESPE Dental AG, Seefeld, Germany). Twenty replicas of randomly selected ART restorations were prepared and marginal adaptation was evaluated by scanning electron microscopy (SEM). After 6 months, the same protocols were repeated. Data were analyzed with paired sample t-tests, Wilcoxon t-tests, Pearson and Spearman correlations, and chi-square tests (p<0.05).

Results

In the sixth month, restoration loss and pulpitis were not observed. The mean weight of samples removed from the cavity floor was less than the baseline (0.014±0.009 and 0.023±0.013 g, respectively) (p<0.01), and the counts of total bacteria, FAB, MS, and LB significantly decreased compared to baseline (p<0.01). The frequency of marginal gaps was increased (p< 0.01).

Conclusions

ART showed that the counts of microorganisms decreased after 6 months although the marginal gap rates of restorations increased.

Clinical relevance

ART can be a reliable treatment approach in adults for 6 months due to the decrease in microorganism counts, although gaps exist.

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Acknowledgements

The authors thank Prof. Dr. Guven Kulekci, Department of Oral Microbiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey, for comments to the microbiological data.

Funding

The work was supported by the Research Fund of Istanbul University, Istanbul, Turkey with Grant number 1432.

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Authors and Affiliations

  1. Department of Restorative Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey

    Meltem Tekbas Atay

  2. Department of Restorative Dentistry, Faculty of Dentistry, Yeniyüzyıl University, Istanbul, Turkey

    Fatma Koray

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Correspondence to Meltem Tekbas Atay.

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All procedures performed in studies involving human participants were in accordance with the ethical standards by the Local Ethics Committee, Faculty of Medicine, Istanbul University (ID: 2007/808) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Tekbas Atay, M., Koray, F. Microbiological and SEM assessment of atraumatic restorative treatment in adult dentition. Clin Oral Invest 25, 6871–6880 (2021). https://doi.org/10.1007/s00784-021-03976-8

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