An ex vivo study on the correlation between lesion size and resin infiltration area in natural proximal subsurface carious lesions deproteinized with sodium hypochlorite

IF 4.8 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-06-05 DOI:10.1016/j.jdent.2025.105858

Ina B. Ulrich , Markus Pasztorek , Wilhelm Frank , Andrej M. Kielbassa

{"title":"An ex vivo study on the correlation between lesion size and resin infiltration area in natural proximal subsurface carious lesions deproteinized with sodium hypochlorite","authors":"Ina B. Ulrich , Markus Pasztorek , Wilhelm Frank , Andrej M. Kielbassa","doi":"10.1016/j.jdent.2025.105858","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This <em>ex vivo</em> study investigated the effects of pre-treatment either with or without a deproteinization procedure using a sodium hypochlorite (NaOCl) solution on percentage resin infiltration in natural non-cavitated proximal subsurface carious lesions of (pre)molars. Moreover, we studied whether a correlation exists between lesion size and infiltration area.</div></div><div><h3>Methods</h3><div>Extracted human premolars and permanent molars (<em>n</em> = 40 each) with macroscopically non-cavitated proximal subsurface carious lesions (ICDAS code 2/radiographic E2 and D1 lesions) were randomly divided into two groups. In Group 1 (control), the carious lesions underwent a standard resin infiltration protocol (deploying 15 % hydrochloric acid, 99 % ethanol, and Icon Caries Infiltrant). With the specimens of Group 2, a deproteinization step using 1 % NaOCl was applied prior to the standard infiltration procedure. Teeth were sectioned mesio-distally (perpendicular to their occlusal tooth surface and through the proximal lesion) and polished to the deepest lesion extension (as defined by DIAGNOdent). Total lesion sizes and infiltration areas were analyzed via confocal laser scanning micrographs. Paired data were submitted to linear regression analysis employing SPSS (v29.0).</div></div><div><h3>Results</h3><div>With the deproteinized specimens (Group 2), a significantly higher percentage of resin infiltration (<em>p</em> = .003) was observed, along with a strong positive correlation between lesion size and infiltrated area (<em>r</em> = .97; <em>p</em> < .001), if compared to Group 1 (<em>r</em> = .89; <em>p</em> < .001).</div></div><div><h3>Conclusions</h3><div>Deproteinization with NaOCl prior to resin infiltration significantly enhances the infiltrant’s penetration ability into non-cavitated carious lesions, resulting in a strong relationship between lesion size and infiltrated area.</div></div><div><h3>Clinical significance</h3><div>Deproteinization by means of NaOCl solution should be implemented as an integral step and key component to the standard infiltration protocol to significantly improve the resin infiltrant’s penetration ability into initial subsurface lesions.</div></div>","PeriodicalId":15585,"journal":{"name":"Journal of dentistry","volume":"160 ","pages":"Article 105858"},"PeriodicalIF":4.8000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of dentistry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0300571225003021","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

This ex vivo study investigated the effects of pre-treatment either with or without a deproteinization procedure using a sodium hypochlorite (NaOCl) solution on percentage resin infiltration in natural non-cavitated proximal subsurface carious lesions of (pre)molars. Moreover, we studied whether a correlation exists between lesion size and infiltration area.

Methods

Extracted human premolars and permanent molars (n = 40 each) with macroscopically non-cavitated proximal subsurface carious lesions (ICDAS code 2/radiographic E2 and D1 lesions) were randomly divided into two groups. In Group 1 (control), the carious lesions underwent a standard resin infiltration protocol (deploying 15 % hydrochloric acid, 99 % ethanol, and Icon Caries Infiltrant). With the specimens of Group 2, a deproteinization step using 1 % NaOCl was applied prior to the standard infiltration procedure. Teeth were sectioned mesio-distally (perpendicular to their occlusal tooth surface and through the proximal lesion) and polished to the deepest lesion extension (as defined by DIAGNOdent). Total lesion sizes and infiltration areas were analyzed via confocal laser scanning micrographs. Paired data were submitted to linear regression analysis employing SPSS (v29.0).

Results

With the deproteinized specimens (Group 2), a significantly higher percentage of resin infiltration (p = .003) was observed, along with a strong positive correlation between lesion size and infiltrated area (r = .97; p < .001), if compared to Group 1 (r = .89; p < .001).

Conclusions

Deproteinization with NaOCl prior to resin infiltration significantly enhances the infiltrant’s penetration ability into non-cavitated carious lesions, resulting in a strong relationship between lesion size and infiltrated area.

Clinical significance

Deproteinization by means of NaOCl solution should be implemented as an integral step and key component to the standard infiltration protocol to significantly improve the resin infiltrant’s penetration ability into initial subsurface lesions.

查看原文本刊更多论文

次氯酸钠脱蛋白自然近端龋下病变病灶大小与树脂浸润面积相关性的离体研究。

目的：本体外研究探讨了使用次氯酸钠（NaOCl）溶液进行脱蛋白预处理或不进行脱蛋白处理对（预）磨牙近端自然无空泡下龋病树脂浸润率的影响。此外，我们还研究了病变大小与浸润面积之间是否存在相关性。方法：拔牙的近端无空泡下龋（ICDAS代码2/ x线片E2和D1病变）的人前磨牙和恒磨牙（ = 各40颗）随机分为两组。在第1组（对照组），龋齿病变接受标准树脂浸润方案（部署15%盐酸，99%乙醇和Icon龋齿浸润剂）。对于第2组的标本，在标准浸润程序之前使用1% NaOCl进行脱蛋白步骤。对牙齿进行中远端（垂直于咬合牙面并穿过近端病变）切片，并抛光至最深的病变延伸（根据诊断仪的定义）。通过激光共聚焦扫描显微照片分析病变大小和浸润面积。配对数据采用SPSS （v29.0）进行线性回归分析。结果：2组脱蛋白标本树脂浸润率显著增高（p = .003），病变大小与浸润面积呈正相关(r = .97；p < .001)，与1组比较(r = .89；P < 0.001)。结论：树脂浸润前用NaOCl进行脱蛋白处理，可显著增强浸润物对非空化龋灶的渗透能力，导致病变大小与浸润面积有很强的相关性。临床意义：应将NaOCl溶液脱蛋白作为标准浸润方案不可或缺的步骤和关键组成部分，以显著提高树脂浸润剂对初始表面下病变的渗透能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.