30 June 2020

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Dental caries in primary molars: how to simplify the restoration

Alessandra Abbà

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Preservation of primary teeth is essential for oral health and for the maintenance of functions of chewing and speech. Nonetheless dental caries among children continues to be one of the major public health disease. To face this problem a variety of resin materials with different physical properties have been studied for use in primary dentition with the aim of time saving and simplification of the technique. One of this is the so-called “self-adhering composite resin” in a flowable composition. It can eliminate the need for a separate adhesive application reducing treatment time.
The purpose of this single blind randomized clinical study was to evaluate the 1year clinical performance of a self-adhering flowable composite and a commercially available self-etch adhesive / composite system in occlusal restorations of primary molars.  

Materials and methods
From March 2012 to September 2013, thirty-one children (10 male, 21 female between 4 and 9 years) were screened and enrolled for this study. The major inclusion criteria was having at least two occlusal primary caries lesions on primary molars in a split-mouth design with no involvement of the pulp. After the clinical and radiographic examination patients were treated with local anesthesia and rubber dam isolation and a randomly assigned restoration method by a pediatric dentist with a split-mouth design. Each child was treated by the same operator. All 31 patient received two different types of restorative treatment. A total of 62 occlusal cavities were restored with either a self-adhering flowable composite or a commercially available self-etch adhesive/composite system according to manufacturers' instructions. The restorations were clinically evaluated after 1 month, and after 3, 6 months and 1 year post-operatively using modified United States Public Health Service (USPHS) criteria for retention (R), color match (CM), marginal discoloration (MD), secondary caries (SC), wear (W), marginal adaptation (MA) and postoperative sensitivity (PS).  

Results
31 patients attended the 1st, 3rd and 6th months recall and 29 patients attended 1 year recall. Lack of retention was not observed in any of the restorations. None of the restorations had marginal discoloration and anatomic form loss on the 1 year follow-up. Restorations did not exhibit post-operative sensitivity at any evaluation period. There were no significant differences between the groups for retention, color match, marginal discoloration, secondary caries, wear, marginal adaptation, postoperative sensitivity after 1 month, 3 months, 6 months and 1 year.  

Conclusions
This study aimed to evaluate the clinical performance of a new self-adhering flowable composite for 1 year. Based on the findings of the present study, self-adhering flowable composite exhibited acceptable clinical results. This material, incorporating bonding agent, allows to save time and minimizes handling errors. Nonetheless there are limited studies about self-adhering flowable composite resin. 
According to the results of the study, self-adhering flowable composite resin can be used successfully in occlusal cavities of primary teeth.  

For additional information:  Clinical evaluation of a self-adhering flowable composite as occlusal restorative material in primary molars: one-year results