title: A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth.
abstract: OBJECTIVE
  The purpose of this project was to evaluate the performance of a dentin adhesive system on carious and noncarious primary dentin in vivo.
  
  
  METHODS
  Forty-eight primary molars with carious lesions were randomly assigned to 2 different treatments: group 1 (control, n = 24)--All identifiable, irreversibly infected dentin was removed prior to the application of the bonding agent and restorative material; group 2 (experimental, n = 24)--Irreversibly infected dentin was partially removed prior to the application of the bonding agent and restorative material. The control and experimental teeth were clinically monitored every 3 months and evaluated 12 months after restoration. The teeth were extracted around the time of exfoliation and processed for scanning electron microscopy.
  
  
  RESULTS
  Retention rate, marginal integrity, and pulpal symptoms were identical in both groups. Radiographically, the radiolucent area associated with the experimental restorations did not increase with time in 75% of the cases. For the control group, the adhesive system formed a hybrid layer. In the experimental group, there was morphologic evidence of the formation of an acid-resistant "altered hybrid layer." An acid-resistant tissue, resulting from the interdiffusion of adhesive resin within the area of carious dentin, was observed adjacent to and under the altered hybrid layer.
  
  
  CONCLUSIONS
  Application of an adhesive restorative system to irreversibly infected dentin did not affect the clinical performance of the restoration.
authors.affiliation: Department of Pedodontics, Federal University of Maranhão, School of Dentistry, São Luís, Brazil.
authors.forename: C C
authors.initials: CC
authors.lastname: Ribeiro
authors.forename: L N
authors.initials: LN
authors.lastname: Baratieri
authors.forename: J
authors.initials: J
authors.lastname: Perdigão
authors.forename: N M
authors.initials: NM
authors.lastname: Baratieri
authors.forename: A V
authors.initials: AV
authors.lastname: Ritter
mesh_terms: D002648:Child; D003188:Composite Resins; D003731:Dental Caries / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000379:methods*; D017220:Dentin-Bonding Agents; D005260:Female; D006801:Humans; D008297:Male; D008963:Molar; D019279:Resin Cements; D012822:Silicon Dioxide; D014094:Tooth, Deciduous / Q000473:pathology*; D016896:Treatment Outcome; D015040:Zirconium
chemical_list: D003188:Composite Resins; D017220:Dentin-Bonding Agents; D019279:Resin Cements; C084018:Scotchbond Multi-Purpose; C083568:Z100 composite resin; D012822:Silicon Dioxide; D015040:Zirconium