Indirect pulp treatment: in vivo outcomes of an adhesive resin system vs calcium hydroxide for protection of the dentin-pulp complex.
OBJECTIVE
The purpose of this prospective and randomized in vivo study was to compare the clinical and radiographic outcomes of an adhesive resin system vs a calcium hydroxide liner for protection of the dentin-pulp complex of primary molars treated with indirect pulp treatment.


METHODS
Forty-eight primary molars with deep occlusal caries, but without preoperative signs and symptoms of irreversible pulpitis, received indirect pulp treatment and were restored with a composite resin (Z100). The teeth were randomly divided into 2 groups according to the material used for protection of the dentin-pulp complex: (1) adhesive resin system (Scotchbond MultiPurpose); and (2) calcium hydroxide liner (Dycal). These teeth were evaluated clinically and radiographicaly for 2 years.


RESULTS
After 2 years, 83% (19/23) of the teeth treated with calcium hydroxide and 96% (24/25) of teeth treated with only the adhesive resin system presented a successful outcome, as determined by clinical and radiographic examination. Interradicular and/or periapical lesions were the most predominant signs of treatment failure, since 3 out of 23 teeth treated with calcium hydroxide and 1 out of 25 teeth treated with only adhesive resin presented this outcome. One tooth treated with the calcium hydroxide liner was diagnosed with internal root resorption at the 18-month examination. Of the 5 teeth diagnosed from radiographs as a failure of the indirect pulp treatment, none presented clinical signs/symptoms of pulpitis or necrosis such as the presence of fistula, enhanced tooth mobility, or pain.


CONCLUSIONS
This study demonstrates that protection of the dentin-pulp complex of primary molars with an adhesive resin system results in similar clinical and radiographic 2-year outcomes as compared to calcium hydroxide when indirect pulp treatment is performed in Class I composite restorations.
Falster
Caline A
CA
Department of Pediatric Dentistry, School of Dentistry, Universidade Federal do Rio Grande do Sul, Brazil.
Araujo
Fernando B
FB
Straffon
Lloyd H
LH
Nör
Jacques E
JE
D002126:Calcium Hydroxide / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002675:Child, Preschool; D003188:Composite Resins; D003731:Dental Caries / Q000628:therapy; D003785:Dental Pulp Capping / Q000379:methods*; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods; D017220:Dentin-Bonding Agents / Q000627:therapeutic use*; D006801:Humans; D008903:Minerals / Q000627:therapeutic use*; D008963:Molar; D011446:Prospective Studies; D019279:Resin Cements / Q000627:therapeutic use*; D012822:Silicon Dioxide; D014094:Tooth, Deciduous; D016896:Treatment Outcome; D015040:Zirconium
D003188:Composite Resins; D017220:Dentin-Bonding Agents; D008903:Minerals; D019279:Resin Cements; C084018:Scotchbond Multi-Purpose; C083568:Z100 composite resin; C025702:Dycal; D012822:Silicon Dioxide; D015040:Zirconium; D002126:Calcium Hydroxide