Histological determination of cariously altered collagen after dentin caries excavation with the polymer bur PolyBur P1
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RESEARCH
Open Access
Histological determination of cariously altered collagen after dentin caries excavation with the polymer bur PolyBur P1 in comparison to a conventional bud bur Jeannine Lohmann1, Edgar Schäfer2 and Till Dammaschke3*
Abstract Background: To compare the polymer bur PolyBur P1 (P1) with tungsten carbide bud bur H1 SE (H1) in removing cariously altered collagen during dentin caries excavation. Methods: Fifty extracted teeth were split in the center of a carious lesion. The 100 specimens were randomly divided into 5 groups. Five dentists were asked to excavate 10 teeth each: one half with P1 and the corresponding half with H1. The time needed for caries excavation was measured. Subsequently, histological specimens were produced and analyzed by light-microscope after Mallory-Azan-staining. The thickness of remaining cariously altered collagen was measured (< 1 mm or > 1 mm). The results were statistically evaluated. Results: The average time to excavate a cavity with P1 was 254 (± 148) sec and 202 (± 129) sec with H1. The difference in times was not statistically significant (p > 0.05). In the group P1 in 66.1% of the sections cariously altered collagen remained, whereas 33.9% showed sound collagen. In the group H1 45.7% sections had remaining cariously altered collagen and 54.3% showed sound collagen. The difference between P1 and H1 was statistically significant (p = 0.004). In the group P1 the layer of cariously altered collagen was significantly more often thicker than 1 mm than in the group H1 (p < 0.05). The variable “type of bur” had a statistically significant influence for the presence of cariously altered collagen (p = 0.003). Conclusions: Conventional H1 bud burs were significantly more effective in removing cariously altered collagen during dentin caries excavation than the polymer bur P1. Keywords: Bud bur, Caries excavation, Collagen, Dentin, PolyBur P1, Polymer bur
Background The modern concept of “minimal-invasive dentistry” calls for more conservative elimination of bacterially infected and irreversibly demineralized carious dentin, in order to preserve as much as possible remineralizable dentin and avoid pulp exposure [1]. The search for a less aggressive, comfortable, and conservative * Correspondence: [email protected] 3 Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, building W 30, 48149 Münster, Germany Full list of author information is available at the end of the article
caries excavation has led to the development of methods which aim at removal of infected dentin only [2]. By removing just the bacterially infected dentin, it should be possible to arrest further progression of the carious lesion. However, there still exist concerns about where to define this caries removal endpoint, because this is hardly achievable clinically [1, 3]. One criterion to distinguish between remineralizable and non-remineralizable dentin may be the hardness of this tissue [1]. The hardness of healthy dentin is between 51
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