Characteristics of secondary caries lesion around composite resin restorations

Abstract

Objetivo: O objetivo deste estudo foi analisar as características de cárie secundária e sua relação com a presença de restaurações com defeitos marginais como gap, degrau negativa (NL, a falta de material restaurador) e degrau positiva (PL, saliência). Materiais e Métodos: Oitenta superfícies proximais de restaurações de resina classe II foram fotografados e analisados utilizando um microscópio estereoscópico (X40). Foi registrada a presença de cáries secundárias externas, gaps, NL, PL e após a remoção de restaurações, a presença de lesão interna. Todos os exames foram realizados em 10 pontos bem definidos. Resultados: A prevalência de cárie secundária e gap foram associados com margem gengival. As restaurações com defeitos marginais (NL e PL) não foram associados a qualquer local específico (vestibular, lingual ou gengival). Observou-se uma relação entre esses defeitos com a prevalência de cárie secundária. A presença da lesão interna foi associada com lesão externa. Embora, em 141 pontos foi observada lesão interna, sem a presença de lesão externa. A maioria destas lesões mostraram envolvimento de esmalte interno. Apenas 8% tinham desmineralização restrito a dentina, que poderia sugerir cárie residuais.

Objective: The aim of this study was to analyze the features of secondary caries and their relationship with the presence of restorations marginal defects as gap, negative ledge (NL, lack of restorative material) and positive ledge (PL, overhang). Materials and methods: Eighty proximal surfaces of Class II resin restorations were photographed and analyzed using a stereomicroscope (X40). It was recorded the presence of external secondary caries, gaps, NL, PL and after the restorations removal, the presence of internal lesion. All the exams were done in 10 welldefined points. Results: The prevalence of secondary caries and gap were associated with gingival margin. The restorations marginal defects (NL and PL) were not associated with any specific location (buccal, lingual or gingival). It was observed a relationship between these defects with secondary caries prevalence (gap: p= 0.004; NL and PL: p= 0.017). This association could be explained by the biofilm accumulation usually observed in the interface tooth surface/ restoration marginal defects. The presence of internal lesion was associated with external lesion. Although, in 141 points was observed internal lesion without the presence of external lesion. The majority of these lesions showed internal enamel involvement. Only 8% had demineralization restricted to dentine, which could suggest residual caries. Conclusion: The results of this study showed that secondary caries lesion frequently began externally on the interface tooth/restoration, where diagnose, control and arrestment of the lesions is possible.