Current concepts in conservative dentistry advocate minimally invasive dentistry and pulp vitality preservation. Moreover, complete removal of carious dentin in deep carious lesions often leads to pulp exposure and root canal treatment, despite the absence of irreversible pulp inflammation. For years, partial caries removal has been performed on primary teeth, but little evidence supports its effectiveness for permanent teeth. Furthermore, the recent development of new antibacterial adhesive systems could be interesting in the treatment of such lesions. The objectives of this study are to compare the effectiveness of partial versus complete carious dentin removal in deep lesions (primary objective) and the use of an antibacterial versus a traditional two-step self-etch adhesive system (main secondary objective). The DEep CAries Treatment (DECAT) study protocol is a multicenter, randomized, controlled superiority trial comparing partial versus complete caries removal followed by adhesive restoration. The minimum sample size required is 464 patients. Two successive randomizations will be performed (allocation ratio 1:1): the first for the type of excavation (partial versus complete) and the second (if no root canal treatment is required) for the type of adhesive (antibacterial versus traditional). For the two objectives, the outcome is the success of the treatment after 1 year, measured according to a composite outcome of five FDI criteria: material fracture and retention, marginal adaptation, radiographic examination (including apical pathologies), postoperative sensitivity and tooth vitality, and carious lesion recurrence. The study will investigate the interest of a conservative approach for the management of deep carious lesions in terms of dentin excavation and bioactive adhesive systems. The results may help practitioners achieve the most efficient restorative procedure to maintain pulp vitality and increase the restoration longevity. ClinicalTrials.gov Identifier NCT02286388 . Registered in November 2014.

The aim of this study was to assess the effect of radiotherapy on bond efficiency of two different adhesive systems using tensile bond strength test. Twenty extracted teeth after radiotherapy and twenty nonirradiated extracted teeth were used. The irradiation was appliedin vivoto a minimal dose of 50 Gy. The specimens of each group were randomly assigned to two subgroups to test two different adhesive systems. A three-step/etch-and-rinse adhesive system (Optibond FL) and a two-steps/self-etch adhesive system (Optibond XTR) were used. Composite buildups were performed with a nanohybrid composite (Herculite XTR). All specimens were submitted to thermocycling ageing (10000 cycles). The specimens were sectioned in 1 mm²sticks. Microtensile bond strength tests were measured. Nonparametric statistical analyses were performed due to nonnormality of data. Optibond XTR on irradiated and nonirradiated teeth did not show any significant differences. However, Optibond FL bond strength was more effective on nonirradiated teeth than on irradiated teeth. Within the limitations of anin vitrostudy, it can be concluded that radiotherapy had a significant detrimental effect on bond strength to human dentin. However, it seems that adhesive choice could be adapted to the substrata. According to the present study, the two-steps/self-etch (Optibond XTR) adhesive system tested could be more effective on irradiated dentin compared to three-steps/etch-and-rinse adhesive system (Optibond FL).

The aim of this work was to characterize the initial wear kinetics of two different types of glass ionomer cement used in dentistry (the conventional glass ionomer cement and the resin-modified glass ionomer cement) under sliding friction after 28-day storing in distilled water or Ringer’s solution. Sliding friction was applied through a pin-on-disk tribometer, in sphere-on-plane contact conditions, under 5 N normal load and 120 rotations per minute. The test lasted 7500 cycles and replicas were performed at 2500, 5000 and 7500 cycles. A profilometer was used to evaluate the wear volume. Data were analysed using Student’st-test at a significant level of 5%. There is no statistical significant difference between the results obtained for a given material with the maturation media (P>0.05). However, for a given maturation medium, there are significant statistical differences between the data obtained for the two materials at each measurement (P<0.0001). The wear rates of both materials decrease continuously during the running-in period between 0 and 2500 cycles. After 2500 cycles, the wear rate becomes constant and equal for both materials. The resin matrix contained in the resin-modified glass ionomer cement weakens the tribological behaviour of this material.