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 demand for patient-specific medicine is steadily increasing, particularly with the need for innovative materials capable not only of supporting tissue regeneration but also accelerating it. The aim of this study was to develop a new printable composite material exhibiting ductile behavior, in contrast to brittle failure, in order to support cell growth even under structural compromise. PBS was selected as a blending component with PLA due to its enhanced biocompatibility for bone tissue regeneration. Both neat PLA and the PLA/PBS blend were subsequently combined with BaTiO₃, processed into filaments, 3D printed, and subjected to mechanical testing. PLA-based composites demonstrated higher stiffness under compression, with up to a 6.5% increase in Young’s modulus compared to the blended samples. However, the incorporation of PBS resulted in a more ductile response, as evidenced by three-point bending tests, even at BaTiO₃ concentrations of 10 wt%. This improved ductility is expected to provide safer conditions for cell growth and enable elastic recovery following mechanical loading.

The demand for patient-specific medicine is growing, particularly with the need for innovative materials that can not only support tissue regeneration but also accelerate it. This study aimed to develop a new printable composite material exhibiting ductile behavior, as opposed to brittle failure, to support cell growth even in the event of structural compromise. PBS was selected in this study to be blended with PLA due to its higher biocompatibility for bone tissue regeneration[1]. Both neat PLA and the PLA/PBS blend were then mixed with BaTiO3, printed and tested by mechanical testing. PLA-based composites demonstrated higher stiffness under compression, with up to 6.5 % higher in Young’s Modulus compared to the blended samples. However, the incorporation of PBS resulted in a more ductile material, as evidenced by 3-point bending tests, even at BaTiO3 concentrations of 10 wt%. This ductility should provide safer conditions for cell growth and allow elastic recovery after mechanical loading.