Abstract
Background: Root caries is common amongst the older population. The risk of caries increases with irregular attenders and special need groups. A simple, reliable and cost- effective therapeutic method is required to deal with this issue.
Objectives: To investigate the clinical effectiveness, patient acceptability and potential to reduce cariogenic microorganisms of a novel restorative material to treat root caries placed using the atraumatic restorative treatment (ART).
Methods: Two clinically-visible root surface carious lesions per patient (n=9) were restored using ART. One root carious lesion was restored with a conventional glass ionomer cement (GIC) and the other with a GIC cement modified with 5% chlorhexidine digluconate (GIC-CHX). Patient acceptability and survival rates of the restorations were evaluated using questionnaires and the modified Ryge criteria (Ryge 1980) at baseline, and after 1, 3 and 6 months. Plaque and saliva samples were collected around both restorations and microbiological analysis for bacterial viability were completed at baseline, 1, 3 and 6 months.
Results: Eighteen restorations were placed using GIC and GIC-CHX in nine patients. After reviewing the restorations at 1, 3 and 6 months following placement, most of the participants (n=8, 88.9%) indicated that they were satisfied with the appearance of the ART restorations, felt no pain during the procedure and experienced no change in taste over time. The set time for GIC-CHX was quicker or the same as GIC (77.8%). At the 6-month examination, 77.8% (n=7) of the GIC-CHX restorations were continuous with the tooth anatomy, whereas 44.4% (n=4) of the GIC restorations were discontinuous. The survival rates of GIC-CHX and control GIC restorations were 88.9% and 66.7% respectively, the main reason for failure was gross marginal defects; however, this result was not statistically significant using the Chi square test (p>0.05). There was no statistically significant reduction in the mean count of the tested microorganisms in plaque samples for both types of restorations at 1, 3 and 6 months although the mean count of Candida and Streptococcus mutans in saliva suspension tended to be lower.
Conclusion: Restoration of carious root surfaces using the ART with GIC-CHX resulted in higher survival rates compared to a control GIC, however, a larger number of patients is needed to confirm the validity of this finding. GIC-CHX restorations applied using ART may be a viable approach for use in outreach dental services to restore root surface carious lesions in the older adults and other special needs groups.