| Summary: | Indiana University-Purdue University Indianapolis (IUPUI) === Seventy five children in the early mixed dentition stage with
operative dentistry completed on 351 deciduous teeth were observed
from 4 to 28 months with periodic bitewing radiographs taken at intervals
of from 4 to 10 months. These cases contained 191 deciduous
teeth in which a calcium hydroxide methyl cellulose base material was
placed beneath the alloy restorations (test teeth) and 160 deciduous
teeth in which no base material was utilized beneath the alloy restorations (control teeth). In each instance all carious dentin was removed before the base material or restoration was completed.
A visual densitometric evaluation utilizing sclerotic index
which is an estimation of the occurrence and intensity of dentin
sclerosis by inspection of bitewing radiographs. This evaluation
indicates that 93% of the test teeth gave evidence of dentin sclerosis
beneath the area of calcium hydroxide base material while 99% of
the control teeth showed no radiographic evidence of dentin sclerosis.
An instrumental densitometric evaluation was made of the projected
bitewing x-ray film images of 115 deciduous teeth utilizing
the Elwood Densitometer. The results of this evaluation indicate
a localized increase of dentin sclerosis, or dentin calcification.
Ranging from 0% to 125% in the test teeth, immediately beneath the
calcium hydroxide base material. The control teeth showed an increased
dentin density range of from 0% to 20% immediately beneath
the alloy restoration.
Histologic examination, both ground and deca1cified sections,
Were made of 20 deciduous teeth with and without calcium hydroxide
ethyl cellulose base material beneath their alloy restorations. The sections
indicated that the sclerotic areas seen radiographically
beneath the calcium hydroxide base material cannot be correlated
with the histologic picture. Microscopically this shows a markedly
irregular secondary dentin characterized by a definite
diminution of dentinal tubules, with an increased amount of dentin matrix.
These changes could have taken place as a result of age, caries or cavity preparation.
From the results of this research it is apparent that a calcium hydroxide methyl cellulose base material is effective in the production of sclerotic dentin in deciduous teeth. There is no doubt that the “white area” seen radiographically is an area of sclerosis of the existing dentin and not an area of recalcification of carious dentin.
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