Correction of the State of Enamel Mineral Metabolism in Persons with Decompensated Caries at Various Times after Oral Cavity Sanitation

Abstract

The aim of the study was to determine the effectiveness of brushite exposure to correct the marginal permeability of composite restorations in persons with a decompensated form of carious process activity; this study also examined the penetrating ability of brushite in the micro-cracks of the enamel-composite border Methods and Results: The study included 120 patients (age 18-40 years) with a decompensated course of the carious process, who underwent complete oral cavity sanitation with the direct composite restoration of 300 teeth. The obtained results were analyzed and interpreted in vivo (the clinical effectiveness of the restoration was assessed according to the Ryge criteria immediately after treatment and 1, 12, and 36 months after treatment) and in vitro (scanning electron microscopy of the enamel-composite joint after applying the composite and after treatment with the studied means). According to the purpose and objectives of the study, two groups of patients were formed: Group 1 (control, n=58): the prevention of recurrent caries after sanitation was carried out using a standard personal hygiene product containing fluorine; Group 2 (experimental, n=62): the prevention of recurrent caries after sanitation was carried out using a natural two-component complex for strengthening and remineralization of enamel RemarsGel. During statistical processing of the obtained data, immediately after sanitation and one month after it, the differences in the indicators of the Ryge criteria in Groups 1 and 2 were statistically insignificant. Twelve months after the sanitation, the Ryge restoration quality indicators in Group 2 were higher than in Group 1 (P≤0.001). After 36 months, the statistical significance of the difference in the restoration quality indicators increased (P≤0.0001). These results were confirmed by the data of scanning electron microscopy. Based on the results obtained, stating the state of the quality of the enamel-composite joint, it can be concluded that brushite crystals are highly effective in preventing violations of the integrity of the enamel-composite joint, which has a direct and immediate impact on the quality of restoration. Conclusion: We consider it necessary to add to the list of main indications for the use of the RemarsGel system one more, a scientifically based indication of the targeted use of the system in the presence of a significant amount of adhesive, both direct and indirect restorations in the oral cavity, especially in the decompensated course of the carious process.