effect of a tight seal on survival of bacteria in saliva-contaminated cavities filled with compos

8/3/2019 Effect of a Tight Seal on Survival of Bacteria in Saliva-contaminated Cavities Filled With Compos

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o f a t i g h t s e a l o n s u r v i v a l o f b a c t e r i a inl iv a - c o n ta m in a te d c a v i t ie s f i l le d w i t hm p o s i t e r e s in

IMKIOCI Deni Traimia tol 1987; 3: 6-9 .

i n . vivo under ;tsej:)lic conditions. The

cem ented over the filling, fhe teeth were ext rac ted after 6 -8

Ingegerd Mejare*, Bertii Mejare** Stig Edwardsson***'Eastman Dental Institute, Stockholm, "Depment ol Endodontics, Danderyds Hospital, Dy d , and '"Department ot Oral Microbiology, Usity ol Lund Schooi of Dentistry, Sweden

Key words: bacteria, composites, saliva.Ingegerd Mejare, Eastman Dental Institute, Dtan 11, S-113 24 Stockholm, Sweden.Accepted for publication 3 June 1986.

odifleations of cavo-surfkce t rea tm ent have

they ean either be trap|)ed there in the smear during preparation or be the result of iiiitrleakage (2, 8). To eliminate baeterial conta m inaduring preparation these aitlliors reeommenduse of an antimicrobial cleanser instead of wasthe cavity with water spray just before fillingearlier studies (1, 7), however, the use of a seemed to completely exclude the presenee of teria under composite fillings. 11 is therefbre of iest to know if bacteria from contamination of sduring preparation survive und er the eompfilling. If not, washing with water and subsecapp lication of a hne r would be sufficient, as suged by Finn (9) and Mjor (10, 11). T ha t microo risms con tam ina tin g the cav ity at the tim e of Iaration may not survive was also suggested bygenholtz et al. (5).

In order to find out if bacteria from saliva tamination survive under composite resin res


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S a l i v a - c o n t a m i n a t e d r e s t o r a t i

2 , 12). Other measures therefore seem necessary.r testing the bioconijialibility of den tal ma terialsThe aim of ihis study was (o find an /// vivo model

a n d m e t h o d s

e- extrac ted for orth od on tie reason w ere

uccal surface was eleaned by pum ieing fbr 5 s.hen a rubber dam was a])plic^d and the tooth

2 mm using a spherical

Saliva was collected from the sublingual s]:)ace onith it lor 1 min. After aird ry ing fbi' 5 min,

I h e cavity floor byI AS-mcditim as pre-(14). Chosen by lot, 1 looth wased with water spr ay for .') s while ilie other w as

, Sweden ) fbr 1 min .Samples for culUiring after the cleansing pro-

I ha I the saliva cotitamination fbl-

of the saliva-contaminated cavities was insufficias a baeteria-eliminating measure and the samptaken after water spray consistently gave heagrowth already after 24 h in TAS-medium. Tmieroorganisms found were typical fbr those usuafound in saliva such as Streptococcus salivarius.The teeth were filled with Adaptie Qohnson aJohnson, Dental Produets Company, East WindsN . J . , U.S.A.) aecording to the manufacturer. Tcomposite was pressed against the tooth with a Mlar strip (Dupont, Wilmington, DelawaU.S.A.). After setting, the outer half of the fillwas removed with a cylindrical diamond bur ahigh-speed ec^uipment and replaced with Pradecement. This cement has no anlimicrobial effbut gives a tight seal (13). Finally, after settingthe eement, an orthodonlic band was cemented wa earboxylate eement to protect the filling agaimechanical wear. The experimental procedure schematically illustrated in Fig. 1.After 6-8 wk the teeth were extracted and imediately taken in sampling medium VMC I, the laboratory for processing in an anaerobic globox. Samples for culturing on blood agar anaerbically and in TAS-mcdium were taken from tbottom of the cavity of one half of the asepticalsplit tooth crown. The other half of the erown wstudied by histological techniques. Details eoneering the sampling, culturing and histological pr

cedures has been described in previous studies (1 4 ) .

PROCEDUR E ISALtVACONTAMINATION

PR OC ED UR E tIa OR PR OCE DUR E nb

PROCEDURE


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et al.

of eleansing procedure, ncj growth ofon thewalls or floor of the cavi-nor in adjacent dentin, after the experimentalof (J 8 wk either ljy the culliiring teehniqueby the liislologic- me tho d. N(3 grow th of bacte riabe observed in the samples taken to test theAll sam|)lesin

the compositedid not seem to survive since growth couldin any sample. Since bacteria haveon the inner surface of composite resinsto the cavity floor only 9 d aftercjf the filling (12), the eompo.site materialself d o e s not seem to exert any significant antimi-the use of Prader's cementany antimierobial effeet of the temporary(13). It therefore seems that theto the area under a tightly sealedis too poor toallow sur-and growth of bacteria from saliva. This waset al. (5). Our results

ob-by studying the viability of carious bacteriaand fissurc^s. Thus, a numbera dramatic reduetionof these baeteria when trapped under(15 18).In agreement with Quist (19), ourfindingssug-com-ofthe eavity walls rather than fromped und er the filling at the time of the

for this suggestionbe found in an earlier study (14) wherewas similar to that of[ue, while b acte ria typical of saliva, i.e. Streptococ-salivarius, were not found. Therefbre, although

of mierocjiganisms and improve thethe liner and the cavity wallsthe neeessity of using an antimierobial agentbe cpiestioned, as was done by Eriksen & Eeidal'fhe efllciency of using water-spray and linerwas also illustrated in an study by

termediale layer of a low-viseous resin and mocations of the cavo-surface have reduced margleakage, a number of studies shows that it iseliminaled (5 7, 19, 20). 'fhe use of an ini])ermecafcium-liydroxidc liner should therefbrestressed.The technique used in this study for excludmarginal leakage ajjpeared appropriate sincegrowth ol bacteria could be observed either byctiltiii ing or by the histological methods. It has bshown earlier that piolection of the ouler parthe filling with Cavil"" did nol eliminale niic rolege due to mechanic al wear of this material duthe ex]3erimeiit;tl period (2). In a recent sludy (IRM-eement also failed to produee a light The use of Praders cement and applieation oorthodcjiitic band over the filling seemed to func

well. I herefbre this techniq ue can be used lothe biocompatibility of various restoialive dematerials in vivo.

C o n c i u s i o n sBac:teria originating from saliva eontamination ing the pre]Daration procedure do not survive utightly sealed eomposite resin restorations. Trationale behind tising an anlimicrobial cleanstherefore quc;stioned. When testing the biocombility in vivo of dental restorative materials it iportant to be able to ensure a lighl seal so aexclude marginal leakage. '1 he techniciue useihis study seems appropriate for this purpose.

R e f e r e n c e s1. B R A N N S T R O M M , N Y I S O R G M. Th e pres ence of bacl er

c a v i l i e s l i l l e c l w i l l i s i l i c a t e c e n i e n i and c o n i p o s i l e r e s i nle ] ia l s . Swed Dcnl J 1 9 7 1 ; 64: 149 .'i.'i.

2 . B R A N N S I R O M M , N Y H O R < ! H . C a v i l y I r e a l t i i e n l w i l h ab i( i d a l l l u o r i d e s o h t t i o t i : G r o w t h of b a c t e i ia and e l l ed i e p n l p . J ProslJwl Dcnl 1 9 7 3 ; :ffl: 303 10.

3. C^visf V. P u l p r e a c l i o t i s in h u m a n l e e l h lo t o o t h cl i n i n g t i i a l e r i a l s . Scand J Dent Res 197. ' j ; 83: .'"it lili.

4 . l'yRiKSKN MM, h i i iDAt , TI. M o n k e y p u l p a l r e s p o n s e top o . s i t c l e s i n r e s t o r a t i o n s in c a v i t i e s t r e a t e d w i l h vclean.sing agents. Scand J Dent Res 1979; 87 : 309 17.

5. Hi'.RGENHOLTZ G, Cox CF, LoiiscHE WJ, SYED SA. Bal eakage a round den ta l res to ra t ions : its clTect on thep u l p . Oral Palliol 1982; //. 439 50.6. ( . )yts' r V. M atgin al a dap tal i on ofcomposite I 'cstoralionlortned in vivo wilh diHereiil acid-etch t(storali\-eecdt tres . Scand J Dcnl Res 198.'); .9.5.- 68 7.'j.


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S a l i v a - c o n t a m i n a t e d r e s t o r a t i o n sc l r < " l r ( i n m i c r o s c o p i c u i \ " r s l i i ; ; i l i o n . y Pni.^l/iii Detil 1974;31:4 2 2 31 .

9 . F I N N S 1 5 . ( i : i \ ' i l \ s i c i i l i z a l l o n . . \ i i i i i i i i c c c s s a r y s U ' | ) . Drill (Tin.Horlh .Am l ! l ( i ( l ; WiS 7(1.

0 . M i O R l A . I I K ' | ) r i n ' l i ' a l i ( i n o f i M c l r r i a i ii l i) i ' N | ) r r i i i i r n t a l i \c s p o s c t l h u m a n c o r c n a l d c t u i i i . Sitiiii/ '/ Drill A(.v H ) 7 4 ; l>'2:191 6.

I M i o i ^ l A . 1 1 i s i i ) l ( ) t ; i ( ( i c i i i o n s i r a l i o i i ol b a c t e r i a . s u b j a t ' t M i l (o( I c i i l a l i c s l i i i a i i K i i N . Sriiii/i J Drill Re.s 1977; 85.' 169 71.

2 . IbuS ' I 'KNSON 15. N o K D l ' . N W M . I . K - | . B u A K K S I R O M M . P l l l | i a lr c a c l i o i i a n i l n i i ( ' i i ) < ) r i ; a n i s n i s u n d e r ( I l c a r l i l C o n i p o s i l c R r -.sin ill d e e p e a \ i l i e s w i d i ac id e l e l i e d d e n l i n . Sicril Drill .71982; 6: IC7 7(i.

A J R . Mier()l)iol()!;i( al cxaminalion oT rool canal.sand periapiea l (issues oll ii nii an (ee(li. Mediodologira l s(ud-i e s . Orlniil 1 id.ski 19()(i; /-t: (speeial arliele).

4 . Mr.|ARE li. Mi".|ARK I, l',inv.\Ri)SS()N S. liaileria benealhcomi3osi(e ics((>ra(i()iis a c uldiiing and liislohaelerioliinieals tudy . Arlii Ddoiilol Sriiiiil 1979; :i7: 2G7 75.

15. J E R O N I M U S 1) | , ' I ' I I . I , MJ, S V E E N OB. Redueed \'ialiili() oMieroo rganisnis uiule i ' denta l sealants . 7 ^J''"' C'//(/ 197542 : 2 7 5 - 8 0 .

16. TiiEiLADF. F,. F"E|ERSKOV O , MiGASENA K, P R A C H Y A B R U E D\\. I'.IIeel of lissnre sealing on the mieroflora in oeelusalissures of h u m a n i c e t h . Archs Oral Rial 1977; 22: 251 9.

17. G O I N G RE, L O E S C H E W J , G R A I N G E R DA, S Y E D SA. Theviabili(y of mieroorgan i s n i s in carious lesions live years aftecovering with a l is sure sealant . J . I / ) . ) 1978;97: 45562.

18. JKNSEN 0 E , H A N D E I . M A N SI.. ['Jlect of an autopolyinerizingsealant on viabi l i ty of miciol lora in oeelusal dental cariesSrmuri Drill Res 1980;88: 3 8 2 - 8 .

19. Cj_visT W ( ^ r e l a t i o n b e t w e e n m a r g i n a l a d a p t a t i o n oi eomposite resin restorations and baeteria l growth in i a \ i t i e sSraiid 'I Deiil Res 1980; 88: 296 300.

20. R E T I E F DH, W O O D S BS, J AMI S ON HC . F.lfeet of cavostn faee(rea lnient on marg ina l l eakage in Cla.ss V eonijiosile resinres iora t ions . J Proslhet Dent 1982; 47: 4 9 6 - 5 0 1 .


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effect of a tight seal on survival of bacteria in saliva-contaminated cavities filled with compos

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