Surface conditioning of natural enamel caries lesions in deciduous teeth in preparation for resin infiltration

Abstract 

Objectives

As a conditioning step for resin infiltration into caries lesions, the relatively impermeable surface layer should be removed using hydrochloric acid gel (15%) to achieve improved infiltration, as it could be shown for permanent teeth. It is unclear whether this etching regimen can be transferred to the deciduous dentition, where differences in surface structure have been reported. Thus, the aim of the present study was to evaluate the effect of phosphoric and hydrochloric acid gels on the surface layer reduction of natural lesions of primary teeth.

Methods

Thirty-two extracted or exfoliated primary molars with lesions confined to enamel were selected. Paired lesion halves were partially etched with either 37% phosphoric (H₃PO₄) or 15% hydrochloric acid gel (HCl) for 30s, 60s, 90s, or 120s, respectively.

Results

Etching with H₃PO₄ resulted in incomplete reduction of the surface layers in all groups [highest percentage reduction (SD) at 120s: 54 (28)%] as observed with confocal microscopy. In contrast, surface layers could be eroded almost completely [99 (3)%] by etching with HCl for 120s.

Conclusion

An effective erosion of the surface layer of natural enamel caries in deciduous teeth can be achieved by etching with 15% hydrochloric acid gel for 90–120s.

Keywords: Caries lesion, Deciduous teeth, Infiltration, Etching, Erosion, Hydrochloric acid, Phosphoric acid