Histologische Untersuchung von konventionell und fluoreszenzunterstützt (FACE) exkavierten kariösen Läsionen

Eines der Hauptprobleme in der Kariestherapie ist die Entscheidung zwischen gesunder und erkrankter Zahnhartsubstanz. Dabei stellt sich immer wieder die Frage, wie weit exkaviert werden soll. Aufgabe dieser Studie war es, den Exkavationserfolg von einer Fluoreszenz-basierten Behandlungsmethode zu un...

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Bibliographic Details
Main Author: Steinbach, Sebastian D.
Contributors: Braun, Andreas (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2017
Online Access:PDF Full Text
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One of the main challenges of caries therapy is to differentiate between healthy and infected tooth tissue. The question arises as to what extend the caries should be excavated. The purpose of this study was to analyze the success of the excavation process using fluorescence-supported treatment. For that matter the total amount of bacteria in the remaining cavity was probed. In addition to that the teeth were histologically rated using the so-called Furrer Zones. Thus, the aim of this study was to compare the conventional method of caries therapy to the fluorescence-supported treatment of infected hard tooth tissue. A total number of 44 decayed human teeth, belonging to the second dentition, were treated. The teeth were rated according to the ICDAS II Classification and divided into two groups. These two groups were subdivided into randomized groups of 11 teeth each. One half was treated conventionally while for the other half the fluorescence-supported therapy was utilized. The caries of each tooth was excavated under standardized conditions: In the conventionally treated group the endpoint of excavation was defined by optical evaluation and testing of the quality of the dentine with a dental probe. In the fluorescence-supported group the teeth were treated until there was no more red fluorescence visible, which is typical for infected dentine. Subsequently, a sample of every cavity was taken. The samples were tested for remaining bacteria via PCR. The results showed no significant difference between both excavation methods. The teeth were cut into halves through the middle of the cavity. After transferring the teeth into resin and staining them with Rhodamine B, Fuchsin and Acid light green dye the histological caries zones according to Furrer were evaluated. The results showed with statistical significance, that less dentine was removed from deeply decayed teeth using the fluorescence-supported method compared to the conventional therapy. However no significant difference 65 between the two methods could be found for teeth with smaller lesions. Both treatment methods achieved the same result regarding residual bacteria in deep and less-deep cavities after excavation, although histologically the fluorescence-supported method removed less dentine. Thus, it can be assumed that the fluorescence-supported method removes less of healthy tooth tissue. Further studies should assess the longevity of the cariesfree tooth tissue of the FACE-treated teeth.