The Assessment of a Minimally Invasive Procedure in the Treatment of Deep Carious Lesions: In vitro and In vivo studies
Minimal invasive procedures in the management of deep carious lesions have been the focus of researchers in recent years. Minimal invasive procedures and the use of calcium silicate cement can maintain vitality in the compromised vital pulps by caries and trauma by providing good seals and enhancing favorable response and healing potential of the pulp to the injury in order to avoid the detrimental effect of devitalization of teeth. The effectiveness of an innovative minimally invasive indirect clinical pulp protection technique (including CarisolvTM gel chemomechanical system and an operating microscope) compared to a control protocol (rotary burs with no magnification) in preserving pulp vitality in symptomatic teeth in patients presenting with signs/symptoms of reversible pulpitis has been tested clinically over a period of one year follow up accompanied by a comprehensive detection of the microbiome associated with those deep carious dentin lesions. The excavation process alongside the restorative materials could have an influence on the infectivity and activity of the remaining bacteria in the dentine, by affecting their ecological stress factors like pH, oxygen, and nutrients. A randomized controlled clinical trial was undertaken which involved recruiting patients with signs of reversible pulpitis. Standardized clinical and radiographic investigations involving CBCT and PA radiographs at baseline and one-year follow-up were used to assess pulp pathology (presence/absence of PA radiolucencies). Bacterial load and composition of the bacterial flora were assessed using non-culture-based DNA extraction, qPCR, and sequencing of the 16S rRNA gene by using next-generation high throughput sequencing.
Assistant Prof Ahmed H. Ali (BDS, MSc, Ph.D.) is a Specialist in Endodontics and Conservative Dentistry. He obtained his BDS (Baghdad, Iraq, 1997) and MSc (Baghdad, 2003) in Iraq, and his Ph.D. in Conservative Dentistry from King’s College London in 2017. After graduation he worked in private and public sectors before he became an Assistant Lecturer in Conservative dentistry in 2003 in College of Dentistry/University of Baghdad, Senior Lecturer in 2008, and Assistant Professor of Conservative Dentistry in 2020. Dr. Ahmed H. Ali has authored several papers in international peer-reviewed journals. Dr. Ahmed Ali is the Coordinator of the Postgraduate program in Conservative Dentistry at the College of the Dentistry/ University of Baghdad. Dr. Ahmed h. Ali has done research work on subjects including minimally invasive procedures in the treatment of deep carious lesions, fiber-reinforced composite posts, dental histology, and endodontic microbiology. Current research interest is focused on minimal invasive endodontics and novel obturation materials