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

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 30 s, 60 s, 90 s, or 120 s, respectively. Results: Etching with H3PO4 resulted in incomplete reduction of the surface layers in all groups [highest percentage reduction (SD) at 120 s: 54 (28)%] as observed with confocal microscopy. In contrast, surface layers could be eroded almost completely [99 (3)%] by etching with HCl for 120 s. 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 9G-120 s. (C) 2009 Elsevier Ltd. All rights reserved.