MODERN METHODS OF RESTORATION OF CARIOUS LESIONS OF THE TOOTH ROOT
Abstract and keywords
Abstract:
The increase in life expectancy in Russia is accompanied by a growing prevalence of root caries, particularly among elderly patients with periodontal diseases. This trend is associated with the anatomical characteristics of root tissues, which contain a lower proportion of inorganic components and are therefore more susceptible to demineralization. This determines the need for restorative techniques that ensure long-term durability and resistance to a moist oral environment. The aim of the study was to analyze the available literature regarding the application of various restorative approaches for the management of root caries lesions. Materials and methods. A review of publications from 2016 to 2026 was conducted using the PubMed, eLIBRARY, Google Scholar, and National Library of Medicine databases. The search was performed using the following keywords: root caries, restoration, adhesive system, glass ionomer cement, resin-modified and hybrid glass ionomer cement, resin-modified glass ionomer cement, hybrid glass ionomer cement. Duplicate publications were excluded. The analysis demonstrated that the selection of adhesive systems and restorative materials directly affects the clinical prognosis. Adhesives based on low-molecular-weight monomers, such as 10-MDP, show strong interaction with sclerotic dentin and maintain stability under conditions of increased moisture. Hybrid glass ionomer cements remain the most preferable option due to the combination of chemical adhesion, pronounced fluoride release, high biocompatibility, and sufficient mechanical strength, making them a reliable choice even in areas subjected to significant functional loading. Modern restorative dentistry considers two main approaches to the treatment of root caries: the use of composite materials with different adhesive protocols and the application of conventional and polymer-modified glass ionomer cements. Results. The literature analysis indicates that 8th-generation adhesive systems and contemporary composite materials provide higher bond strength and improved marginal sealing, whereas glass ionomer cements and resin-modified glass ionomers retain clinical relevance under conditions of inadequate isolation due to their chemical adhesion. Further studies are required to optimize material selection.

Keywords:
root caries, restoration, adhesive system, glass ionomer cement, GIC, resin-modified glass ionomer cement, hybrid glass ionomer cement
References

1. Reznik E.S. Prodolzhitel'nost' zhizni v Rossii: tendencii i faktory, opredelyayuschie ee. V: Morozov S.D., Zhiromskaya V.B., redaktory. Rossiya i mirovoe soobschestvo: problemy demografii, ekologii i zdorov'ya naseleniya: Sbornik statey VI Mezhdunarodnoy nauchno-prakticheskoy konferencii; Penza; 10–11 iyulya 2023 goda. Penza: Penzenskiy gosudarstvennyy agrarnyy universitet; 2023. S. 197-199. [Reznik E.S. Life expectancy in russia: trends and factors determining it. In: Morozov S.D., Zhiromskaya V.B., editors. Russia and the world community: problems of demography, ecology and public health: Collection of articles of the VI International Scientific and Practical Conference; Penza; July 10-11, 2023. Penza: Penza State Agrarian University; 2023. Pp. 197-199. (In Russ.).] https://elibrary.ru/item.asp?id=54357285

2. Tonprasong W., Inokoshi M., Shimizubata M., Yamamoto M., Hatano K., Minakuchi S. Impact of direct restorative dental materials on surface root caries treatment. Evidence based and current materials development: A systematic review. The Japanese dental science review. 2022;58:13-30. https://doi.org/10.1016/j.jdsr.2021.11.004

3. Hayes M., Burke F., Allen P.F. Incidence, Prevalence and Global Distribution of Root Caries. Monographs in oral science. 2017;26:1-8. https://doi.org/10.1159/000479301

4. Romanenko I.G., Chepurova N.I., Zueva A.S. Vybor adgezivnyh sistem pri lechenii kariesa kornya zuba (obzor literatury). Vestnik medicinskogo instituta «REAVIZ». Reabilitaciya, Vrach i Zdorov'e. 2021;(2):50-61. [Romanenko I.G., Chepurova N.I., Zueva A.S. Selection of adhesive systems in treatment of tooth root caries (literature review). Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2021;(2):50-61. (In Russ.)]. https://doi.Org/10.20340/vmi-rvz.2021.2.CLIN.2 UDK 616.314-002.4-089.27

5. Dohan Z., Friedlander L.T., Cooper P.R., Li K.C., Ratnayake J.T., Mei M.L. In Vitro Models Used in the Formation of Root Caries Lesions-A Review of the Literature. Dentistry journal. 2023;11(12):269. https://doi.org/10.3390/dj11120269

6. Fu Y., Ekambaram M., Li K.C., Zhang Y., Cooper P.R., Mei M.L. In Vitro Models Used in Cariology Mineralisation Research-A Review of the Literature. Dentistry journal. 2024;12(10):323. https://doi.org/10.3390/dj12100323

7. AlQranei M.S., Balhaddad A.A., Melo M.A.S. The burden of root caries: Updated perspectives and advances on management strategies. Gerodontology. 2021;38(2):136-153. https://doi.org/10.1111/ger.12511

8. Razumova S.N., Brago A.S., Ruda O.R., Talandis A.G., Hashanova L.M., Mendosa E.Yu., Rusanov F.S. Adgezionnaya prochnost' kompozitnyh restavraciy prisheechnoy oblasti. Rossiyskiy stomatologicheskiy zhurnal. 2025;29(1):13-20. [Razumova S.N., Brago A.S., Ruda O.R., Talandis A.G., Khaskhanova L.M., Mendosa E.Y., Rusanov F.S. Adhesive strength of cervical composite restorations. Russian Journal of Dentistry. 2025;29(1):13-20. (In Russ.)]. https://doi.org/10.17816/dent639931

9. Chen H., Feng S., Jin Y., Hou Y., Zhu S. Comparison of bond strength of universal adhesives using different etching modes: A systematic review and meta-analysis. Dental materials journal. 2022;41(1):1-10. https://doi.org/10.4012/dmj.2021-111

10. Alhilou A., Beddis H.P., Mighell A.J., Durey K. Dentin dysplasia: diagnostic challenges. BMJ case reports. 2018;2018:bcr2017223942. https://doi.org/10.1136/bcr-2017-223942

11. Kreher D., Ernst B.L.V., Ziebolz D., Haak R., Ebert T., Schmalz G. Dental Caries in Adult Patients with Rheumatoid Arthritis-A Systematic Review. Journal of clinical medicine. 2023;12(12):4128. https://doi.org/10.3390/jcm12124128

12. Moore C., McLister C., Cardwell C., O'Neill C., Donnelly M., McKenna G. Dental caries following radiotherapy for head and neck cancer: A systematic review. Oral oncology. 2020;100:104484. https://doi.org/10.1016/j.oraloncology.2019.104484

13. Abou Neel E A, Aljabo A, Strange A, Ibrahim S., Coathup M., Young A. M. et al. Demineralization-remineralization dynamics in teeth and bone. International journal of nanomedicine. 2016;11:4743-4763. https://doi.org/10.2147/IJN.S107624

14. Sáez F.J., Badiola I. Dentine. In: Sáez F.J., Badiola I. Essential Oral Histology. Cham: Springer; 2025. Pp. 343-366. (Learning Materials in Biosciences). https://doi.org/10.1007/978-3-032-03165-5_18

15. Teodosio L.M., de Queiroz A.M., de Oliveira H.F., Silva-Sousa A.C., Sousa-Neto M.D., Lopes-Olhê F.C. et al. Physical and biochemical shifts of irradiated dentin during caries progression. Journal of dentistry. 2025;162:106023. https://doi.org/10.1016/j.jdent.2025.106023

16. Cai X., Chen Y., Wu J., Wang A., Wang X. ACS Applied Materials & Interfaces 2025;17(2):3106-3115. https://doi.org/10.1021/acsami.4c20204

17. Damé-Teixeira N., Parolo C.C.F., Maltz M. Specificities of caries on root surface. Monographs in oral science. 2017;26:15-25. https://doi.org/10.1159/000479303

18. Razumova S.N., Brago A.S., Bragunova R.M., Pecherskiy B.O. Osobennosti primeneniya adgezivnyh sistem pri restavracii zubov s razrusheniem emalevogo cervikal'nogo kol'ca: obzor. Rossiyskiy stomatologicheskiy zhurnal. 2026;30(1). [Razumova S.N., Brago A.S., Bragunova R.M., Pecherskyi B.O. Specific Features of Using Adhesive Systems in the Restoration of Teeth with Destruction of the Enamel Cervical Ring. Russian Journal of Dentistry. 2026;30(1). (In Russ.)]. https://doi.org/10.17816/dent701455

19. Hariyani N., Setyowati D., Spencer A.J., Luzzi L., Do L.G. Root caries incidence and increment in the population - A systematic review, meta-analysis and meta-regression of longitudinal studies. Journal of dentistry. 2018;77:1-7. https://doi.org/10.1016/j.jdent.2018.06.013

20. Melkumyan A.R., Bragunova R.M., Razumova S.N., Brago A.S., Safronova O.V. Sravnitel'naya ocenka antimikrobnyh svoystv obrazcov kompozitnyh materialov s dobavleniem i bez dobavleniya antisepticheskogo sredstva. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya. 2018;20(S1):30-31. [Melkumyan A.R., Bragunova R.M., Razumova S.N., Brago A.S., Safronova O.V. Comparative assessment of antimicrobial properties of composite materials samples with and without the addition of antiseptic agent. Clinical Microbiology and Antimicrobial Chemotherapy. 2018;20(S1):30-31. (In Russ.)]. https://www.elibrary.ru/item.asp?id=35619152

21. Gupta S., Gupta S., Mehra M., Gupta T., Grover R. Comparative Evaluation of Shear Bond Strength of Fifth, Seventh, and Eighth-generation Bonding Agents in Permanent Teeth: An In Vitro Study. International journal of clinical pediatric dentistry. 2025;18(3):281–286. https://doi.org/10.5005/jp-journals-10005-3096

22. Alomran W.K., Nizami M.Z.I., Xu H.H.K., Sun J. Evolution of Dental Resin Adhesives—A Comprehensive Review. Journal of Functional Biomaterials. 2025;16(3):104. https://doi.org/10.3390/jfb16030104

23. Jalannavar P., Kalgapure S.K., Parmar V., Singh S., Arya A., Dudekula K. et al. An In Vitro Comparison of Seventh-and Eighth-generation Dentin Bonding Agents Microtensile Durability Employing Giomer. World journal of dentistry. 2024;16(Suppl 4):S3351-S3353. https://doi.org/10.5005/jp-journals-10015-2368

24. Yao Y., Wu D., Cifuentes-Jimenez C.C., Sano H., Alvarez-Lloret P., Yamauti M. et al. Comprehensive Evaluation of Long-Term Dentin Bond Strength, Water Sorption, Solubility, and Degree of Conversion of Self-Adhesive Resin Composites. The Journal of Adhesive Dentistry. 2024;26:213-222. https://doi.org/10.3290/j.jad.b5749506

25. Aref N.S., Alrasheed M.K. Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: an in-vitro study. 2022;23(1):10. https://doi.org/10.1186/s40510-022-00404-9

26. Singh S., Bhadauria U.S., Sharma A., Verma Mathur R. Comparative evaluation of microleakage with total-etch, universal (self-etch mode), and nano adhesive systems in class V composite restorations: An in-vitro study. Cureus. 2023;15(10):e46766. https://doi.org/10.7759/cureus.46766

27. Bharti S., Parminder D., Ritu M., Harpreet K., Swati R., Apra B. Bonding Efficacy of 5th, 6th, 7th & 8th Generation Bonding Agents on Primary Teeth. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 2018;17(3):61–66. https://doi.org/10.9790/0853-1703136166

28. Eradina N.S., Rachmadi P., Permatasari N.N.G.W. Comparison of shear bond strength between 7th and 8th generation bonding agents in flowable composite resin. World Journal of Advanced Research and Reviews. 2024;23(01):2791–2794. https://doi.org/10.30574/wjarr.2024.23.1.2289

29. Wen Y., Zhao X., Li S.K.Y., Lo E.C.M., Jiang C.M. Factors associated with the success of restorative treatment for root caries: A systematic review with meta-analysis. Journal of Dentistry. 2025;153:105539. https://doi.org/10.1016/j.jdent.2024.105539

30. Betancourt D.E., Baldion P.A., Castellanos J.E. Resin-dentin bonding interface: mechanisms of degradation and strategies for stabilization of the hybrid layer. International journal of biomaterials. 2019;2019:5268342. https://doi.org/10.1111/j.1754-4505.2012.00302.x

31. Kamath U., Arun C.R. Comparative evaluation of Microleakage of class II composite restoration by using 6th 7th and 8th generation dentin bonding agents: An in vitro study. International Journal of Applied Dental Sciences. 2019;5(1):147-150. https://www.oraljournal.com/archives/2019.v5.i1.C.549/comparative-evaluation-of-microleakage-of-class-ii-composite-restoration-by-using-6th-7th-and-8th-generation-dentin-bonding-agents-an-in-vitro-study

32. Wendlinger M., Nuñez A., Moreira P., Carneiro T. S., Cochinski G. D., Siqueira F. et al. Effect of the absence of HEMA on the bonding properties of universal adhesive systems containing 10-mdp: An in vitro study. Operative Dentistry. 2023;48(5):500-512. https://doi.org/10.2341/22-050-L

33. Dey S., Shenoy A., Kundapur S.S., Das M., Gunwal M., Bhattacharya R. Evaluation of the effect of different contaminants on the shear bond strength of a two-step self-etch adhesive system, one-step, self-etch adhesive system and a total-etch adhesive system. Journal of International Oral Health. 2016;8(3):1-7. https://doi.org/10.2047/jioh-08-03-15

34. Xiao S., Wang H., Liang K., Tay F., Weir M.D., Melo M.A.S. et al. Novel multifunctional nanocomposite for root caries restorations to inhibit periodontitis-related pathogens. Journal of dentistry. 2019;81:17-26. https://doi.org/10.1016/j.jdent.2018.12.001

35. Saridena U.S.N.G., Sanka G.S.S.J., Alla R.K., Ramaraju A.V., Sajjan MC S., Mantena S.R. An overview of advances in glass ionomer cements. International Journal of Dental Materials. 2022;4(4):89-94. https://doi.org/10.37983/IJDM.2022.4403

36. Alqarni A.S., Al Ghwainem A. Assessment of the efficacy and bond strength of different dentin-bonding agents with adhesives on primary teeth: An in vitro study. The Journal of Contemporary Dental Practice. 2024;25(4):342-345. https://doi.org/10.5005/jp-journals-10024-3658

37. Tyagi G., Jain S., Deshwal S., Singh S., Poonia N., Sharma S. Comparative study of dentin remineralization with Nano-amorphous calcium phosphate-modified bioactive restoratives. Journal of Oral Biology and Craniofacial Research. 2025;15(4):684-690. https://doi.org/10.1016/j.jobcr.2025.04.009

38. Alnozaily R., Alkherbash A.M., Diaban S., Alshammari A.F., Al-Haddad A., Madfa A.A. Clinical Performance of Resin-Based Composite and Resin-Modified Glass Ionomer in Restoring Cervical Carious Lesions: A Systematic Review and Meta-Analysis. Journal of Esthetic and Restorative Dentistry. 2025. https://doi.org/10.1111/jerd.70088

39. Al-Salamony H., Akah M., Naguib E.A., Safwat O.M. Clinical Evaluation of Bulk-fill Alkasite Restoration vs Resin-modified Glass Ionomer in Class V Carious Lesions: 1-year Randomized Clinical Trial. The Journal of Contemporary Dental Practice. 2024;25(12):1127-1134. https://doi.org/10.5005/jp-journals-10024-3787

40. Zhao I.S., Mei M.L., Burrow M.F., Lo E.C., Chu C.H. Effect of silver diamine fluoride and potassium iodide treatment on secondary caries prevention and tooth discolouration in cervical glass ionomer cement restoration. International journal of molecular sciences. 2017;18(2):340. https://doi.org/10.3390/ijms18020340

41. Bharali K., Das M., Jalan S., Paul R., Deka A. To compare and evaluate the sorption and solubility of four luting cements after immersion in artificial saliva of different pH values. Journal of Pharmacy & Bioallied Sciences. 2017;9(Suppl 1):S103-S106. https://doi.org/10.4103/jpbs.JPBS_153_17

42. Koç-Vural U., Kerimova-Köse L., Kiremitci A. Long-term clinical comparison of a resin-based composite and resin modified glass ionomer in the treatment of cervical caries lesions. Odontology. 2025;113(1):404-415. https://doi.org/10.1007/s10266-024-00958-6

43. Gavranović-Glamoč A., Ajanović M., Kazazić L., Strujić-Porović S., Zukić S., Jakupović S. et al. Evaluation of Solubility of Luting Cements in Different Solutions. Acta medica academica. 2020;49(1):57-66. https://doi.org/10.5644/ama2006-124.284

44. Kim D.Y., Aryan N., Lawson N.C., Cheon K. Comparison of Luting Cement Solubility: A Narrative Review. Dentistry Journal. 2024;12(11):365. https://doi.org/10.3390/dj12110365

45. El Ghamrawy M., Kamal D., Hamza H. Clinical performance and cost-effectiveness of low-shrinkage giomer resin composite versus resin-modified glass ionomer in cervical carious lesions: a 12-month randomized controlled trial. BMC Oral Health. 2025;25(1):1295. https://doi.org/10.1186/s12903-025-06594-y


Login or Create
* Forgot password?