Preventive and Therapeutic Proximal Sealing: A 3.5-Year Randomized Controlled Clinical Trial Follow-Up

Basili, Cristian; Emilson, Claes‐Göran; Corvalan, Gonzalo C.; Moran, Maria Paz; Torres, Carlos; Quiroz, Mariela D.; Gomez, Santiago S.

doi:10.1159/000470851

Cited by 11 publications

(17 citation statements)

References 17 publications

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“…After the application of topical anaesthesia to reduce pain and the placement of the wedge, the resin penetrated the proximal lesions, and only one visit was needed for application [27,38,46,47]. Comparatively, sealing is more complex than in ltration, as it requires two visits [19][20][21][22][23]. In addition, the commercial product "Icon" is available for standard application in resin in ltration [27].…”

Section: Discussionmentioning

confidence: 99%

“…1). Ultimately, 21 articles of the 16 latest studies were included (Tables 1a-b and Table 2), of which 9 articles were related to 4 different series of studies and 1 article compared in ltration and sealing to the control group individually [19][20][21][22][23][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48].…”

Section: Study Selectionmentioning

confidence: 99%

“…In terms of caries risk levels, 2 studies reported high risk [21,46,47], 4 studies reported moderate to high risk [33,34,37,39,40], 1 study reported low to moderate risk [38], 2 studies reported low to high risk [36,42], 3 studies reported mixed risk levels [23,41,[43][44][45] and 4 studies did not report caries risk in the articles [19,20,22,35,48]. Four caries risk statuses were included in the subgroup analysis: low [42], low to moderate [38], moderate to high [33,34,37,39,40] and high [21,42,46,47]. All trials used radiographic lesion progression as the primary outcome.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…In addition, sealing has been investigated to e ciently arrest lesion progression in vivo and in vitro [16][17][18]. The procedure of sealing involves the application of a resin sealant, polyurethane tape or adhesives after tooth separation [19][20][21][22][23]. Previous systematic reviews and meta-analyses have shown that micro-invasive treatments are more effective than non-invasive treatments [3,11,[24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

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Infiltration and Sealing for Managing Non-Cavitated Proximal Lesions: A Systematic Review and Meta-Analysis

Chen¹,

Chen

Lin³

2020

Preprint

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Background: Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels.Methods: Electronic databases (Cochrane Library, PubMed and Embase) were searched for published literature, and references were manually searched. Split-mouth randomized controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. In total, 995 citations were identified, and 16 RCTs (21 articles) were included.Results: For subgroup analysis, infiltration and sealing reduced the odds of lesion progression (infiltration vs non-invasive: OR = 0.20, 95% CI: 0.15 to 0.29; sealing vs placebo: OR = 0.27, 95% CI: 0.18 to 0.41). For both primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI: 0.20 to 0.45; permanent dentition: OR = 0.19, 95% CI: 0.13 to 0.27). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.19, 95% CI: 0.14 to 0.27). For patients with different risk levels, there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.23, 95% CI: 0.07 to 0.75; low to moderate risk: OR=0.38, 95% CI: 0.18 to 0.81; moderate to high risk: OR=0.17, 95% CI: 0.17 to 0.29; and high risk: OR=0.14, 95% CI: 0.07 to 0.26). Infiltration was superior to non-invasive treatments for patients at different caries risk levels (low risk: OR = 0.07, 95% CI: 0.02 to 0.22; low to moderate risk: OR=0.38, 95% CI: 0.18 to 0.81; moderate to high risk: OR=0.19, 95% CI: 0.09 to 0.38; and high risk: OR=0.14, 95% CI: 0.07 to 0.29).Conclusion: Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Infiltration and Sealing for Managing Non-Cavitated Proximal Lesions: A Systematic Review and Meta-Analysis

Chen¹,

Chen

Lin³

2020

Preprint

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“…This underlines the need for minimally invasive approaches to prevent or postpone the restorative treatment cycle [Qvist, 2008]. For approximal tooth surfaces, the use of resin sealing or infiltration as microinvasive treatment methods for initial non-cavitated carious lesions has shown promising clinical results when it comes to controlling the progression of approximal lesions in children and young adults, with various levels of caries risk [Gomez et al, 2005;Martignon et al, 2006Martignon et al, , 2010Martignon et al, , 2012Meyer-Lueckel et al, 2012, 2016Basili et al, 2017;Krois et al, 2018].…”

Section: Introductionmentioning

confidence: 99%

Sealing Proximal Non- and Micro-Cavitated Carious Lesions Using a One-Session Separator Technique: A 2-Year Randomised Clinical Study

Lindquist

Emilson

2020

Caries Res

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The presence of initial caries accounts for the majority of approximal carious lesions in many countries. The aim of this clustered, split-mouth, randomised, controlled clinical trial was to use a metal separator to widen the approximal space in a one-visit session before sealing and to evaluate patient acceptance, together with the efficacy of the proximal sealing in arresting incipient carious lesions after 2 years. A total of 48 patients with a mean age of 41.9 years were selected. They had at least one pair of proximal initial carious lesions, including the distal surface of the canines to the mesial surface of the third molars (bite-wing score D1–D3). The patient’s caries risk at baseline was analyzed using a Cariogram. All surfaces were examined for mutans streptococci (ms) counts. The separator technique made it possible to diagnose whether or not a microcavity was present. After 2 years, 212 surfaces in 45 subjects were examined using the same as baseline standardized digital follow-up radiographs. Two analyses were performed, one sensitive, where a progression or a regression was assessed if one of the examiners made one of those diagnoses, and one conservative, where unchanged. For both analyses, the sealed test surfaces showed a significantly higher regression (67 and 29%) compared to the control group (13 and 2%) <i>p</i> < 0.0001. It did not appear that the baseline variables, such as the caries risk, surface diagnoses, or ms counts, influenced the caries outcome. In the test group, there was no difference in caries progression if there was a microcavity or not. The separation treatment was well accepted by the patients. The method of separation for diagnosis and sealing treatment in a single session appears to be a clinically applicable method for the control of proximal carious lesions.

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How to intervene in the caries process: proximal caries in adolescents and adults—a systematic review and meta-analysis

et al. 2020

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Objectives For an ORCA/EFCD consensus, this systematic review assessed the question "How to intervene in the caries process in proximal caries in adolescents and adults". Material and methods Separating between the management of initial and cavitated proximal caries lesions, Medline via PubMed was searched regarding non-operative/non-invasive, minimally/micro-invasive and restorative treatment. First priority was systematic reviews or randomized controlled trials (RCTs), otherwise cohort studies. After extraction of data, the potential risk of bias was estimated depending on the study type, and the emerging evidence for conclusions was graded.Results Regarding non-invasive/non-operative care (NOC), no systematic reviews or RCTs were found. In cohort studies (n = 12) with a low level of evidence, NOC like biofilm management and fluoride was associated with a low proportion and slow speed of progression of initial proximal lesions. Minimally/micro-invasive (MI) treatments such as proximal sealants or resin infiltration (four systematic reviews/meta-analyses) were effective compared with a non-invasive/placebo control at a moderate level of evidence. Data on restorative treatment came with low evidence (5 systematic reviews, 13 RCTs); with the limitation of no direct comparative studies, sample size-weighted mean annual failure rates of class II restorations varied between 1.2 (bulk-fill composite) and 3.8% (ceramic). Based on one RCT, class II composite restorations may show a higher risk of failure compared with amalgam. Conclusions Proximal caries lesions can be managed successfully with non-operative, micro-invasive and restorative treatment according to lesion stage and caries activity. Clinical relevance Proximal caries treatment options like non-operative, micro-invasive and restorative care should be considered individually.

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Preventive and Therapeutic Proximal Sealing: A 3.5-Year Randomized Controlled Clinical Trial Follow-Up

Cited by 11 publications

References 17 publications

Infiltration and Sealing for Managing Non-Cavitated Proximal Lesions: A Systematic Review and Meta-Analysis

Infiltration and Sealing for Managing Non-Cavitated Proximal Lesions: A Systematic Review and Meta-Analysis

Sealing Proximal Non- and Micro-Cavitated Carious Lesions Using a One-Session Separator Technique: A 2-Year Randomised Clinical Study

How to intervene in the caries process: proximal caries in adolescents and adults—a systematic review and meta-analysis

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