Resin Infiltration of Non-Cavitated Proximal Caries Lesions in Primary and Permanent Teeth: A Systematic Review and Scenario Analysis of Randomized Controlled Trials

Abstract

The present study aimed to meta-analyze and evaluate the certainty of evidence for resin infiltration of proximal carious lesions in primary and permanent teeth. While resin infiltration has been shown efficacious for caries management, the certainty of evidence remains unclear. The protocol was registered with PROSPERO (CRD42018080895), and PRISMA guidelines have been followed. The databases PubMed, Embase, and Cochrane CENTRAL were systematically screened, complemented by hand searches and cross-referencing. Eleven relevant articles were identified and included, i.e., randomized controlled trials (RCTs) comparing the progression of resin infiltrated proximal caries lesions (combined with non-invasive measures) in primary or permanent teeth with non-invasive measures. Random-effects meta-analyses and trial sequential analyses (TSA) were performed for per-protocol (PP), intention-to-treat (ITT), and best/worst case (BC/WC) scenarios. Six included trials assessed lesions in permanent teeth and five trails assessed lesions in primary teeth. The trials had a high or unclear risk of bias. Risk of caries progression was significantly reduced for infiltrated lesions in the PP, ITT, and BC scenarios in both permanent teeth and primary teeth, but not in the WC scenario. According to the TSA, firm evidence was reached for all of the scenarios except the WC. In conclusion, there is firm evidence for resin infiltration arresting proximal caries lesions in permanent and primary teeth.

Morphological evaluation of the effectiveness of the “Icon” resin infiltration method in acute and chronic superficial dental caries

“…Modern paradigms of dental caries treatment are focused on biological approaches to the treatment of the disease and its main manifestationcarious lesions (Zero, 1999). Today, we can trace the evolution of carious lesions treatment from surgical and invasive approaches of the era of Greene Vardiman Black, the founder of dentistry, in which the American scientist described the principle of "preventive expansion of the carious cavity" to the modern period of minimally invasive biological approaches (Gray & Shellis, 2002;Cebula et al, 2023;Philip & Suneja, 2023). Minimally invasive dentistry can be defined as a philosophy of professional treatment that deals with early diagnosis and the earliest possible treatment of the disease at the micro level (Calache et al, 2013;Tassery et al, 2013).…”

Resinas Infiltrantes: Uma Abordagem Preventiva E Minimamente Invasiva Na Odontologia

“…Resultados estéticos satisfatórios com a aplicação do IconⓇ em MB ativas em dentes permanentes foram encontrados após tratamento ortodôntico (Knosel et al, 2013;Senestraro et al, 2013;Knosel et al, 2019;Kannan et al, 2019;Simon et al, 2022;Wierichs et al, 2023 [a]), também na paralisação das lesões em faces oclusais de dentes decíduos (Bakhshandeh et al, 2014) e proximais de decíduos e/ou permanentes (Paris et al, 2010;Ammari et al, 2018;Arthur et al, 2018;Paris et al, 2020). Apesar de existir outras possibilidades de tratamento para MB, como por exemplo, agentes remineralizantes, microabrasão e clareamento ao redor da mancha, a resina infiltrante pode ser escolhida como opção porser uma técnica minimamente invasiva confiável, pois apresenta eficácia e estabilidade comprovada a longo prazo, e é de fácil e rápida aplicação (Casanã-Ruiz et al, 2023;Puleio et al, 2022;Cebula et al, 2023;Arthur et al, 2018). Entretanto, possui um elevado custo quando comparada a outras técnicas (Lima et al, 2020).…”

The penetration depth of resin infiltration into enamel: A systematic review

“…[ 4 ] In addition to inhibiting caries, resin infiltration can conceal early caries lesions and enamel opacity. [ 5 ] Although the refractive index of the infiltrant (1.52) is near to that of enamel/apatite (1.62), as opposed to the refractive indices of water (1.33) and air (1.00), light scattering decreases with infiltration penetration. [ 5 6 ] When microporosities in enamel lesions are filled with resin, they lose their whitish discoloration and resemble the color of healthy enamel.…”

“…[ 5 ] Although the refractive index of the infiltrant (1.52) is near to that of enamel/apatite (1.62), as opposed to the refractive indices of water (1.33) and air (1.00), light scattering decreases with infiltration penetration. [ 5 6 ] When microporosities in enamel lesions are filled with resin, they lose their whitish discoloration and resemble the color of healthy enamel. [ 6 7 ] This novel technique has been proven to fill, reinforce, and stabilize demineralized enamel and preserve the integrity of the tooth.…”

“…[ 6 7 ] This novel technique has been proven to fill, reinforce, and stabilize demineralized enamel and preserve the integrity of the tooth. [ 4 6 , 7 ] Thus, the parameters used to evaluate the success of resin infiltration include caries arresting potential,[ 5 ] increased microhardness of enamel and improved esthetic outcomes. [ 6 7 ]…”