Satisfaction with dental care among patients who receive invasive or non-invasive treatment for non-cavitated early dental caries: findings from one region of the National Dental PBRN

Lin

2021

BMC Oral Health

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 Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised 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. Results In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15–0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18–0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20–0.45; permanent dentition: OR = 0.20, 95% CI 0.14–0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.17, 95% CI 0.10–0.29; and high risk: OR = 0.14, 95% CI 0.07–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.20, 95% CI 0.10–0.39; and high risk: OR = 0.14, 95% CI 0.05–0.37). Conclusion Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.

Section: Discussionmentioning

confidence: 99%

Infiltration and sealing for managing non-cavitated proximal lesions: a systematic review and meta-analysis

Lin

2021

BMC Oral Health

“…Noninvasive treatments are regarded as ethical and should be considered part of the treatment plan [60]. Even though, patients may refuse non-invasive treatments and favour invasive treatments under some circumstances [61]. Thus, for patients with proximal caries lesions, micro-invasive treatments seems to be a meaningful and important choice.…”

Section: Discussionmentioning

confidence: 99%

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

Chen¹,

Lin³

2020

Preprint

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.

“…Non-invasive treatments are regarded as ethical and should be considered part of the treatment plan, especially when the disease process is controlled [44,70]. However, patients might refuse non-invasive treatments and favour invasive treatments under some circumstances [71]. Thus, for patients with proximal caries lesions, micro-invasive treatments seem to be a meaningful and important choice.…”

Section: Discussionmentioning

confidence: 99%

Infiltration and sealing for managing non-cavitated proximal lesions: A systematic review and meta-analysis

Chen¹,

Lin³

2020

Preprint

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: Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised 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.Results: In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs non-invasive: OR = 0.21, 95% CI: 0.15 to 0.30; sealing vs placebo: OR = 0.27, 95% CI: 0.18 to 0.42). For both the 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 = 0.20, 95% CI: 0.14 to 0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI: 0.14 to 0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI: 0.01 to 8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI: 0.08 to 0.72; low to moderate risk: OR=0.38, 95% CI: 0.18 to 0.81; moderate to high risk: OR = 0.17, 95% CI: 0.10 to 0.29; and high risk: OR = 0.14, 95% CI: 0.07 to 0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI: 0.01 to 8.27), infiltration was superior (low risk: OR = 0.24, 95% CI: 0.08 to 0.72; low to moderate risk: OR = 0.38, 95% CI: 0.18 to 0.81; moderate to high risk: OR = 0.20, 95% CI: 0.10 to 0.39; and high risk: OR = 0.14, 95% CI: 0.05 to 0.37).Conclusion: Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.