A randomized clinical trial on the sealing of occlusal carious lesions: 3–4-year results

Abstract

This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8-43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3-4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3-4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.

A Novel Dental Sealant Containing Dimethylaminohexadecyl Methacrylate Suppresses the Cariogenic Pathogenicity of Streptococcus mutans Biofilms

“…Although sealants are a widely used preventive approach against occlusal carious lesions, the failure rate is high. Longitudinal data [5,6] show reasons for failure related to bacterial colonization underneath the sealed fissures with the progressive demineralization and development of cavitation.…”

Tratamento Minimamente Invasivo De Lesões Cariosas Em Odontopediatria

“…No caso de lesões oclusais, estas devem possuir uma abertura de até 3 mm (ABOPED, 2020). Sua realização consiste apenas na limpeza da superfície, através de profilaxia, e posterior realização do procedimento restaurador, sem realizar remoção de tecido cariado nem qualquer tipo de instrumentação da cavidade (BAKHSHANDEH; QVIST; EKSTRAND, 2012;ALVES et al, 2017;DIAS et al, 2018).…”

“…Apesar de ainda pouco estudada em odontopediatria, verificou-se que ela reduz o tempo de cadeira e não eleva a ansiedade das crianças, sendo uma boa alternativa para esses pacientes (DIAS et al, 2018). Sua atuação promove o controle da doença através do restabelecimento do equilíbrio bucal, sendo uma técnica operatória simples e menos invasiva, representando uma opção viável para o tratamento de lesões pequenas ou não cavitadas (ALVES et al, 2017;ABOPED, 2020). Recomendase que, diante de situações de dúvida sobre restaurar ou não um elemento dentário, deve-se optar pela reavaliação (ABOPED, 2020).…”

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

“…One rather interesting sealant study assessed the efficacy of sealing occlusal carious lesions in permanent molars and premolars. 305 This randomized clinical trial included teeth with carious lesion depth to the middle third of dentin and randomly assigned the teeth to either sealant or conventional restorative treatment. No caries removal was performed before sealant placement, and the teeth were followed up for 3 to 4 years.…”

“…Sealants were applied in 1 group of teeth and conventional restorative treatment in the other half. 305 The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3-to 4-year period, and the failure rate of restored teeth was 6%, wheras for the sealed teeth, it was 26%. The significant difference in the durability of the treatment was due to failure of the sealants that frequently debond from the surface and not to the progression of caries itself.…”