Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth

Dorri, Mojtaba; Dunne, Stephen; Walsh, Tanya; Schwendicke, Falk

doi:10.1002/14651858.cd010431.pub2

Cited by 104 publications

(127 citation statements)

References 59 publications

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“…The results demonstrate that after 3.5 years, proximal sealing on the sound mesial surfaces of the first permanent molars were efficacious in preventing the development of dental caries. These are findings that are in line with the findings of recent reports showing that sealing and infiltration methods are efficacious in reducing the progression of non-cavitated proximal lesions [Dorri et al, 2015;Schwendicke et al, 2015;Meyer-Lueckel et al, 2016].…”

Section: Discussionsupporting

confidence: 89%

“…There is an immense potential for initial caries to develop into lesions and this has motivated studies on the use of sealing to arrest the progression of caries on both occlusal and proximal tooth surfaces [Splieth et al, 2010;Ammari et al, 2014;Dorri et al, 2015;Schwendicke et al, 2015]. Promising results have been obtained by microinvasive treatment of early Keywords Caries · Caries detection/diagnosis/prevention · Minimally invasive dentistry · Preventive dentistry · Proximal sealing · Risk factors Abstract Objective: The aim of this split-mouth, randomized controlled clinical trial was to evaluate the efficacy of proximal sealing for avoiding the development of new caries lesions or arresting incipient caries lesions on the mesial surface of first permanent molars (6m) abutting lesions on the distal surface of second primary molars (05d) in children at high caries risk.…”

confidence: 99%

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

et al. 2017

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Objective: The aim of this split-mouth, randomized controlled clinical trial was to evaluate the efficacy of proximal sealing for avoiding the development of new caries lesions or arresting incipient caries lesions on the mesial surface of first permanent molars (6m) abutting lesions on the distal surface of second primary molars (05d) in children at high caries risk. Methods: A total of 61 children 8-10 years old were selected based on the caries status of the proximal sites of 05d and 6m. Children with caries on 05d and caries-free 6m were placed in the preventive sealing group and children with caries on both 05d and 6m in the therapeutic group. The children in each group had one 6m surface pair and in each pair one 6m surface was randomly allocated to receive a preventive or therapeutic sealing. Using a split-mouth design, the other 6m surface in the pair served as control. Results: After 3.5 years, standardized follow-up radiographs were obtained for the 45 children who remained. In the preventive sealing group, 4 out of 30 (13.3%) sealed and 16 out of 30 (53.3%) unsealed sound 6m surfaces had developed new caries lesions (p = 0.004, McNemar test). In the therapeutic sealing group, the progression of the carious lesions on 6m was observed in 3 out of 15 sealed (20.0%) and 8 out of 15 (53.3%) unsealed caries control surfaces (p = 0.06). Conclusions: Preventive sealing on sound 6m surfaces abutting 05d lesions in children at high caries risk efficaciously prevents the development of caries lesions. Therapeutically sealing active non-cavitated caries lesions reduces the progression.

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Section: Discussionsupporting

confidence: 89%

confidence: 99%

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

et al. 2017

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“…With the more recent insight that caries is not an infectious disease and (complete) carious tissue removal is not necessary [Ricketts et al, 2013], the recommended moment of operative intervention is when preventive measures such as biofilm control, remineralisation strategies and sealing are no longer expected to be successful [Marinho et al, 2013;Ricketts et al, 2013;Dorri et al, 2015]. As a current guideline, cavitated lesions are considered appropriate candidates for operative intervention [Meyer-Lueckel and Paris, 2016].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Intervention for Primary Caries Lesions: Are Dentists Implementing This Concept?

Laske¹,

Opdam²,

Bronkhorst³

et al. 2018

Caries Res

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Contemporary minimally invasive treatment concepts for restorative treatment of primary caries lesions include both delayed intervention and smaller-sized preparations restricted to removal of carious tissue. The aim of this study was to investigate whether these concepts have resulted in a trend towards a more conservative choice made by dentists regarding treatment thresholds and restorative techniques. The results from previously conducted, precoded questionnaires developed by Espelid and Tveit, as well as from a recent Dutch questionnaire, were collected and analysed. A worldwide trend towards more minimally invasive strategies in the operative treatment of caries lesions could not be observed, neither for the initiation of operative treatment nor for the preparation techniques. However, in some countries, changes over time could be assessed, especially in Norway, where a reduction in the proportion of interventions is visible for both occlusal and approximal lesions, indicating that more dentists are postponing interventions until the lesions have progressed to a deeper level. From the Dutch national survey, it could be concluded that operators that intervene at an earlier stage of approximal lesioning (stage ≤4) also intervene at an earlier stage of occlusal caries (stage ≤3) (p = 0.012; OR = 2.52; 95% CI: 1.22–5.22). Generally, it can be concluded that dentists worldwide still tend to operatively intervene at a too early stage of caries, although variations exist between countries. A worldwide shift could be observed in the restorative material applied, since composite resin has almost completely replaced amalgam for restoring primary caries lesions.

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“…After two years, only 16% of the lesions in the monitoring arm had caries that progressed into dentin requiring invasive treatment. Given the evidence that, if done properly, non-invasive options such as sealants may be successful at arresting these types of lesions 23–24 .…”

Section: Discussionmentioning

confidence: 99%

Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions

Makhija¹,

Shugars²,

Gilbert³

et al. 2017

The Journal of the American Dental Association

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Background A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency, but where caries is suspected due to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). Our objective was to quantify the characteristics of SOCLs and their relationship to lesion depth/activity after surgically opening these lesions. Methods Ninety-three dentists participated. When consented patients presented with a SOCL, information was recorded about the tooth, lesion, treatment(s) done and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted chi-square test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster. Results 1593 SOCLs were analyzed. Lesion color varied from yellow/light brown (40%) to dark brown/black (47%), with 13% other color. A majority (69%) of SOCLs had a rough surface when examined with an explorer. Over 1/3 of the SOCLs (39%) were treated surgically. Of the surgically treated SOCLs (n=585), 61% had dentinal caries. There were statistically significant associations between lesion depth and color (p=0.03), luster (p=0.04) and roughness (p=0.01). 52% of patients were classified as being at elevated caries risk. There were no significant associations between lesion depth and patient risk (p=0.07). Conclusion Although statistically significant, the clinical characteristics studied do not provide accurate guidance for making definitive treatment decisions, and result in high rates of false positives. Practical implications Given that 39% of opened lesions did not have dentinal caries or were inactive, evidence-based preventive management is an appropriate alternative to surgical intervention.

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Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth

Cited by 104 publications

References 59 publications

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

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

Minimally Invasive Intervention for Primary Caries Lesions: Are Dentists Implementing This Concept?

Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions

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