Two year clinical evaluation of air abrasion for treating questionable carious lesions

Air abrasion is utilized by approximately 25% of the dentists in the United States to prepare small cavity preparations. Objectives: This is a two year report of a randomized clinical trial that investigates if tooth structure is conserved by early treatment of small questionable carious lesions. Methods: The authors enrolled 93 dental patients with a total of 223 questionable, incipient pit and fissure carious lesion into a randomized clinical trial. Each lesion (tooth) was randomly assigned to either a treatment or control (observed) group. Each tooth in the treatment group was air abraded to remove any questionable carious lesions. An impression of the cavity preparation was made prior to restoring with flowable composite. Teeth in both groups were recalled every six months for evaluation of the restorations using a modified Ryge criteria, and caries using radiographs, mirror and standardized explorer. If a control tooth was diagnosed with caries it was prepared, impressed and restored exactly as a treatment tooth. Weights of preparation impressions of teeth in the treatment and control groups were compared using an independent samples t-test. Results: During the second year of recall 5 additional control teeth were diagnosed and treated for caries compared with 9 during the first year. First year data reported in JADA volume 132:762-69. The mean weight of the impressions of the preparations in control teeth was 0.028 grams and for the early treatment group 0.026 grams. There was no significant difference between the weights of the preparation impressions (p=0.390). No additional treatment teeth required retreatment during the second year of recall. Conclusions: After 24 months there was no significant difference in the mean volume of the preparation impressions when comparing the early treatment group and the control group. No restorations / sealants required retreatment during the second year of recall.