Occlusal Dentin Caries Lesions Without Obvious Cavitation: Control, Seal or Restore?

Objectives: The aim of this randomized clinical trial was to compare the efficacy of three clinical protocols for the management of caries lesions in dentin without obvious cavitation . The three protocols were: a) to apply fluoride varnish (GFV); b) to seal with resin modified glass ionomer cement (GS); c) to restore with resin modified glass ionomer cement (GPR).
Methods: A total of 43 primary molars from 22 children that clinically presented with shadow in dentine (CAST 4) and radiographically a carious lesion involving up to half of the dentine were selected. The teeth were randomized into 3 groups as follows: GFV (n=14) – application of fluoride varnish; GS (n=17) – sealing with resin modified glass ionomer cement; and GPR (n=12) – restoration with resin modified glass ionomer cement. The treatments were performed by a single calibrated operator and evaluated by two independent examiners by means of clinical and radiographic examination after 6 months
Results: The results were obtained through descriptive analysis to compare the groups.
Considering sealant/restoration failure only one restoration needed to be replaced. For the caries progression outcome observed at the radiographs, only one tooth from the GFV progressed to cavitation. In terms of the efficacy of the treatments, there was no statistically significant difference (p>0.05) among the tested protocols.
Conclusions: It was concluded that the three types of treatments presented similar performance and satisfactory success rate after 6 months of follow-up.