IADR Abstract Archives
Postponing Restorative Intervention of Occlusal Dentin Caries by Non-Invasive Sealing
Objectives: To investigate the possibility of postponing restorative intervention of manifest occlusal caries in the young permanent dentition by non-invasive sealing
Methods: This prospective, RCT-designed study, approved by the Ethics Committee, includes 521 occlusal caries lesions in 521 patients, aged 6-17 years (mean 11.9). Based on clinical and radiographic assessment all lesions were in need of restorative treatment. After randomization (ratio 2:1), 368 resin sealings and 153 composite-resin restorations were performed by 68 dentists from 2006 to 2009 in 9 PDHS. Treatments were annually controlled, clinically and radiographic, until patients were referred to private dentistry at age 18 years. Chi-square test, Kaplan-Meier survival-analyses and Cox regression-analyses were applied for statistical data-analyses.
Results: After 5-8 years (mean 7.0) the dropout rate was 8%, and 54% of the treatments were completed due to age (50%) or primary caries (4%). 31% of the sealings were replaced by restorations and 12% were still functioning although some were repaired/renewed. 7% of the restorations were repaired/renewed and 20% were still functioning. No endodontics was performed. 7-yr survival for sealings not repaired/renewed/replaced by restorations was 42% (SE 5%), and 92% (SE 2%) for restorations not repaired/renewed (p<0.001). The median survival time for sealings not replaced by restorations was 7.4 years. Survival of sealings was increased in patients with low caries risk and/or excellent oral hygiene, 2nd molar teeth compared to 1st molar teeth, and lesions not extending the middle third of the dentin. Survival of sealings was not influenced by eruption stage of tooth, nor by surface demineralization/cavitation.
Conclusions: Notably, the results indicate the possibility of postponing restorative intervention of occlusal dentin caries lesions in young permanent teeth by non-invasive sealing. As expected, the restorations showed the best survival, but more than half of the sealed lesions were still not restored after the first 7 years.
Methods: This prospective, RCT-designed study, approved by the Ethics Committee, includes 521 occlusal caries lesions in 521 patients, aged 6-17 years (mean 11.9). Based on clinical and radiographic assessment all lesions were in need of restorative treatment. After randomization (ratio 2:1), 368 resin sealings and 153 composite-resin restorations were performed by 68 dentists from 2006 to 2009 in 9 PDHS. Treatments were annually controlled, clinically and radiographic, until patients were referred to private dentistry at age 18 years. Chi-square test, Kaplan-Meier survival-analyses and Cox regression-analyses were applied for statistical data-analyses.
Results: After 5-8 years (mean 7.0) the dropout rate was 8%, and 54% of the treatments were completed due to age (50%) or primary caries (4%). 31% of the sealings were replaced by restorations and 12% were still functioning although some were repaired/renewed. 7% of the restorations were repaired/renewed and 20% were still functioning. No endodontics was performed. 7-yr survival for sealings not repaired/renewed/replaced by restorations was 42% (SE 5%), and 92% (SE 2%) for restorations not repaired/renewed (p<0.001). The median survival time for sealings not replaced by restorations was 7.4 years. Survival of sealings was increased in patients with low caries risk and/or excellent oral hygiene, 2nd molar teeth compared to 1st molar teeth, and lesions not extending the middle third of the dentin. Survival of sealings was not influenced by eruption stage of tooth, nor by surface demineralization/cavitation.
Conclusions: Notably, the results indicate the possibility of postponing restorative intervention of occlusal dentin caries lesions in young permanent teeth by non-invasive sealing. As expected, the restorations showed the best survival, but more than half of the sealed lesions were still not restored after the first 7 years.