IADR Abstract Archives
Approximal Lesion-Infiltration Supplementary To F-Varnish In HCR-Population – 2YR-Results
Objectives: Contemporary management options of early, non-cavitated caries lesions at approximal surfaces include resin-infiltration. Micro-invasive resin-infiltration has shown to inhibit lesion progression and may offer an alternative to traditional invasive operative treatment. A clinical protocol for lesion-infiltration proposes a more informed, less-invasive approach: minimizing possible harms, while preserving tooth-structure and healthcare resources. Utilizing split-mouth design in addition to multiple F–varnish applications, adjunct proactive lesion-management by resin-infiltration is investigated and compared to historically reactive standard-of-care (SOC). Study aim: Evaluation of approximal lesion-infiltration effects, supplementary to SOC-management in High Caries Risk (HCR)-patients.
Methods: 42 consented HCR-subjects (6.9+3.0 DMFT) were enrolled for management of two interproximal lesions. All patients received professional HCR-regimen: oral hygiene instructions, diet-counseling, dental prophylaxis, F-dentifrice and repeated F-varnish applications. Two affected E2/D1-surfaces were randomly treated by resin-infiltration (ICON, DMG) or mock-infiltration (control). Individually-standardized digital radiographs provided visual determination of lesion-size distribution at baseline and at recall. Data were analyzed by logistic regression and McNemar test.
Results: 24 pairs (57.1%) presented for 2-YR recall evaluations. Visual radiographic assessment showed lesion-progression in control group only. Categorical assessment (single radiographs) resulted in 1 discordant D2-lesion pair with control lesion progressing into dentin (D1). Radiographic image sets (1yr/2yr) were analyzed for changes in lesion-surface and density over time. Pairwise assessment showed 5 additional control lesions (2 E2, 3 D1) slowly progressing within category, while infiltrated lesions were stable.
Conclusions: After 2 years, visual radiograph assessment revealed stable lesions in infiltrated group versus limited lesion progression in control group. The data confirmed the trend of lesion inhibition by infiltration therapy.
Long-term follow-up may strengthen the evidence for efficacy of resin infiltration combined with SOC HCR-regimen including F-varnish.
Methods: 42 consented HCR-subjects (6.9+3.0 DMFT) were enrolled for management of two interproximal lesions. All patients received professional HCR-regimen: oral hygiene instructions, diet-counseling, dental prophylaxis, F-dentifrice and repeated F-varnish applications. Two affected E2/D1-surfaces were randomly treated by resin-infiltration (ICON, DMG) or mock-infiltration (control). Individually-standardized digital radiographs provided visual determination of lesion-size distribution at baseline and at recall. Data were analyzed by logistic regression and McNemar test.
Results: 24 pairs (57.1%) presented for 2-YR recall evaluations. Visual radiographic assessment showed lesion-progression in control group only. Categorical assessment (single radiographs) resulted in 1 discordant D2-lesion pair with control lesion progressing into dentin (D1). Radiographic image sets (1yr/2yr) were analyzed for changes in lesion-surface and density over time. Pairwise assessment showed 5 additional control lesions (2 E2, 3 D1) slowly progressing within category, while infiltrated lesions were stable.
Conclusions: After 2 years, visual radiograph assessment revealed stable lesions in infiltrated group versus limited lesion progression in control group. The data confirmed the trend of lesion inhibition by infiltration therapy.
Long-term follow-up may strengthen the evidence for efficacy of resin infiltration combined with SOC HCR-regimen including F-varnish.