J C Hamilton1, J B Dennison, K W Stoffers, K B Welch. 1. Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 N. University, Ann Arbor, Mich. 48109, USA. jchamilt@umich.edu
Abstract
BACKGROUND: The efficacy of treating questionable incipient lesions early with air abrasion, a modality used by many practitioners, has not been adequately demonstrated. METHODS: The authors enrolled 223 teeth, each with a questionable incipient pit-and-fissure carious lesion, from 93 dental patients in a projected five-year randomized clinical trial. Caries was defined as softness, decalcification or cavitation at the base of a pit or fissure or radiographic evidence of caries. Each tooth was randomly assigned to either a treatment group (n = 113 teeth) or a control group (n = 110 teeth) (which was observed but left untreated until the definition of caries was met). Each tooth in the treatment group was air-abraded and restored with a flowable resin-based composite. The authors re-examined teeth in both groups every six months; they evaluated the restorations using a modified set of Ryge criteria and inspected teeth for caries using radiographs, mirrors and standardized explorers. RESULTS: Of the 113 teeth with questionable incipient carious lesions air-abraded in the treatment group, 50 had caries extending into dentin. After 12 months of clinical service, there were three sealants that exhibited a partial loss of sealant which did not require any re-treatment. Two restorations with penetrating staining were re-treated. In the control group at the end of 12 months, only nine of the 86 recalled teeth were diagnosed with pit-and-fissure caries and were treated with air abrasion and restored with flowable resin-based composite. There was no statistically significant difference between the volume of the treatment and control preparations. CONCLUSION: After 12 months of clinical service, two preventive resin-based composite restorations in the treatment group required re-treatment. Fewer teeth than expected in the control group were diagnosed as having caries and were treated. CLINICAL IMPLICATIONS: The merit of treating questionable incipient pit-and-fissure carious lesions early with air abrasion has not been demonstrated after 12 months in this clinical study.
RCT Entities:
BACKGROUND: The efficacy of treating questionable incipient lesions early with air abrasion, a modality used by many practitioners, has not been adequately demonstrated. METHODS: The authors enrolled 223 teeth, each with a questionable incipient pit-and-fissure carious lesion, from 93 dental patients in a projected five-year randomized clinical trial. Caries was defined as softness, decalcification or cavitation at the base of a pit or fissure or radiographic evidence of caries. Each tooth was randomly assigned to either a treatment group (n = 113 teeth) or a control group (n = 110 teeth) (which was observed but left untreated until the definition of caries was met). Each tooth in the treatment group was air-abraded and restored with a flowable resin-based composite. The authors re-examined teeth in both groups every six months; they evaluated the restorations using a modified set of Ryge criteria and inspected teeth for caries using radiographs, mirrors and standardized explorers. RESULTS: Of the 113 teeth with questionable incipient carious lesions air-abraded in the treatment group, 50 had caries extending into dentin. After 12 months of clinical service, there were three sealants that exhibited a partial loss of sealant which did not require any re-treatment. Two restorations with penetrating staining were re-treated. In the control group at the end of 12 months, only nine of the 86 recalled teeth were diagnosed with pit-and-fissure caries and were treated with air abrasion and restored with flowable resin-based composite. There was no statistically significant difference between the volume of the treatment and control preparations. CONCLUSION: After 12 months of clinical service, two preventive resin-based composite restorations in the treatment group required re-treatment. Fewer teeth than expected in the control group were diagnosed as having caries and were treated. CLINICAL IMPLICATIONS: The merit of treating questionable incipient pit-and-fissure carious lesions early with air abrasion has not been demonstrated after 12 months in this clinical study.
Authors: S K Makhija; G H Gilbert; E Funkhouser; J D Bader; V V Gordan; D B Rindal; D J Pihlstrom; V Qvist Journal: Caries Res Date: 2014-01-29 Impact factor: 4.056
Authors: Sonia K Makhija; Gregg H Gilbert; Ellen Funkhouser; James D Bader; Valeria V Gordan; D Brad Rindal; Vibeke Qvist; Pia Nørrisgaard Journal: J Am Dent Assoc Date: 2014-11 Impact factor: 3.634
Authors: Sonia K Makhija; Gregg H Gilbert; Ellen Funkhouser; James D Bader; Valeria V Gordan; D Brad Rindal; Michael Bauer; Daniel J Pihlstrom; Vibeke Qvist Journal: J Am Dent Assoc Date: 2012-12 Impact factor: 3.634
Authors: Falk Schwendicke; Tanya Walsh; Thomas Lamont; Waraf Al-Yaseen; Lars Bjørndal; Janet E Clarkson; Margherita Fontana; Jesus Gomez Rossi; Gerd Göstemeyer; Colin Levey; Anne Müller; David Ricketts; Mark Robertson; Ruth M Santamaria; Nicola Pt Innes Journal: Cochrane Database Syst Rev Date: 2021-07-19