Yuanyuan Chen1,2,3, Dongru Chen4,2,3, Huancai Lin5,6,7. 1. Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China. 2. Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China. 3. Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China. 4. Department of Orthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China. 5. Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China. linhc@mail.sysu.edu.cn. 6. Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China. linhc@mail.sysu.edu.cn. 7. Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China. linhc@mail.sysu.edu.cn.
Abstract
BACKGROUND: Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels. METHODS: Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. RESULTS: In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15-0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18-0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20-0.45; permanent dentition: OR = 0.20, 95% CI 0.14-0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14-0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01-8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08-0.72; low to moderate risk: OR = 0.38, 95% CI 0.18-0.81; moderate to high risk: OR = 0.17, 95% CI 0.10-0.29; and high risk: OR = 0.14, 95% CI 0.07-0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01-8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08-0.72; low to moderate risk: OR = 0.38, 95% CI 0.18-0.81; moderate to high risk: OR = 0.20, 95% CI 0.10-0.39; and high risk: OR = 0.14, 95% CI 0.05-0.37). CONCLUSION: Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.
BACKGROUND: Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels. METHODS: Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. RESULTS: In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15-0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18-0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20-0.45; permanent dentition: OR = 0.20, 95% CI 0.14-0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14-0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01-8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08-0.72; low to moderate risk: OR = 0.38, 95% CI 0.18-0.81; moderate to high risk: OR = 0.17, 95% CI 0.10-0.29; and high risk: OR = 0.14, 95% CI 0.07-0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01-8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08-0.72; low to moderate risk: OR = 0.38, 95% CI 0.18-0.81; moderate to high risk: OR = 0.20, 95% CI 0.10-0.39; and high risk: OR = 0.14, 95% CI 0.05-0.37). CONCLUSION: Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.
Authors: Gordon H Guyatt; Andrew D Oxman; Gunn E Vist; Regina Kunz; Yngve Falck-Ytter; Pablo Alonso-Coello; Holger J Schünemann Journal: BMJ Date: 2008-04-26
Authors: N J Cochrane; P Shen; S J Byrne; G D Walker; G G Adams; Y Yuan; C Reynolds; B Hoffmann; S G Dashper; E C Reynolds Journal: Caries Res Date: 2012-04-05 Impact factor: 4.056