Sealing of carious lesions in deciduous molars
DOI:
https://doi.org/10.35699/2178-1990.2023.42396Keywords:
Dental cavity, Child, Dental materialsAbstract
Aim: To investigate the effectiveness of sealing a dentin caries lesion compared to the removal of partial caries followed by restoration in deciduous molars.
Methods: The randomized clinical trial was planned to be performed on 60 children, aged 3 to 8 years. Children were randomized by lot, with allocation into 3 groups, 20 per group: Group 1 (G1) consisted of children who received a sealing of caries using fluid resin; Group 2(G2) included children who received the sealing of caries performed with high viscosity glass ionomer cement, and Group 3(G3) conducted with children where the removal of partial caries was followed by restoration with resinous glass ionomer cement. Clinical and radiographic follow-ups were performed before and after the intervention, as well as every four months for one year, investigating whether there was a fracture in the sealing or restoration (marginal infiltration), paralysis, regression, or evolution of the carious process in the three groups.
Results: The sample was reduced to 49 children given that, during the radiographic clinical control phase, 11 were not located due to a change of address. The G1 group presented 50% cases with regression and 50% cases with paralysis. The G2 group presented 62.5% of the cases with regression and 37.5% of the cases with paralysis, while the G3 group showed 60% of the cases with regression and 40% with paralysis. There was no statistically significant association between the type of group and the progression of the lesion, with no difference found between the groups (p value=0.74).
Conclusion: There was no difference between the groups regarding the progression of carious lesions when treated only with fluid resin sealing or with high viscosity glass ionomer cement or with conventional restoration with resinous glass ionomer cement after the removal of decayed tissue.
Downloads
References
Innes NP, Clarkson JE, Douglas GVA, Ryan V, Wilson N, Homer T, et al. Child care management: a randomized controlled trial in dental practice. J Dent Res. 2020;99(1):36-43.
Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: a systematic review and meta regression. J Dent Res. 2015;94(5):650-8.
Vasconcelos AA, Girão DC, Parisotto TM, Imparato JCP. Selamento de lesões de cáries oclusais em metade externa de dentina em dentes decíduos: estudo clínico randomizado em crianças cearenses. Rev Odontol Bras Central. 2017;26(77):26-32.
Santamaria RM, Innes NPT, Machiulskiene V, Evans DJP, Splieth CH. Caries management strategies for primary molars: 1-yr randomized control trial results. J Dent Res. 2014;93(11):1062-9.
Mijan M, Amorim RG, Leal SC, Mulder J, Oliveira L, Creugers NHJ, et al. The 3.5-year survival rates of primary molars treated according to three treatment protocols: a controlled clinical trial. Clin Oral Investig. 2014;18(4):1061-9.
Franzon R, Guimarães LF, Magalhães CE, Haas AN, Araujo FB. Outcomes of one-step incomplete and complete excavation in primary teeth: a 24-month randomized controlled trial. Caries Res. 2014;48(5):376-83.
Maltz M, Alves LS, Jardim JJ, Moura MS, Oliveira EF. Incomplete caries removal in deep lesions: a 10- year prospective study. Am J Dent. 2011;24(4):211-4.
Shinkai K, Taira Y, Suzuki S, Suzuki M. In vitro wear of flowable resin composite for posterior restorations. Dent Mater J. 2016;35(1):37-44.
Bakhshandeh A, Qvist V, Ekstrand KR. Sealing occlusal caries lesions in adults referred for restorative tratment: 2–3 years of follow-up. Clin Oral Invest. 2012;16(2):521-9.
Goldman AS, Chen X, Fan M, Frencken JE. Methods and preliminary findings of a cost-effectiveness study of glass-ionomer-based and composite resin sealant materials after 2 yr. Eur J Oral Sci. 2014;122(3):230-7.
Amorim RG, Frencken JE, Raggio DP, Chen X, Hu X, Leal SC. Survival percentages of atraumatic restorative treatment (ART) restorations and sealants in posterior teeth: an updated systematic review and metaanalysis. Clin Oral Investig. 2018;22(8):2703-25.
Dhar V, Hsu KL, Coll JA, Ginsberg E, Ball M, Chhibber S, et al. Evidence-based update of pediatric dental restorative procedures: dental materials. J Clin Pediatr Dent. 2015;39(4):303-10.
Dias KR, Andrade CB, Wait TT, Chamon R, Ammari MM, Soviero VM, et al. Efficacy of sealing occlusal caries with a flowable composite in primary molars: A 2-year randomized controlled clinical trial. J Dent. 2018;74:49-55.
Faustino-Silva DD, Figueiredo MC. Atraumatic restorative treatment-ART in early childhood caries in babies: 4years of randomized clinical trial. Clin Oral Investig. 2019;23(10):3721-9.
Hesse D, Bonifacio CC, Mendes FM, Braga MM, Imparato JCP, Raggio DP. Sealing versus partial caries removal in primary molars: a randomized clinical trial. BMC Oral Health. 2014;14:58-64.
Ladewig NM, Camargo LB, Tedesko TK, Floriano I, Gimenez T, Imparato JCP, et al. Management of dental caries among children: a look at the cost-effectiveness. Expert Rev Pharma Outcomes Res. 2018;18(2):127-34.
Mijan M, Amorim RG, Leal SC, Mulder J, Oliveira L, Creugers NHJ, et al. The 3.5-year survival rates of primary molars treated according to three treatment protocols: a controlled clinical trial. Clin Oral Investig. 2014;18(4):1061-9.
Smales RJ, Gao W. In vitro caries inhibition at the enamel margins of glass-ionomer restoratives developed for the ART approach. J Dent. 2000;28(4):249-56.
Binas Junior LV, Barros AKC, Silva LHV, Gaia LGTM, Binas IWV, Mendonça ICG. Cimento de ionômero de vidro: revisão de literatura. Braz J Health Rev. 2022;5(2):6893-902.
Van’t Hof MA, Frencken JE, Helderman WHVP, Holmgren CJ. The atraumatic restorative treatment (ART) approach for managing dental caries: a meta-analysis. Int Dent J. 2006:56(6):345-51.
Moura MS, Sousa GP, Brito MHSF, Silva MCC, Lima MDM, Moura LFAD, et al. Does low-cost GIC have the same survival rate as high-viscosity GIC in atraumatic restorative treatments? A RCT. Braz Oral Res. 2020;33:e125.
Olegário IC, Pacheco ALB, Araújo MP, Ladewig NM, Bonifácio CC, Imparato JCP, et al. Low-cost GICs reduce survival rate in occlusal ART restorations in primary molars after one year: a RCT. J Dent. 2017;57:45-50.
Pacheco ALB, Olegário IC, Bonifácio CC, Calvo AFB, Imparato JCP, Raggio DP. One year survival rate of ketac molar versus vitro molar for occlusoproximal ART restorations: a RCT. Braz Oral Res. 2017;31:e88.
Muniz AB, Bessa ERL, Holanda MAR, Damasceno AGRL, Souza Júnior PRP, Melo ECS, et al. Cimento de ionômero de vidro em odontopediatria: revisão narrativa. REAS. 2020;12(10):e3853.
Bertacchini, SM, Abate PF, Blank A, Baglieto MF, Macchi RL. Solubility and fluoride release in ionomers and compomers. Quintessence Int. 1999;30(3):193-7.
Bonifácio CC, Kleverlaan CJ, Raggio DP, Werner A, Carvalho RCR, Van Amerogen WE. Physical-mechanical properties of glass ionomer cements indicated for atraumatic restorative treatment. Aust Dent J. 2009;54(3):233-7.
Burke FJT, Fleming GJP, Owen FJ, Watson DJ. Materials for restoration of primary teeth: 2. glass ionomer derivatives and compomers. Dent Update. 2002;29(1):10-4,16-7.
Dhar V, Hsu KL, Coll JA, Ginsberg E, Ball BM, Chhibber S, et al. Evidence-based update of pediatric dental restorative procedures: dental materials. J Clin Pediatr Dent. 2015;39(4):303-10.
Fontelles MJ, Simões MG, Almeida JC, Fontelles RGS. Research methodology: guidelines for calculating the sample size. Rev Paran Med. 2010;24(2):57-64.
Schulz KF, Altman DG, Moher D; Consort Group. Consort 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332.
Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. Consort 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010;63(8):e1-37.
Krleza-Jerić K, Chan AW, Dickersin K, Sim I, Grimshaw J, Gluud C. Principles for international registration of protocol information and results from human trials of health-related interventions: Ottawa statement (part 1). BMJ. 2005;330(7497):956-8.
