Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis
Volume 42, Issue 10, October 2014, Pages 1217–1227
Abstract
Objectives
The
aim of this study was to perform a systematic review and meta-analysis
on the effectiveness of sealing non-cavitated proximal caries lesions in
primary and permanent teeth.
Data
Only
controlled clinical trials and randomized controlled clinical trials
that evaluated the effectiveness of sealing on non-cavitated proximal
caries with a minimum follow-up of 12 months were included in the study.
The primary outcome should be arrestment/progression of proximal caries
evaluated by bitewing radiographs. A risk of bias evaluation based on
the Cochrane Collaboration common scheme for bias was carried out for
each study. The meta-analysis was performed on the studies considered
low risk of bias and with pair-wise visual reading results through
RevMan software.
Sources
A
comprehensive search was performed in the Systematic Electronic
Databases: Pubmed, Cochrane Library, Scopus, IBI Web of Science, Lilacs,
SIGLE, and on website Clinical trials.gov, through until June 2013.
Study selection
From
967 studies identified, 10 articles and 3 studies with partial results
were assessed for eligibility. However three articles were excluded and
our final sample included 10 studies. According to the risk of bias
evaluation, six studies were considered “high” risk of bias, and four
“low” risk of bias. The forest plot of the meta-analysis showed low
heterogeneity (I2 = 29%) and a favourable outcome
for the Infiltrant. The chance of caries progression when this technique
was used was significantly lower (p = 0.002) compared with Placebo.
Conclusion
Our
results suggest that the technique of sealing non-cavitated proximal
caries seems to be effective in controlling proximal caries in the short
and medium term. Further long-term randomized clinical trials are still
necessary to increase this evidence.
Clinical significance
Contemporary
dentistry is focused in minimally invasive approaches that prevent the
destruction of sound dental tissues next to carious lesions. This paper
searches for evidence of the efficacy of sealing/infiltrating
non-cavitated proximal caries in arresting caries progression both in
permanent and primary teeth.
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