Clinical success of infiltrant and resin sealant on incipient caries of permanent teeth: an integrative review of literature

PIMENTA, Alexssandro Fermiano; SANTOS DAROZ, Claudia Batitucci dos

doi:10.1590/1981-86372022000620200030

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

ORIGINAL • Rev Gaúch. Odontol. 70 • 2022 • https://doi.org/10.1590/1981-86372022000620200030 linkcopy

Clinical success of infiltrant and resin sealant on incipient caries of permanent teeth: an integrative review of literature

Sucesso clínico do infiltrante e selante resinoso em cáries incipientes de dentes permanentes: uma revisão integrativa da literatura

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To perform an integrative literature review, presenting techniques to seal incipient caries, their advantages, indications and failures, and comparing their clinical success.

Methods: The guiding question for this literature review was: What technique, sealant or resin infiltration, provides longer clinical longevity in sealing incipient caries lesions in permanent teeth? 1707 scientific articles published from 2005 to 2019 were searched in the PubMed, LILACS and SciELO databases, using the following keywords: “caries sealing”, “resinous infiltrant,” and “caries progression”. After their titles and abstracts were read, 10 papers were selected according to the inclusion criteria: papers written in the English language, randomized clinical control trials lasting at least one year, and techniques using infiltration sealing or resin sealant as the treatment method of active carious lesions in occlusal and proximal surfaces of permanent teeth with involvement up to the outer layer of dentin. The Mann-Whitney statistical test was used to compare the techniques (alpha=0.05).

Results: Six studies used a split mouth design, and 4 studies had a parallel design, for a total sample of 1316 teeth. The studies achieved a high rate of clinical success in controlling carious lesion progression, with an average rate of 80% for the sealant, and 88% for the infiltrant, and with no statistical difference between the techniques (p-value=0.358).

Conclusions: No difference in the clinical efficacy was observed between the resinous sealing and infiltrative resin techniques of incipient lesions in permanent teeth in one to seven years of follow-up.

Indexing terms
Complementary therapies; Dental caries; Pit and fissure sealants

Procedure	Statistics
Resinous sealant	Quantity	6
	Average Success Rate	0.80
	Min - Max	0.62 - 0.98
	Standard Deviation	0.15
Infiltrative resin	Quantity	5
	Average Success Rate	0.89
	Min - Max	0.68 - 0.98
	Standard Deviation	0.12

Author/year	Design	Intervention	Comparison	Nº of samples: patients/teeth	Age average	Success rate (%)
Gomez et al. [⁸]	(Parallel design)	Resin Sealant – Concise 3M	Prophylaxis / Fluoride varnish application	50/262	14.7 (± sd)	I:93 C:87.9
Bakhshandeh et al. [⁹]	(Parallel design)	Resin Sealant – Delton; Dentsply	Restoration- Adhesive Scotchbond Multi-Purpose; Resin Filtek Supreme XT 3M	52/72	28 (± sd)	I:68 C:100
Borges et al. [¹⁰]	(Parallel design)	Resin Sealant – Dentsply/Caulk	Hygiene instructions	35/60	16 (± sd)	I:88 C:3.9
Martignon et al. [¹¹]	Split mouth	Resin Infiltration- ICON	Adhesive Sealant Prime & Bond/control: Hygiene instructions	39/117	21 (± sd)	I: 68 C: 59
Meyer-Lueckel et al. [¹²]	Split mouth	Resin Infiltration-ICON	Hygiene instructions and diet control	20/26	-	I:95 C:45
Qvist et al. [¹³]	(Parallel design)	Delton LC, Ultraseal Clinpro, Grandio, Helioseal F e Clear	Tetric Evoceram, Spectrum AB, Z100, Z250, Herculite & Charisma	521/521	11.5 (± sd)	I:72 C: 97
Arthur et al. [¹⁴]	Split mouth	Resin Infiltration-ICON	Irrigation with water	17/27	26 (± sd)	I: 93 C:81.4
Basili et al. [¹⁵]	Split mouth	Resin Sealant - Concise 3M	Resin Sealant- Concise 3M Preventative	45/61	11.9 (± sd)	I: 62 C:75
Anauate-Netto et al. [⁵]	Split mouth	Resin Infiltration-ICON	Resin sealant- Alpha Seal DFL	23/86	14.4 (± sd)	I: 98 C:94.4
Peters et al. [¹⁶]	Split mouth	Resin infiltration- ICON	Mock infiltration	42/84	21 (± sd)	I: 89 C:73.5

Author/year	Title	Study period (years)	Sealant	Icon infiltrant	Surface of intervention	Important considerations
Gomez et al. [⁸]	“A 2-year clinical evaluation of sealed noncavitated approximal posterior carious lesions in adolescents”	2	Yes	No	Proximal	The success rate after 2-3 years was 93% in the sealant group. The dentin sealant progression rate was 11/153. The results suggest that sealants may serve as a promising technique to arrest incipient proximal lesions.
Bakhshandeh et al. [⁹]	“Sealing occlusal caries lesions in adults referred for restorative treatment: 2-3 years of follow-up”	3	Yes	No	Occlusal	Of the 72 lesions, 78% had cavitation, with greater involvement in dentin. Sealants n = 38 and restorations n = 12 were functional. 7 sealants were reapplied and 3 were replaced by a restoration over a period of 4,11 and 13 months, respectively. In the sealant group, there was regression of lesion in 1 tooth and deposition of tertiary dentin in 9 teeth.
Borges et al. [¹⁰]	“Arrest of non-cavitated dentinal occlusal caries by sealing pits and fissures: a 36-month, randomized controlled clinical trial”	3	Yes	No	Occlusal	After 8 months, 25/26 lesions in the control group progressed and were restored and excluded from follow-up. There were 3 progressions due to partial or total loss of sealant in the period prior to the 12-month follow-up, in the experimental group. They have hence been restored and were excluded from follow-up. There was no progression in the experimental group after 12, 24 and 36 months. There was significant statistical difference between the groups.
Martignon et al. [¹¹]	“Infiltrating/sealing proximal caries lesion: a 3-year randomized clinical trial”	3	No	Yes	Proximal	The infiltrant showed a low score 3 lesion progression (amelodentinal junction level) compared to Group B (Prime&Bond Adhesive sealing). Group C (placebo) had a higher lesion progression rate. There is no statistical difference between infiltration and adhesive sealing, although the infiltrant had more consistent sealing rates.
Meyer Lueckel et al. [¹²]	“Randomized controlled clinical trial on proximal caries infiltration: three-year follow-up”	3	No	Yes	Proximal	A total of 1/20 progressions were found in the Icon infiltrant vs. 7/20 in the control groups. No lesion regression was observed until 36 months of follow-up. The results show that infiltration is an effective method of controlling non-cavitated caries progression.
Qvist et al. [¹³]	“Sealing occlusal dentin caries in permanent molars: 7-year results of a randomized controlled trial”	7	Yes	No	Occlusal	Sealant survival rate of 75% in 7.5 years, and failure percentage of 6.4%. Factors like moderate/high risk of cavities, first molar carious lesions in the distal pit, and multiple fissures influence the increase in failure rate. The authors consider that lesions in dentin can be treated with resinous sealants, and cavitated lesions do not influence the longevity or effect of resinous sealing. Deeper lesions in dentin should not be sealed.
Arthur et al. [¹⁴]	“Proximal carious lesions infiltration - a 3year follow-up study of a randomized controlled clinical trial”	3	No	Yes	Proximal	A total of 2 progressions were found in the infiltrant group vs. 5 progressions in the control group. No added benefit was found in infiltration versus placebo. Beneficial effect is provided when disease control is not achieved on an individual level. No statistical difference was observed.
Basili et al. [¹⁵]	“Preventive and therapeutic proximal sealing: a 3.5-year randomized controlled clinical trial follow-up”	3.5	Yes	No	Proximal	In the preventive group, 4/30 test surfaces (13.3%) developed an initial carious lesion. In the therapeutic group, 3/15 test lesions showed progression (20%). The preventive fraction of the preventive group was 75%, and therapeutic, 62% (sample limitation). The lower values for the therapeutic group maybe be attributed to a smaller sample after 3.5 years-considered a limitation of the study. The results of this clinical study show that proximal sealing can be valid and effective.
Anauate-Netto et al. [⁵]	“Caries progression in non-cavitated fissures after infiltrant application: a 3 year follow-up of a randomized controlled clinical trial”	3	Yes	Yes	Occlusal	The results showed no significant difference between the groups (sealant vs. infiltrant). The resinous infiltrant presents the same clinical efficacy results as the conventional sealant for repairing pit and fissure lesions. Similar results for marginal integrity were observed after 3 years. In exploratory drilling, a loss can be observed in the regularity of the sealant surface after 3 years of application.
Author/year	Title	Study period (years)	Sealant	Icon infiltrant	Surface of intervention	Important considerations
Peters et al. [¹⁶]	Resin infiltration: “An effective adjunct strategy for managing high caries risk – a within-person randomized controlled clinical trial”	2	No	Yes	Proximal	The group of infiltrated lesions (RI) showed less growth in the external third of the dentin compared to the placebo group. The progression rate of the placebo group was 95%. Only one progression occurred in the RI group. Infiltration was considered an adjunct/ assistant to the preventative measures (oral hygiene and prophylaxis done by a professional) effectively. The infiltrative technique is not a cure to the disease; its effect inhibits and reduces progression of carious lesions.

vertical_align_top show_chart

more_horiz close
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Faculdade São Leopoldo Mandic Rua José Rocha Junqueira, 13, CEP: 13045-755 , Tel.: +55 (19) 3211-3689 - Campinas - SP - Brazil
E-mail: contato@revistargo.com.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

[1] Note: ^*Legends: Success rate- I: Intervention; C: Comparison.