A retrospective clinical study on the resin infiltration of proximal caries lesions: the operator\u2019s effect

E Diab,D Hesse,C C Bonifacio

doi:10.1007/s40368-021-00653-y

E Diab, D Hesse + Show 1 more

Open Access

https://doi.org/10.1007/s40368-021-00653-y

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Abstract

PurposeThis retrospective university-based study investigated the effect of operators’ training and previous experience on the success of resin infiltration (RI) in arresting proximal non-cavitated caries lesions in primary and permanent teeth.MethodsInformation was collected regarding RI of proximal non-cavitated caries lesions in primary and permanent teeth with a follow-up period up to 32 months. Factors investigated were: operators’ clinical experience and training, patient’s age, tooth, arch, mouth-side, surface treated, tooth separation, and baseline lesion depth. Kaplan–Meier survival and Cox regression analysis with shared frailty were used (α = 5%).ResultsA total of 130 proximal surfaces treated on 115 teeth of 43 children (11 ± 4.4 years) were evaluated. Survival of RI was 46% up to 32 months. Lesions treated by non-trained dentists were more likely-to-present progression than those performed by non-trained dental students under supervision (HR 2.41, 95% CI: 1.00–5.80); conversely, no difference was found between non-trained dental students under supervision and trained dentists (HR 0.52, 95% CI: 0.16–1.70). Additionally, dentin lesions were 59% more-likely-to-present progression than enamel lesions (HR 0.41, 95% CI: 0.17–0.99).ConclusionThe operator’s experience and training could influence the success of RI on proximal non-cavitated caries lesions and it should be taken into consideration when choosing this treatment modality.

Highlights

The management of caries lesions nowadays follows the concepts of the minimal invasive philosophy as the traditional operative invasive methods have been substituted by less invasive approaches (Frencken et al 2012)
Three recent systematic reviews concluded that the treatment of non-cavitated enamel and initial dentinal proximal caries lesions using resin infiltration (RI) was more effective than professional fluoride application or advice on flossing (Dorri et al 2015; Domejean et al 2015; Chatzimarkou et al 2018)
One surface from an included child was excluded from the analysis because at baseline the radiolucency was obviously spread in the outer half of the dentin

Summary

Introduction

The management of caries lesions nowadays follows the concepts of the minimal invasive philosophy as the traditional operative invasive methods have been substituted by less invasive approaches (Frencken et al 2012) In this way, the treatment of non-cavitated caries lesions preferably comprises of strategies to enhance remineralisation, e.g. fluoride therapy or improving the individual's oral hygiene (Cury and Tenuta 2009; Holmen et al 1987). The treatment of non-cavitated caries lesions preferably comprises of strategies to enhance remineralisation, e.g. fluoride therapy or improving the individual's oral hygiene (Cury and Tenuta 2009; Holmen et al 1987) Those methods can halt the progression of incipient lesions, their effectiveness relies on patient compliance. Three recent systematic reviews concluded that the treatment of non-cavitated enamel and initial dentinal proximal caries lesions using RI was more effective than professional fluoride application or advice on flossing (Dorri et al 2015; Domejean et al 2015; Chatzimarkou et al 2018)

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