Title: 0574 - Sealing or Restoring Manifest Occlusal Caries in Young Permanent Teeth: 10 Years Results


Vibeke Qvist (Presenter)
University of Copenhagen

Tove Andersen, Public Dental Health Service
Kirsten M√łller, Public Dental Health Service
Mette Borum, Public Dental Health Service
Azam Bakhshandeh, University of Copenhagen


Objectives: To investigate the possibility of postponing restorative intervention of manifest occlusal caries in young permanent dentition by non-invasive sealing.

Methods: This prospective, practice based, RCT included 521 occlusal dentin caries lesions in 521 patients, aged 6-17 years. Based on clinical and radiographic assessments, all lesions required restorative treatment. After randomization (ratio 2:1), 368 resin sealings and 153 composite resin restorations were performed by 68 dentists in 2006-2009. Treatments were controlled annually, clinically and radiographically, until patients were transferred to private dentistry at age 18 years. Chi-square test, Fisher-Exact test and Kaplan-Meier survival analysis were applied for statistical analyses.

Results: After an average observation period of 10.4 years (8.8-11.6), data from 341 sealings and 152 restorations in first and second molars were analyzed. The remaining 27 sealings and 1 restoration had to be excluded due to insufficient numbers. The dropout rate was 8%; 51% of the treatments were completed due to age, and 4% because of primary caries. Of the sealings, 49% were retreated, including 33% replaced by restorations; only 1% was still functioning. Of the restorations 7% were repaired/renewed; 11% were still functioning (p<0.001). No endodontics was performed. Radiographic caries progression was recorded in 29% of the sealed, and 3% of the restored lesions (p<0.001). The 10-year survival for sealings not-replaced by restorations was 45%; for restorations it was 91%. It was 51% for sealings arresting caries progression compared to 95% for restorations (p<0.001). Factors related to patient and tooth influenced the outcomes.

Conclusions: The results underline that it is possible to postpone or avoid restorative intervention of occlusal dentin caries lesions in young permanent teeth by non-invasive sealing. As expected, the restorations showed the highest survival, but almost half of the sealed lesions were successfully arrested during the 10 years without invasive intervention.

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE