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 Møller, 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.
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