School of Dentistry, University of Michigan, Ann Arbor, MI, USA & Clinical Professor, School of Dentistry, Louisiana State University Health Science Center, New Orleans, LA, USA.
Operative and Comprehensive Dentistry, USADC West Point, NY & Comprehensive Dentistry, DC, USA.
J Dent. 2018 Dec;79:24-30. doi: 10.1016/j.jdent.2018.09.005. Epub 2018 Sep 15.
Micro-invasive resin-infiltration has shown to inhibit lesion progression of proximal non-cavitated carious lesions, suggesting an alternative to early operative treatment. This split-mouth, randomized placebo-controlled clinical trial evaluated the effects of proximal lesion infiltration supplementary to standard-of-care management in high caries risk (HCR)-patients.
Forty-two HCR-subjects with two similar interproximal posterior lesions received professional HCR-regimen including repeated F-varnish applications. Two affected E2/D1-surfaces were randomized and concurrently treated by resin-infiltration or mock-infiltration (control). Individually standardized digital radiographs provided visual determination of lesion-size distribution at baseline and 2-year follow-up. Data were analyzed by logistic regression and McNemar's test.
Thirty-two lesion pairs (76%) were evaluated after 2 years. Categorical lesion depths were not different between groups (P > .5). Comparative pairwise assessment (image sets BL-2 yr) showed significantly more progression in control (7) versus infiltration (1) lesions (P = .035). Cumulative prevented fraction after two years was 97% for infiltrated lesions versus 74% for control lesions.
Two-year follow-up showed resin infiltration to be a highly efficacious (RRR: 86-89%) therapy. Long-term follow-up is needed to strengthen the evidence for efficacy of resin-infiltration as an adjunct to standard-of-care HCR-regimen including F-varnish.
Showing 24% more stabilized lesions, the resin-infiltrated group performed significantly better than their controls, confirming successful early lesion management. Adjunct resin-infiltration provided an effective micro-invasive approach to inhibit short-term lesion progression.
微创树脂渗透已被证明可抑制近非窝沟龋损的病变进展，表明其是早期手术治疗的替代方法。本研究采用随机安慰剂对照的临床研究，评估了标准治疗管理之外对高龋风险（HCR）患者近中面病变进行渗透补充治疗的效果。
42 名 HCR 患者有两个相似的近中后牙邻面龋损，接受了包括重复 F 涂料应用在内的专业 HCR 治疗方案。两个受影响的 E2/D1 表面被随机分为树脂渗透组或模拟渗透（对照组），并进行同期治疗。个体标准化数字射线照相术在基线和 2 年随访时提供病变大小分布的视觉确定。数据通过逻辑回归和 McNemar 检验进行分析。
2 年后评估了 32 对病变（76%）。两组间的病变深度无差异（P>.5）。比较性成对评估（BL-2 年图像集）显示，对照组（7 个）比渗透组（1 个）的病变进展明显更多（P=.035）。两年后渗透组的累积预防分数为 97%，对照组为 74%。
2 年随访显示树脂渗透是一种非常有效的治疗方法（RRR：86-89%）。需要长期随访以加强树脂渗透作为包括 F 涂料在内的 HCR 治疗标准的辅助治疗的有效性证据。
渗透组显示 24%更多的稳定病变，表现明显优于对照组，证实了早期病变管理的成功。辅助树脂渗透为抑制短期病变进展提供了一种有效的微创方法。
