School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Operative and Comprehensive Dentistry, USADC West Point, NY, USA.
J Dent Res. 2019 Dec;98(13):1497-1502. doi: 10.1177/0022034519876853. Epub 2019 Sep 16.
This study reports 3-y outcomes of a split-mouth randomized clinical trial. Resin infiltration's capacity to arrest caries lesion progression in noncavitated proximal lesions is affirmed. Forty-two consented young adults, blinded to tooth surface allocation, were treated with resin infiltration on 1 randomly selected surface and concurrently experienced a mock infiltration procedure on another. Both treatments were provided as an adjunct to the currently accepted standard-of-care regimen (periodic prophylaxis and serial fluoride varnish applications) appropriate for the management of high caries risk. Challenging periods of low oral hygiene compliance were expected. The primary outcome measure was 3-y radiographic lesion progression. Blinded investigators evaluated each study surface for lesion progression with a series of images obtained at intervals over the 3-y course of study. Proportions of progressing lesions were compared with McNemar's test. Twenty-nine noncavitated lesion pairs in permanent posterior teeth demonstrating caries penetrating into inner enamel or outer dentin were included in the analyses. No adverse events were reported. Radiographic progression was recorded in 4 of 29 infiltrated lesions (14%) and 14 of 29 control lesions (48%, < .003). Adjunct resin infiltration demonstrated a high 3-y efficacy of 71% (relative risk reduction). The prevented fraction was 86% for infiltration versus 52% for controls. Resin infiltration was 100% successful in arresting caries progression in inner enamel lesions (E2) and 64% in outer dentin lesions (D1). Supplementary microinvasive resin infiltration is significantly more efficacious in reducing proximal lesion progression than management by standard noninvasive therapy alone. Long-term results may shed light on whether this represents the arrest or delay of the caries disease process (ClinicalTrials.gov NCT01584024).
本研究报告了一项分口随机临床试验的 3 年结果。树脂渗透在阻止非龋近中面病变龋病进展方面的能力得到了肯定。42 名同意参与的年轻成年人对牙面分配不知情，随机选择一面接受树脂渗透治疗，另一面同时接受模拟渗透治疗。两种治疗均作为目前接受的标准护理方案（定期预防和定期氟化物涂料应用）的辅助手段，适用于高龋风险的管理。预计会有口腔卫生依从性低的困难时期。主要结局测量指标是 3 年放射学病变进展。盲法研究者用一系列在 3 年研究过程中每隔一段时间获得的图像评估每个研究表面的病变进展情况。用 McNemar 检验比较进展病变的比例。纳入了 29 对永久性后牙的非龋性病变，这些病变的龋病已穿透内釉质或外牙本质，进行了分析。没有报告不良事件。在 29 个渗透病变中有 4 个（14%）和 29 个对照病变中有 14 个（48%，<.003）记录了放射学进展。辅助树脂渗透的 3 年疗效为 71%（相对风险降低）。与对照组相比，渗透组的预防分数为 86%，对照组为 52%。树脂渗透在阻止内釉质病变（E2）的龋病进展方面成功率为 100%，在阻止外牙本质病变（D1）的龋病进展方面成功率为 64%。补充微创树脂渗透在减少近中面病变进展方面明显优于单纯标准非侵入性治疗。长期结果可能会揭示这是否代表了龋病进程的阻断或延迟（ClinicalTrials.gov NCT01584024）。
