Efficacy of resin infiltration technique in preventing the progression of non-cavitated proximal initial caries lesions
Level of evidence: B
Resin infiltration seems to reduce caries progression both in primary and permanent teeth.
Recent systematic reviews and meta-analyses have shown that resin infiltration significantly reduces the possibility of caries progression compared with the control «Liang Y, Deng Z, Dai X ym. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2675-2684 »1, «Faghihian R, Shirani M, Tarrahi MJ ym. Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis. Pediatr Dent 2019;41:88-94 »2. The resin infiltration technique is effective both in primary and permanent teeth «Liang Y, Deng Z, Dai X ym. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2675-2684 »1, «Faghihian R, Shirani M, Tarrahi MJ ym. Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis. Pediatr Dent 2019;41:88-94 »2, «Bagher SM, Hegazi FM, Finkelman M ym. Radiographic Effectiveness of Resin Infiltration in Arresting Incipient Proximal Enamel Lesions in Primary Molars. Pediatr Dent 2018;40:195-200 »3. The quality of evidence is moderate.
Resin infiltration is effective in arresting the progression of non-cavitated proximal caries involved in enamel and enamel-dentin junction. When proximal caries involves dentin, the therapeutic efficacy of resin infiltration decreases «Liang Y, Deng Z, Dai X ym. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2675-2684 »1. The quality of evidence is low.
No relevant side effects of the resin infiltration technique have been observed «Faghihian R, Shirani M, Tarrahi MJ ym. Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis. Pediatr Dent 2019;41:88-94 »2.
Applicability of the evidence to the Finnish population is good.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias «Additional comments for included studies»1 |
|---|---|---|---|---|---|
| RCT = randomized controlled trial; SR = systematic review; MA = meta-analysis | |||||
| «Liang Y, Deng Z, Dai X ym. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2675-2684 »1 | SR/MA | Included studies were split-mouth randomized controlled trials (RCTs). Population: Children and adults with non-cavitated proximal caries, detected by radiographs. | Resin infiltration compared to non-invasive measures (e.g. fluoride varnish), mock or placebo treatment | Caries progression assessed by radiographs | 2/4 studies unclear risk (deficiency of information for judging allocation concealment (selection bias)) 1/4 studies high performance bias (no information on the blinding of participants and personnel) |
| «Faghihian R, Shirani M, Tarrahi MJ ym. Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis. Pediatr Dent 2019;41:88-94 »2 | SR/MA | Included studies were split-mouth randomized controlled trials (RCTs). Population: Children and adults, with non-cavitated proximal caries, detected by radiographs. | Resin infiltration technique compared to non-invasive measures (e.g. placebo, fluoride therapy, and oral health instructions) | Caries progression assessed by radiographs | 4/8 studies unclear risk (deficiency of information for judging allocation concealment) 5/8 studies high risk of performance bias (dentists were aware of the intervention) 3/8 studies unclear risk of performance bias (blinding of participants and personnel) 1/8 unclear risk of bias (incomplete outcome data) 1/8 high risk of other bias |
| «Bagher SM, Hegazi FM, Finkelman M ym. Radiographic Effectiveness of Resin Infiltration in Arresting Incipient Proximal Enamel Lesions in Primary Molars. Pediatr Dent 2018;40:195-200 »3 | RCT | Split-mouth RCT45 healthy 5 to 8 years old children from the pediatric dentistry clinic at Tufts University School of Dental Medicine, USA. Subjects had at least two non-adjacent, incipient proximal enamel carious lesions in primary molars. | Resin infiltration compared to standard-of-care preventive measures (fluoride application, oral hygiene, and diet counselling) | Caries progression assessed by radiographs | The investigator who performed the treatment and the subjects were not blind with respect to which group a lesion belonged. The examiners who evaluated the radiographs were blind regarding group. |
Results
| Reference | Number of studies and number of carious lesions (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (OR) (95 % CI) / (RR) (95 % CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate Risk of bias is moderate The quality of evidence is downgraded due to limited number (8) of studies and participants. I = intervention; C = comparison; CI = confidence interval OR = Odds Ratio RR = Risk Ratio | |||||
| «Liang Y, Deng Z, Dai X ym. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2675-2684 »1 | 4 studies 288 / 288 | 12-36 months | 32 (11.1 %) | 117 (40.6 %) | OR: 0.15 (0,09 to 0.24) |
| «Faghihian R, Shirani M, Tarrahi MJ ym. Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis. Pediatr Dent 2019;41:88-94 »2 | 8 studies 580/580 | 12-36 months | RR: 0.374 (0.291 to 0.480) | ||
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (OR) (95 % CI) |
|---|---|---|---|---|---|
| Level of evidence: low The quality of evidence is downgraded due to limited number (3) of studies and participants. I = intervention; C = comparison; CI = confidence interval OR = Odds Ratio | |||||
| «Liang Y, Deng Z, Dai X ym. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2675-2684 »1 | 3 studies 249/249 | 18-36 months | Enamel: 0/116 Enamel-dentin junction 1/15 Dentin: 7/118 | Enamel: 20/130 Enamel-dentin junction 7/14 Dentin: 14/105 | Enamel: 0.05 (0.01-0.35) Enamel-dentin junction 0.07 (0.01-0.70) Dentin: 0.42 (0.16-1.10) |
| Reference | Number of studies and number of carious lesions (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (RR) (95 % CI) |
|---|---|---|---|---|---|
| Level of evidence: moderateThe quality of evidence is downgraded due to limited number of studies and participants. I = intervention; C = comparison; CI = confidence interval RR = Risk Ratio | |||||
| «Liang Y, Deng Z, Dai X ym. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2675-2684 »1 | 3 studies 249/249 | 12-36 months | 23 (9.24 %) | 93 (37.3 %) | RR 0.247 (0.162 to 0.377) |
| «Faghihian R, Shirani M, Tarrahi MJ ym. Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis. Pediatr Dent 2019;41:88-94 »2 | 4 studies 342/342 | 18-36 months | RR 0.307 (0.210 to 0.449) | ||
| Reference | Number of studies and number of carious lesions (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (RR) (95 % CI) |
|---|---|---|---|---|---|
| Level of evidence: moderateThe quality of evidence is downgraded due to limited number (5) of studies and participants. I = intervention; C = comparison; CI = confidence interval RR = Risk Ratio | |||||
| «Faghihian R, Shirani M, Tarrahi MJ ym. Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis. Pediatr Dent 2019;41:88-94 »2 | 4 studies238 / 238 | 8-34 months | RR: 0.434 (0.311 to 0.605) | ||
| «Bagher SM, Hegazi FM, Finkelman M ym. Radiographic Effectiveness of Resin Infiltration in Arresting Incipient Proximal Enamel Lesions in Primary Molars. Pediatr Dent 2018;40:195-200 »3 | 1 study45/45 | 24 | 10/25 (40 %) | 18/25 (72 %) | RR: 0.556(0.324 to 0.952) |
References
- Liang Y, Deng Z, Dai X ym. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018;22:2675-2684 «PMID: 30238416»PubMed
- Faghihian R, Shirani M, Tarrahi MJ ym. Efficacy of the Resin Infiltration Technique in Preventing Initial Caries Progression: A Systematic Review and Meta-Analysis. Pediatr Dent 2019;41:88-94 «PMID: 30992105»PubMed
- Bagher SM, Hegazi FM, Finkelman M ym. Radiographic Effectiveness of Resin Infiltration in Arresting Incipient Proximal Enamel Lesions in Primary Molars. Pediatr Dent 2018;40:195-200 «PMID: 29793566»PubMed