A clinical evaluation of air-abrasion treatment of questionable carious lesions. A 12-month report.
BACKGROUND
The efficacy of treating questionable incipient lesions early with air abrasion, a modality used by many practitioners, has not been adequately demonstrated.


METHODS
The authors enrolled 223 teeth, each with a questionable incipient pit-and-fissure carious lesion, from 93 dental patients in a projected five-year randomized clinical trial. Caries was defined as softness, decalcification or cavitation at the base of a pit or fissure or radiographic evidence of caries. Each tooth was randomly assigned to either a treatment group (n = 113 teeth) or a control group (n = 110 teeth) (which was observed but left untreated until the definition of caries was met). Each tooth in the treatment group was air-abraded and restored with a flowable resin-based composite. The authors re-examined teeth in both groups every six months; they evaluated the restorations using a modified set of Ryge criteria and inspected teeth for caries using radiographs, mirrors and standardized explorers.


RESULTS
Of the 113 teeth with questionable incipient carious lesions air-abraded in the treatment group, 50 had caries extending into dentin. After 12 months of clinical service, there were three sealants that exhibited a partial loss of sealant which did not require any re-treatment. Two restorations with penetrating staining were re-treated. In the control group at the end of 12 months, only nine of the 86 recalled teeth were diagnosed with pit-and-fissure caries and were treated with air abrasion and restored with flowable resin-based composite. There was no statistically significant difference between the volume of the treatment and control preparations.


CONCLUSIONS
After 12 months of clinical service, two preventive resin-based composite restorations in the treatment group required re-treatment. Fewer teeth than expected in the control group were diagnosed as having caries and were treated.


CONCLUSIONS
The merit of treating questionable incipient pit-and-fissure carious lesions early with air abrasion has not been demonstrated after 12 months in this clinical study.
Hamilton
J C
JC
Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 N. University, Ann Arbor, Mich. 48109, USA. jchamilt@umich.edu
Dennison
J B
JB
Stoffers
K W
KW
Welch
K B
KB
D000293:Adolescent; D000328:Adult; D020906:Air Abrasion, Dental; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D003188:Composite Resins; D001840:Dental Bonding; D003731:Dental Caries / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000628:therapy; D003736:Dental Cavity Lining; D003737:Dental Cavity Preparation / Q000379:methods*; D003743:Dental Enamel / Q000473:pathology; D003750:Dental Fissures / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000628:therapy*; D003793:Dental Restoration, Permanent; D019243:Enamel Microabrasion; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements; D006801:Humans; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D011859:Radiography; D019233:Retreatment; D013223:Statistics as Topic; D013499:Surface Properties; D017001:Tooth Demineralization / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000628:therapy
D003188:Composite Resins; D005899:Glass Ionomer Cements; D010895:Pit and Fissure Sealants; C090969:Tetric; C111840:flowable hybrid composite