title: Efficacy of sealing proximal early active lesions: an 18-month clinical study evaluated by conventional and subtraction radiography.
abstract: This study assessed the efficacy of sealing proximal lesions on adult patients using a split-mouth design. Eighty-two 15- to 39-year-olds from the Dental Faculties in Copenhagen and Bogotá participated, each having 2 or more proximal lesions in the following radiographic stages: (1) lesion restricted to the outer half of enamel; (2) lesion from the inner half of enamel including the enamel dentine junction, and (3) lesion restricted to the outer third of dentine. Standardized geometrically aligned baseline and follow-up radiographs were obtained. One randomly selected lesion (test) in each patient was sealed with 1 of 2 resins. The patients were instructed to floss all the proximal lesions 3 times per week. The baseline to 18 months difference in caries lesion progression status was assessed using 3 methods: (1) radiographs were independently assessed visually; (2) radiographs were read in pairs, and (3) using subtraction radiography of digitized images. A total of 72 subjects finished the study (12.2% dropout). The compliance concerning flossing was poor (15%). For the repeated examinations kappa was 0.84 for the visual examination, 0.44 for the paired readings and 0.84 for the subtraction examination. Two test lesions and 1 control lesion were restored. For the independent radiograph assessment method 10 and 26% progressed in the test and control group, respectively (p > 0.05); with the paired radiograph method the corresponding data were 22% in the test and 47% in the control groups (p < 0.01). By subtraction radiography 44% of the test group and 84% of the control were judged to have progressed (p < 0.001). The sealing technique was superior to instructing patients to floss, and subtraction radiography appeared to be the most sensitive method for assessing lesion progression.
authors.affiliation: Department of Cariology and Endodontics, Dental Faculty, University of Copenhagen, Copenhagen, Denmark. kim@odont.ku.dk
authors.forename: S
authors.initials: S
authors.lastname: Martignon
authors.forename: K R
authors.initials: KR
authors.lastname: Ekstrand
authors.forename: R
authors.initials: R
authors.lastname: Ellwood
mesh_terms: D000293:Adolescent; D000328:Adult; D003105:Colombia; D003718:Denmark; D003731:Dental Caries / Q000000981:diagnostic imaging* / Q000473:pathology / Q000517:prevention & control*; D003742:Dental Devices, Home Care; D018450:Disease Progression; D006801:Humans; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D011861:Radiography, Dental; D015203:Reproducibility of Results; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013382:Subtraction Technique
chemical_list: D010895:Pit and Fissure Sealants