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Advisory Committee Chair

Nathaniel C Lawson

Advisory Committee Members

Amjad Javed

Augusto Robles

John Burgess

Document Type

Thesis

Date of Award

2017

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

Dental caries is the most widespread of all diseases. It causes destruction of tooth structure by dissolving the enamel first, then progressing to the dentin. While it is possible to replace carious tooth structure with invasive restorations, it is highly desirable to arrest or reverse the disease process so that the restorations can be avoided. One of the most difficult areas to clean or use preventive, non-surgical treatment is the contact area between teeth. Recently treatment with resin polymers to infiltrate enamel and dentin affected by caries has been in-troduced. The infiltration technique arrests the lesion progression by penetrating and sealing the porous lesion, arresting ongoing acidic damage and mechanically restores the damaged tooth structure. Objective: To assess the clinical efficacy of a resin infiltration system (ICON, DMG) for incipient interproximal lesions in posterior permanent teeth as a means of arresting carious lesion progression. Materials and Methods: A protocol was developed and submitted to the IRB for approval. Fifty-six volunteers (14+ years) with two posterior incipient proximal carious lesions (E1, E2, or D1) were enrolled in a clinical trial to evaluate the efficacy of resin infiltration treat-ment compared to current watch-and-wait approach combined with oral hygiene reinforce-ment and fluoride application. Each subject with at least 2 small incipient lesions without clinical signs of surface cavitation was selected, one lesion was treated with ICON resin infiltration and the other was treated with inactive placebo. Follow-up was performed at 6 months by clinical examination and digital bitewing radiographs. Lesion progression was assessed by a visual pair-wise comparison of the digital bitewing radiographs. Results: At 6-month follow-up, 31 patients were examined for clinical evaluation and 27 for radiographic evaluation (60 lesions- 24 in low-risk group, 36 in moderate-risk groups). 2 lesions in the control group progressed in depth. No lesion progression in depth was ob-served for the treatment group. No categorical lesion progression was observed in treatment and control group. No adverse effects were recorded. Conclusion: With the limitations of the present study, no significant difference was ob-served between incipient proximal caries lesions treated with resin infiltration vs. placebo at 6-month recall.

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