Aesthetic caries infiltration - Long-term masking efficacy after 6 years

Richard Johannes Wierichs; Franziska Langer; Céline Kobbe; Bedram Abou-Ayash; Marcella Esteves-Oliveira; Michael Wolf; Isabel Knaup; Hendrik Meyer-Lueckel

doi:10.1016/j.jdent.2023.104474

Aesthetic caries infiltration - Long-term masking efficacy after 6 years

J Dent. 2023 May:132:104474. doi: 10.1016/j.jdent.2023.104474. Epub 2023 Mar 4.

Authors

Richard Johannes Wierichs¹, Franziska Langer², Céline Kobbe³, Bedram Abou-Ayash³, Marcella Esteves-Oliveira⁴, Michael Wolf², Isabel Knaup², Hendrik Meyer-Lueckel³

Affiliations

¹ Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland. Electronic address: richard.wierichs@unibe.ch.
² Department of Orthodontics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
³ Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland.
⁴ Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland; Department of Restorative Dentistry and Endodontology, Justus-Liebig-University Giessen, Giessen, Germany.

PMID: 36878424
DOI: 10.1016/j.jdent.2023.104474

Abstract

Objectives: This study aimed to evaluate the masking efficacy of caries infiltration technique of initial caries lesions (ICL) six years after debonding and single treatment.

Methods: In 10 adolescents, 74 ICL (ICDAS 2) in 74 teeth were treated by resin infiltration (Icon, DMG) at a mean (SD) of 1.2 (1.2) months after bracket removal. The etching procedure was performed up to 3 times. Standardized digital images were taken before treatment (T₀), seven days (T₇) and 6 years (T₂₁₉₀) after treatment. Outcomes included the evaluation of the color differences between carious and healthy enamel at T₀, T₇ and T₂₁₉₀ by quantitative colorimetric analysis (ΔE), ICDAS scores, quantitative light-induced fluorescence (QLF; ΔF,ΔQ,WS Area) and qualitative visual evaluation (5-point Likert-scale [deteriorated (1), unchanged (2), improved, but not satisfying (3), improved and no further treatment required (4), completely masked (5)).

Results: The median color difference ΔΕ₀ (25^th/75^th percentiles) at T₀ was 10.3 (8.56/13.0). At T₇ a significant decrease was observed (ΔΕ₇=3.7 (2.0/5.8); p<0.001; Friedmann-test; ICDAS p<0.001; Chi-square test). No significant changes based on ΔΕ (p=0.972; Friedmann-test) and ICDAS grading (p=0.511, chi-square test) were observed between T₇ and T₂₁₉₀ (ΔΕ₂₁₉₀=2.9 (1.8/4.2)). Furthermore, at T₂₁₉₀ four experienced dentists classified 50% and 37% of the lesions as "improved and no further treatment required" and "completely masked", respectively (Fleiss kappa: T₂₁₉₀: 0.782 (substantial agreement)).

Conclusion: Aesthetic caries infiltration can effectively mask post-orthodontic initial caries lesions for at least 6 years. These results for most of the teeth could not only be observed by quantitative but also by qualitative analysis.

Clinical significance: Resin infiltration efficaciously masks post-orthodontic initial carious lesions. The optical improvement can be observed directly after treatment and remains stable for at least six years.

Keywords: Aesthetics; Caries infiltration; Enamel lesions; Infiltrant; Post-orthodontic treatment; Resin; White spot lesion.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acid Etching, Dental / methods
Adolescent
Dental Caries Susceptibility
Dental Caries* / pathology
Dental Caries* / therapy
Esthetics, Dental
Humans
Resins, Synthetic*

Substances

Resins, Synthetic