Advertisement

Caries Infiltration

  • Vera M. Soviero
Chapter

Abstract

This chapter presents caries infiltration, a micro-invasive treatment, as an option to treat non-cavitated proximal carious lesions. In the first part, the chapter provides a summary of the process of initiation and progression of proximal carious lesions from the histological and clinical point of views. The reader will have the chance to review basic knowledge in order to have enough support to understand the concept behind the management of proximal caries by caries infiltration. Then, the biological and chemical principles that led to the development of the infiltration concept are briefly described. Moreover, the reason why crucial steps of the technique must be strictly followed is explained. In the next part, indications and contraindications for caries infiltration are discussed, a decision tree is presented, and clinical cases are used to explain and to demonstrate the technique step by step. In the final part, the clinical efficacy and safety of caries infiltration is discussed based on the best scientific evidence available provided by clinical trials and systematic reviews and meta-analyses.

Keywords

Proximal caries Caries infiltration Resin infiltration Micro-invasive treatment Minimally invasive dentistry 

References

  1. 1.
    Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380–7.CrossRefGoogle Scholar
  2. 2.
    Cortes A, Ekstrand KR, Gamboa LF, González L, Martignon S. Caries status in young Colombian children expressed by the ICCMS™ visual/radiographic combined caries staging system. Acta Odontol Scand. 2017;75(1):12–20.CrossRefGoogle Scholar
  3. 3.
    Santos MND, Rodrigues LKA, Peres RCR, Yokoyama RT, Gavazzi JCC, Gavião MBD. Relationships between occlusal or free-smooth and approximal caries in mixed dentition. Acta Odontol Scand. 2009;63(5):308–13.CrossRefGoogle Scholar
  4. 4.
    Anderson M, Stecksén-Blicks C, Stenlund H, Ranggård L, Tsilingaridis G, Mejàre I. Detection of approximal caries in 5-year-old Swedish children. Caries Res. 2005;39(2):92–9.CrossRefGoogle Scholar
  5. 5.
    Lillehagen M, Grindefjord M, Mejàre I. Detection of approximal caries by clinical and radiographic examination in 9-year-old Swedish children. Caries Res. 2007;41(3):177–85.CrossRefGoogle Scholar
  6. 6.
    Schwendicke F, Paris S, Stolpe M. Detection and treatment of proximal caries lesions: milieu-specific cost-effectiveness analysis. J Dent. 2015;43(6):647–55.CrossRefGoogle Scholar
  7. 7.
    Koch G, Helkimo AN, Ullbro C. Caries prevalence and distribution in individuals aged 3-20 years in Jönköping, Sweden: trends over 40 years. Eur Arch Paediatr Dent. 2017;18(5):363–70.CrossRefGoogle Scholar
  8. 8.
    Stenlund H, Mejàre I, Källestål C. Caries rates related to approximal caries at ages 11-13: a 10-year follow-up study in Sweden. J Dent Res. 2002;81(7):455–8.CrossRefGoogle Scholar
  9. 9.
    Mejàre I, Källestål C, Stenlund H. Incidence and progression of approximal caries from 11 to 22 years of age in Sweden: a prospective radiographic study. Caries Res. 1999;33(2):93–100.CrossRefGoogle Scholar
  10. 10.
    Mejàre I. Bitewing examination to detect caries in children and adolescents – when and how often? Dent Update. 2005;32(10):588–97.CrossRefGoogle Scholar
  11. 11.
    Holmen L, Thylstrup A, Øgaard B, Kragh F. A polarized light microscopic study of progressive stages of enamel caries in vivo. Caries Res. 1985;19(4):348–54.CrossRefGoogle Scholar
  12. 12.
    Bjørndal L, Thylstrup A. A structural analysis of approximal enamel caries lesions and subjacent dentin reactions. Eur J Oral Sci. 1995;103(1):25–31.CrossRefGoogle Scholar
  13. 13.
    Holmen L, Thylstrup A, Øgaard B, Kragh F. A scanning electron microscopic study of progressive stages of enamel caries in vivo. Caries Res. 1985;19(4):355–67.CrossRefGoogle Scholar
  14. 14.
    Isaksson H, Alm A, Koch G, Birkhed D, Wendt LK. Caries prevalence in Swedish 20-year-olds in relation to their previous caries experience. Caries Res. 2013;47(3):234–42.CrossRefGoogle Scholar
  15. 15.
    Mejàre I, Stenlund H. Caries rates for the mesial surface of the first permanent molar and the distal surface of the second primary molar from 6 to 12 years of age in Sweden. Caries Res. 2000;34(6):454–61.CrossRefGoogle Scholar
  16. 16.
    Vanderas AP, Gizani S, Papagiannoulis L. Progression of proximal caries in children with different caries indices: a 4-year radiographic study. Eur Arch Paediatr Dent. 2006;7(3):148–52.CrossRefGoogle Scholar
  17. 17.
    Heidmann J, Hølund U, Poulsen S. Changing criteria for restorative treatment of approximal caries over a 10-year period. Caries Res. 1987;21(5):460–3.CrossRefGoogle Scholar
  18. 18.
    Heidmann J, Helm S, Helm T, Poulsen S. Changes in prevalence of approximal caries in 17-year-olds and related restorative treatment strategies over a 6-year period. Community Dent Oral Epidemiol. 1988;16(3):167–70.CrossRefGoogle Scholar
  19. 19.
    Tveit AB, Espelid I, Skodje F. Restorative treatment decisions on approximal caries in Norway. Int Dent J. 1999;49(3):165–72.CrossRefGoogle Scholar
  20. 20.
    Elderton RJ. Clinical studies concerning re-restoration of teeth. Adv Dent Res. 1990;4:4–9.CrossRefGoogle Scholar
  21. 21.
    Schwendicke F, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res. 2016;28(2):58–67.CrossRefGoogle Scholar
  22. 22.
    Baelum V, Hintze H, Wenzel A, Danielsen B, Nyvad B. Implications of caries diagnostic strategies for clinical management decisions. Community Dent Oral Epidemiol. 2012;40(3):257–66.CrossRefGoogle Scholar
  23. 23.
    Ferreira Zandoná A, Santiago E, Eckert GJ, Katz BP, Pereira de Oliveira S, Capin OR, et al. The natural history of dental caries lesions: a 4-year observational study. J Dent Res. 2012;91(9):841–6.CrossRefGoogle Scholar
  24. 24.
    Mariath AAS, Casagrande L, de Araujo FB. Grey levels and radiolucent lesion depth as cavity predictors for approximal dentin caries lesions in primary teeth. Dentomaxillofac Radiol. 2007;36(7):377–81.CrossRefGoogle Scholar
  25. 25.
    Coutinho TC, daRocha Costa C. An in vivo comparison of radiographic and clinical examination with separation for assessment of approximal caries in primary teeth. Eur J Paediatr Dent. 2014;15(4):371–4.PubMedGoogle Scholar
  26. 26.
    Pitts NB, Rimmer PA. An in vivo comparison of radiographic and directly assessed clinical caries status of posterior approximal surfaces in primary and permanent teeth. Caries Res. 1992;26(2):146–52.CrossRefGoogle Scholar
  27. 27.
    Meyer-Lueckel H, Paris S. When and how to intervene in the caries process. Oper Dent. 2016;41(S7):S35–47.CrossRefGoogle Scholar
  28. 28.
    Mariath AAS, Bressani AEL, de Araujo FB. Elastomeric impression as a diagnostic method of cavitation in proximal dentin caries in primary molars. J Appl Oral Sci. 2007;15(6):529–33.CrossRefGoogle Scholar
  29. 29.
    Thylstrup A, Bruun C, Holmen L. In vivo caries models--mechanisms for caries initiation and arrestment. Adv Dent Res. 1994;8(2):144–57.CrossRefGoogle Scholar
  30. 30.
    Holmen L, Mejare M, Malmgren B, Thylstrup A. The effect of regular professional plaque removal on dental caries in vivo. Caries Res. 1988;22(4):250–6.CrossRefGoogle Scholar
  31. 31.
    Holmen L, Thylstrup A, Artun J. Clinical and histological features observed during arrestment of active enamel carious lesions in vivo. Caries Res. 1987;21(6):546–54.CrossRefGoogle Scholar
  32. 32.
    Hujoel PP, Cunha-Cruz J, Banting DW, Loesche WJ. Dental flossing and interproximal caries: a systematic review. J Dent Res. 2006;85(4):298–305.CrossRefGoogle Scholar
  33. 33.
    de Oliveira KMH, Nemezio MA, Romualdo PC, da Silva RAB, de Paula E Silva FWG, Küchler EC. Dental flossing and proximal caries in the primary dentition: a systematic review. Oral Health Prev Dent. 2017;15(5):427–34.PubMedGoogle Scholar
  34. 34.
    Martignon S, Ekstrand KR, Gomez J, Lara JS, Cortes A. Infiltrating/sealing proximal caries lesions: a 3-year randomized clinical trial. J Dent Res. 2012;91(3):288–92.CrossRefGoogle Scholar
  35. 35.
    Phark J-H, Duarte S, Meyer-Lueckel H, Paris S. Caries infiltration with resins: a novel treatment option for interproximal caries. Compend Contin Educ Dent. 2009;30(3):13–7.PubMedGoogle Scholar
  36. 36.
    Ahovuo-Saloranta A, Hiiri A, Nordblad A, Worthington H, Mäkelä M. Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev. 2004;23(3):CD001830.Google Scholar
  37. 37.
    Ahovuo-Saloranta A, Forss H, Walsh T, Hiiri A, Nordblad A, Mäkelä M, et al. Sealants for preventing dental decay in the permanent teeth. Cochrane Database Syst Rev. 2013;82(3):CD001830.Google Scholar
  38. 38.
    Yengopal V, Mickenautsch S, Bezerra AC, Leal SC. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: a meta analysis. J Oral Sci. 2009;51(3):373–82.CrossRefGoogle Scholar
  39. 39.
    Griffin SO, Oong E, Kohn W, Vidakovic B, Gooch BF, CDC Dental Sealant Systematic Review Work Group, et al. The effectiveness of sealants in managing caries lesions. J Dent Res. 2008;87(2):169–74.CrossRefGoogle Scholar
  40. 40.
    Papageorgiou SN, Dimitraki D, Kotsanos N, Bekes K, van Waes H. Performance of pit and fissure sealants according to tooth characteristics: a systematic review and meta-analysis. J Dent. 2017;66:8–17.CrossRefGoogle Scholar
  41. 41.
    Gomez SS, Basili CP, Emilson CG. A 2-year clinical evaluation of sealed noncavitated approximal posterior carious lesions in adolescents. Clin Oral Investig. 2005;9(4):239–43.CrossRefGoogle Scholar
  42. 42.
    Gomez SS, Onetto JE, Uribe SA, Emilson CG. Therapeutic seal of approximal incipient noncavitated carious lesions: technique and case reports. Quintessence Int. 2007;38(2):e99–105.PubMedGoogle Scholar
  43. 43.
    Robinson C, Hallsworth AS, Weatherell JA, Künzel W. Arrest and control of carious lesions: a study based on preliminary experiments with resorcinol-formaldehyde resin. J Dent Res. 1976;55(5):812–8.CrossRefGoogle Scholar
  44. 44.
    Paris S, Meyer-Lueckel H, Mueller J, Hummel M, Kielbassa AM. Progression of sealed initial bovine enamel lesions under demineralizing conditions in vitro. Caries Res. 2006;40(2):124–9.CrossRefGoogle Scholar
  45. 45.
    Paris S, Meyer-Lueckel H, Kielbassa AM. Resin infiltration of natural caries lesions. J Dent Res. 2007;86(7):662–6.CrossRefGoogle Scholar
  46. 46.
    Robinson C, Brookes SJ, Kirkham J, Wood SR, Shore RC. In vitro studies of the penetration of adhesive resins into artificial caries-like lesions. Caries Res. 2001;35(2):136–41.CrossRefGoogle Scholar
  47. 47.
    Paris S, Meyer-Lueckel H. Inhibition of caries progression by resin infiltration in situ. Caries Res. 2010;44(1):47–54.CrossRefGoogle Scholar
  48. 48.
    Soviero VM, Paris S, Leal SC, Azevedo RB, Meyer-Lueckel H. Ex vivo evaluation of caries infiltration after different application times in primary molars. Caries Res. 2013;47(2):110–6.CrossRefGoogle Scholar
  49. 49.
    Paris S, Meyer-Lueckel H, Cölfen H, Kielbassa AM. Resin infiltration of artificial enamel caries lesions with experimental light curing resins. Dent Mater J. 2007;26(4):582–8.CrossRefGoogle Scholar
  50. 50.
    Meyer-Lueckel H, Paris S. Improved resin infiltration of natural caries lesions. J Dent Res. 2008;87(12):1112–6.CrossRefGoogle Scholar
  51. 51.
    Fan PL, Seluk LW, O'Brien WJ. Penetrativity of sealants: I. J Dent Res. 1975;54(2):262–4.PubMedGoogle Scholar
  52. 52.
    Paris S, Soviero VM, Seddig S, Meyer-Lueckel H. Penetration depths of an infiltrant into proximal caries lesions in primary molars after different application times in vitro. Int J Paediatr Dent. 2012;22(5):349–55.CrossRefGoogle Scholar
  53. 53.
    Paris S, Soviero VM, Schuch M, Meyer-Lueckel H. Pretreatment of natural caries lesions affects penetration depth of infiltrants in vitro. Clin Oral Investig. 2013;17(9):2085–9.CrossRefGoogle Scholar
  54. 54.
    Meyer-Lueckel H, Paris S, Kielbassa AM. Surface layer erosion of natural caries lesions with phosphoric and hydrochloric acid gels in preparation for resin infiltration. Caries Res. 2007;41(3):223–30.CrossRefGoogle Scholar
  55. 55.
    Meyer-Lueckel H, Chatzidakis A, Naumann M, Dörfer CE, Paris S. Influence of application time on penetration of an infiltrant into natural enamel caries. J Dent. 2011;39(7):465–9.CrossRefGoogle Scholar
  56. 56.
    Ekstrand KR, Bruun G, Bruun M. Plaque and gingival status as indicators for caries progression on approximal surfaces. Caries Res. 1998;32(1):41–5.CrossRefGoogle Scholar
  57. 57.
    Paris S, Hopfenmuller W, Meyer-Lueckel H. Resin infiltration of caries lesions: an efficacy randomized trial. J Dent Res. 2010;89(8):823–6.CrossRefGoogle Scholar
  58. 58.
    Meyer-Lueckel H, Bitter K, Paris S. Randomized controlled clinical trial on proximal caries infiltration: three-year follow-up. Caries Res. 2012;46(6):544–8.CrossRefGoogle Scholar
  59. 59.
    Meyer-Lueckel H, Balbach A, Schikowsky C, Bitter K, Paris S. Pragmatic RCT on the efficacy of proximal caries infiltration. J Dent Res. 2016;95(5):531–6.CrossRefGoogle Scholar
  60. 60.
    Caglar E, Kuscu OO, Hysi D. Four year evaluation of proximal resin infiltration in adolescents. Acta Stomatol Croat. 2015;49(4):304–8.CrossRefGoogle Scholar
  61. 61.
    Arthur RA, Zenkner JE, d'Ornellas Pereira Júnior JC, Correia RT, Alves LS, Maltz M. Proximal carious lesions infiltration-a 3-year follow-up study of a randomized controlled clinical trial. Clin Oral Investig. 2018;22(1):469–74.CrossRefGoogle Scholar
  62. 62.
    Ammari MM, Jorge RC, Souza IPR, Soviero VM. Efficacy of resin infiltration of proximal caries in primary molars: 1-year follow-up of a split-mouth randomized controlled clinical trial. Clin Oral Investig. 2017;94(5):650–8.Google Scholar
  63. 63.
    Ekstrand KR, Bakhshandeh A, Martignon S. Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year. Caries Res. 2010;44(1):41–6.CrossRefGoogle Scholar
  64. 64.
    Rai P, Pandey RK, Khanna R. Qualitative and quantitative effect of a protective chlorhexidine varnish layer over resin-infiltrated proximal carious lesions in primary teeth. Pediatr Dent. 2016;38(4):40–5.PubMedGoogle Scholar
  65. 65.
    Altarabulsi MB, Alkilzy M, Petrou MA, Splieth C. Clinical safety, quality and effect of resin infiltration for proximal caries. Eur J Paediatr Dent. 2014;15(1):39–44.PubMedGoogle Scholar
  66. 66.
    Ammari MM, Soviero VM, da Silva Fidalgo TK, Lenzi M, Ferreira DMTP, Mattos CT, et al. Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis. J Dent. 2014;42(10):1217–27.CrossRefGoogle Scholar
  67. 67.
    Dorri M, Dunne SM, Walsh T, Schwendicke F. Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth. Cochrane Database Syst Rev. 2015;15(11):CD010431.Google Scholar
  68. 68.
    Schwendicke F, Meyer-Lueckel H, Stolpe M, Dörfer CE, Paris S. Costs and effectiveness of treatment alternatives for proximal caries lesions. PLoS One. 2014;9(1):e86992.CrossRefGoogle Scholar
  69. 69.
    Mattos-Silveira J, Floriano I, Ferreira FR, Viganó MEF, Mendes FM, Braga MM. Children's discomfort may vary among different treatments for initial approximal caries lesions: preliminary findings of a randomized controlled clinical trial. Int J Paediatr Dent. 2015;25(4):300–4.CrossRefGoogle Scholar
  70. 70.
    Croll TP, Killian CM, Miller AS. Effect of enamel microabrasion compound on human gingiva: report of a case. Quintessence Int. 1990;21(12):959–63.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Vera M. Soviero
    • 1
    • 2
  1. 1.Department of Preventive and Community DentistryUniversidade do Estado do Rio de JaneiroRio de JaneiroBrazil
  2. 2.Dental SchoolFaculdade Arthur Sá Earp NetoPetrópolisBrazil

Personalised recommendations