Abordagem científica e clínica do selamento de lesões de cárie em superfícies oclusais e proximais / Scientific and clinical approach to sealing occlusal and proximal carious lesions

O objetivo deste estudo foi revisar a literatura para evidenciar os aspectos científicos e técnicos envolvidos no selamento de lesões de cárie em superfícies oclusais e proximais. Após a análise dos artigos referenciados, encontrados a partir de busca eletrônica e manual, observou-se que há trabalhos estudando a possibilidade de paralisação da lesão oclusal e proximal com procedimentos não invasivos. Diversos estudos são discutidos e o passo a passo da técnica para selamento proximal é abordado. O selamento parece ser uma ferramenta eficaz na paralisação da lesão cariosa em superfícies proximais, o que vem a ser um ganho de estrutura dental sadia em relação às técnicas invasivas. Apesar deste procedimento se mostrar bastante promissor em superfícies proximais, outros estudos clínicos devem ser realizados.

This study reviewed the literature to evidence the scientific and technical aspects involved in sealing occlusal and proximal carious lesions. Many studies report that it is possible to arrest the progression of occlusal and proximal caries with noninvasive procedures. Thus, sealing may accomplish this effectively and preserve more dental tissue than traditional caries treatment methods. The technique used for sealing proximal caries is discussed step-by-step. This technique seems very promising for arresting caries progression in proximal surfaces but more studies are necessary since studies on the topic are few.

Effectiveness of sealing active proximal caries lesions with an adhesive system: 1-year clinical evaluation

The objective of this study was to evaluate the effectiveness of a therapeutic sealant to arrest non-cavitated proximal carious lesion progression. The study population comprised 44 adolescents who had bitewing radiographs taken for caries diagnosis. Non-cavitated lesions extending up to half of dentin thickness were included in the sample. In the experimental group (n = 33), the proximal caries-lesion surfaces were sealed with an adhesive (OptiBond Solo, Kerr) after tooth separation. The control group (n = 11) received no treatment, except for oral hygiene instructions including use of dental floss. Follow-up radiographs were taken after one year and were analyzed in comparison with baseline radiographs. In a blind study setting, visual readings were performed by two examiners, blinded to whether the examined radiograph was baseline or follow-up, and whether it concerned a test or control lesion. The efficacy of sealing treatment was evaluated by the McNemar test (0.05). About 22 percent of the sealed lesions showed reduction, 61 percent showed no change and 16 percent showed progression. For the control lesions, the corresponding values were 27 percent, 36 percent and 36 percent respectively. The number of lesions that showed reduction and no changes were merged and therefore 83.3 percent of the sealed lesions and 63.6 percent of the control lesions were considered clinically successful. No statistical significance was detected (p > 0.05). In the course of 1 year, sealing proximal caries lesions was not shown to be superior to lesion monitoring.