Sealing of carious lesions in dentin of deciduous molars: clinical controlled and randomized study

The aim of this study was to evaluate the efficacy of the sealing technique performed on carious dentin in primary molars. For this, a controlled, randomized clinical trial was developed. Prior to the trial, a study method was executed. Thus, the risk of caries in children (n = 28) aged 3-9 years old was compared by the using of the following predictors instruments: Cariogram® with microbiological analysis (salivary levels of Streptococcus mutans - SM) included in the model; Cariogram® without SM included in the model; and a form based on Cariogram® also without SM variable. The results showed no difference between the assessment methods (p> 0.05) and the salivary levels of SM were not essential to assess the caries risk of children. Taking these results into account, the subjects were randomly divided into two groups: main (SCT) and control (PRCT), considering the risk classification (low, moderate or high) to the disease. Thus a homogenization of the groups was achieved, regarding the caries risk status of children. Seeking to compare SCT with PRCT, the main outcomes of the trial were the clinical success of sealings and restorations (by USPHS criteria); as well as the presence or absence of caries progression (paired analysis of bitewing radiographs), evaluated by blind independent examiners over 1-year follow-up. The anxiety of children before and after each treatment and the time required for each intervention comprised the secondary outcomes. Salivary levels of S. mutans, Lactobacillus spp., Candida spp. and Bifidobacterium spp. were also observed and compared between the groups before and after the treatments. After 1 year of follow up, 22 patients were evaluated, thus 44 teeth with occlusal lesions (1.5 mm diameter) in the outer half of dentin were analysed. Clinically, there was no difference between the groups regarding restorations. Only one molar from SCT showed lesion progression after 1 year, but there was no statistical difference between the treatments (p = 0.529). The anxiety level did not change significantly after the two interventions (p = 0.650). The average treatment time SCT (9.03 ± 1.91 min) was statistically lower (p = 0.002) than the mean of the PRCT (17.13 ± 5.26). In addition, the salivary levels of all target microorganisms were not different between children included in both groups at each assessment point. The results demonstrated that caries sealing technique performed on the outer half of carious dentin may be used in dentistry since it did not alter the children anxiety, reduced chair time and demosntrated clinical success rate and no radiographic statistical difference in relation to the partial caries removal followed by restoration.