Reviewing and comparing strategies for treating pit-and-fissure lesions in permanent teeth
July 3, 2015
This summary is based on the article published in Dental Research Journal: Treating Pit-and-Fissure Caries: A Systematic Review and Network Meta-analysis (April 2015)
Schwendicke, A.M. Jäger, S. Paris, L.Y. Hsu, and Y.K. Tu
Context
For shallow or moderately deep pit-and-fissure lesions, various treatment options are available:
- Noninvasive treatments (e.g., fluoride application, antibacterial treatments, oral hygiene advice) avoid any dental hard tissue removal;
- Micro-invasive treatments (e.g., sealing) remove only a few micrometers of hard tissues by etching; and
- Minimally invasive methods (e.g., “preventive” resin/sealant restoration) remove carious dentin but avoid sacrificing sound tissues.
Purpose of the article
Systematically review and compare these strategies for treating pit-and-fissure lesions in permanent teeth.
Key Messages
- Micro-invasive and minimally invasive treatments efficacious to avoid invasive retreatments after treating pit-and-fissure lesions in permanent teeth.
- Current evidence indicates that noninvasive treatments might also be suitable for this purpose, while effect estimates remain non-significant.
- The need for any retreatment was significantly higher in micro-invasively (i.e., sealed) lesions than in those that received noninvasive or minimally invasive treatments.
- The studies supporting these findings, however, were mostly of limited quality; thus, the overall certainty of our findings is thus low or very low.
- Clinical treatment decisions should consider the long-term sequelae stemming from any of these retreatments, as well as the costs and subjective impacts of different therapies.
- Available treatment options seem suitable for treating shallow or moderately deep pit-and-fissure lesions in permanent teeth.
References