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Restorative Dentistry Supporting Your Practice

Reviewing and comparing strategies for treating pit-and-fissure lesions in permanent teeth

Best Dental CareThis 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:

  1. Noninvasive treatments (e.g., fluoride application, antibacterial treatments, oral hygiene advice) avoid any dental hard tissue removal;
  2. Micro-invasive treatments (e.g., sealing) remove only a few micrometers of hard tissues by etching; and
  3. 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

List of references (PDF)

 

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