K A R I E S – d I A G N O S T I K , R I S K B E d ö M N I N G O C H I C K E - I N vA S I v B E H A N d L I N G
338
Table 6.3 Treatment of early coronal caries lesions.
Studies with low quality and relevance.
Author
Year,
reference
Country
Study design Blinding
Reprodu-
cibility test
Patient
population
No
Sex
Age
Baseline
prevalence
Type of lesions
studied
Diagnostic
criteria
Drop-out
Interven-
tion (I)
Control (C)
Obser-
vation
time
End-
points
Results
Study
quality and
relevance
Comments
Brazzelli et al
2006 [15]
United
Kingdom
Systematic
literature
review
3 unpublished
studies
4 abstracts
–
–
–
–
I1: Ozone +
reductant
I2: Reductant
only
I3: Ozone +
reductant +
fissure sealant
I4: Reductant +
fissure sealant
6–12
months
DIAGNO-
dent
ECM
Reversal
of caries
Progres-
sion of
caries
1 study showed
positive signi-
ficant effects
on clinical
severity scores,
DIAGNO-
dent and ECM
with ozone +
reductant vs
no ozone. 2
studies showed
no difference
between
groups
Low
The results
are based on
unpublished
studies
de Liefde
1987 [9]
New Zealand
RCT
Field study
Not stated
No reliability
test
N: 444
Sex not stated
Age: <10 years
(76% ≤8 years).
Children atten-
ding selected
dental clinics
with erupted
permanent 1st
molars with
occlusal initial
(enamel) caries
Mean dft at
age 5=4.3
Occlusal surfaces
permanent 1st
molars
Visual-tactile,
diagnostic
criteria
not clear
Only
those who
completed
the study
included
I: Application
of 2% NaF solu-
tion 1 x/week
for 3 weeks,
repeated after
3 months +
application of
NaF solution
every 6 months
C: Application
of NaF solution
every 6 months
2 years,
8 months
New
DFS on
occlusal
surfaces of
permanent
1st molars
% not restored
surfaces:
I: 67%
C: 64% (NS)
Low
339
K A P I T E L 6 • b E h A n d L I n g Av T I d I g A K A r I E s s K A d o r
Author
Year,
reference
Country
Study design Blinding
Reprodu-
cibility test
Patient
population
No
Sex
Age
Baseline
prevalence
Type of lesions
studied
Diagnostic
criteria
Drop-out
Interven-
tion (I)
Control (C)
Obser-
vation
time
End-
points
Results
Study
quality and
relevance
Comments
Brazzelli et al
2006 [15]
United
Kingdom
Systematic
literature
review
3 unpublished
studies
4 abstracts
–
–
–
–
I1: Ozone +
reductant
I2: Reductant
only
I3: Ozone +
reductant +
fissure sealant
I4: Reductant +
fissure sealant
6–12
months
DIAGNO-
dent
ECM
Reversal
of caries
Progres-
sion of
caries
1 study showed
positive signi-
ficant effects
on clinical
severity scores,
DIAGNO-
dent and ECM
with ozone +
reductant vs
no ozone. 2
studies showed
no difference
between
groups
Low
The results
are based on
unpublished
studies
de Liefde
1987 [9]
New Zealand
RCT
Field study
Not stated
No reliability
test
N: 444
Sex not stated
Age: <10 years
(76% ≤8 years).
Children atten-
ding selected
dental clinics
with erupted
permanent 1st
molars with
occlusal initial
(enamel) caries
Mean dft at
age 5=4.3
Occlusal surfaces
permanent 1st
molars
Visual-tactile,
diagnostic
criteria
not clear
Only
those who
completed
the study
included
I: Application
of 2% NaF solu-
tion 1 x/week
for 3 weeks,
repeated after
3 months +
application of
NaF solution
every 6 months
C: Application
of NaF solution
every 6 months
2 years,
8 months
New
DFS on
occlusal
surfaces of
permanent
1st molars
% not restored
surfaces:
I: 67%
C: 64% (NS)
Low
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340
Table 6.3 continued
Author
Year,
reference
Country
Study design Blinding
Reprodu-
cibility test
Patient
population
No
Sex
Age
Baseline
prevalence
Type of lesions
studied
Diagnostic
criteria
Drop-out
Interven-
tion (I)
Control (C)
Obser-
vation
time
End-
points
Results
Study
quality and
relevance
Comments
Forsman
1974 [10]
Sweden
RCT school
classes
Double blind
No reliability
test
N: 135 in each
group
Female/Male
I1: 44/83 (after
drop-out)
I2: 77/49 (after
drop-out)
Age: 11–12 years
at baseline
Mean DMFS:
4–5
Approximal
surfaces
Own criteria
17 (6%)
I1: 0.2% NaF
10 ml rinsing
2 min 1 x/week
I2: 0.025% NaF
10 ml rinsing
2 min 1 x/week
2 years
Progres-
sion or no
progres-
sion of
enamel
caries
on BW
No progression
in enamel
I1: 67 surfaces
I2: 66 surfaces
(NS).
Significant
effect in girls
Low
Aim of study
was not to
assess pro-
gression. No
statistics on
progression.
Small sample
Gisselsson et al
1994 [14]
Sweden
CCT
Blinded
Reliability test
N: 233 (I: 59,
C1: 58, C2: 116)
Sex not stated
Age: 4 years
I: 2.59
C1: 4.53
C2: 4.20
Approximal
surfaces, primary
molars
Gröndahl 1984,
Peyron 1992
18 (8%)
I: 1% CHX gel
applied by flos-
sing 4 x/year
C1: Placebo gel
applied by flos-
sing 4 x/year
C2: No gel
treatment
All groups F-
tablet 0.25 mg
1 x 1
3 years
Progres-
sion of
approxi-
mal caries
on BW
after 2
years
I (n=9): 11/28
lesions no
progression
C1 (n=18):
13/66 lesions
no progression
p<0.05
Low
Small numbers
of events
Heller et al
1995 [11]
USA
Retrospective
follow-up
No
No reliability
test
Children in
8 schools
All children with
≥1 erupted, not
restored or
sealed 1st per-
manent molar
were included.
All children
who completed
5-year follow-
up after fissure
sealant
N: 113 (I: 96,
C: 17)
Sex not stated.
Age: 7
Mean DFS: 3.1
Occlusal surfaces
permanent 1st
molars
Visual-tactile
diagnosis; own
criteria
–
I: Fissure sea-
lant (Delton)
C: No treat-
ment
5 years
New
DFS on
occlusal
surfaces of
permanent
1st molars
Sealed surfa-
ces with initial
caries at sealing
developed
manifest caries
more seldom
than surfaces
not sealed
OR: 9
Low
Retrospective
Low number
of children
(C-group)
341
K A P I T E L 6 • b E h A n d L I n g Av T I d I g A K A r I E s s K A d o r
Author
Year,
reference
Country
Study design Blinding
Reprodu-
cibility test
Patient
population
No
Sex
Age
Baseline
prevalence
Type of lesions
studied
Diagnostic
criteria
Drop-out
Interven-
tion (I)
Control (C)
Obser-
vation
time
End-
points
Results
Study
quality and
relevance
Comments
Forsman
1974 [10]
Sweden
RCT school
classes
Double blind
No reliability
test
N: 135 in each
group
Female/Male
I1: 44/83 (after
drop-out)
I2: 77/49 (after
drop-out)
Age: 11–12 years
at baseline
Mean DMFS:
4–5
Approximal
surfaces
Own criteria
17 (6%)
I1: 0.2% NaF
10 ml rinsing
2 min 1 x/week
I2: 0.025% NaF
10 ml rinsing
2 min 1 x/week
2 years
Progres-
sion or no
progres-
sion of
enamel
caries
on BW
No progression
in enamel
I1: 67 surfaces
I2: 66 surfaces
(NS).
Significant
effect in girls
Low
Aim of study
was not to
assess pro-
gression. No
statistics on
progression.
Small sample
Gisselsson et al
1994 [14]
Sweden
CCT
Blinded
Reliability test
N: 233 (I: 59,
C1: 58, C2: 116)
Sex not stated
Age: 4 years
I: 2.59
C1: 4.53
C2: 4.20
Approximal
surfaces, primary
molars
Gröndahl 1984,
Peyron 1992
18 (8%)
I: 1% CHX gel
applied by flos-
sing 4 x/year
C1: Placebo gel
applied by flos-
sing 4 x/year
C2: No gel
treatment
All groups F-
tablet 0.25 mg
1 x 1
3 years
Progres-
sion of
approxi-
mal caries
on BW
after 2
years
I (n=9): 11/28
lesions no
progression
C1 (n=18):
13/66 lesions
no progression
p<0.05
Low
Small numbers
of events
Heller et al
1995 [11]
USA
Retrospective
follow-up
No
No reliability
test
Children in
8 schools
All children with
≥1 erupted, not
restored or
sealed 1st per-
manent molar
were included.
All children
who completed
5-year follow-
up after fissure
sealant
N: 113 (I: 96,
C: 17)
Sex not stated.
Age: 7
Mean DFS: 3.1
Occlusal surfaces
permanent 1st
molars
Visual-tactile
diagnosis; own
criteria
–
I: Fissure sea-
lant (Delton)
C: No treat-
ment
5 years
New
DFS on
occlusal
surfaces of
permanent
1st molars
Sealed surfa-
ces with initial
caries at sealing
developed
manifest caries
more seldom
than surfaces
not sealed
OR: 9
Low
Retrospective
Low number
of children
(C-group)
The table continues on the next page
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342
BW = Bitewing radiographs; C = Control; CCT = Clinical controlled trial;
CHX = Chlorhexidine; DMFS = Decayed, filled teeth; ECM = Electronic caries
monitor; DEJ = Dentine enamel junction; DFS = Decayed, filled surfaces;
F = Fluor; I = Intervention; NaF = Natrium fluoride; NS = Not significant;
OR = Odds ratio; RCT = Randomized controlled trial
Author
Year,
reference
Country
Study design Blinding
Reprodu-
cibility test
Patient
population
No
Sex
Age
Baseline
prevalence
Type of lesions
studied
Diagnostic
criteria
Drop-out
Interven-
tion (I)
Control (C)
Obser-
vation
time
End-
points
Results
Study
quality and
relevance
Comments
Hyde
1973 [12]
Canada
RCT
Blinded
examiner
No reliability
test
N: 377
Age and sex
not stated
Caries in pri-
mary dentition.
Approximal
initial caries
Not stated
Approximal sur-
faces permanent
1st molars
Radiographic:
own criteria
255 (67%)
I1: Stannous F
I2: Phosphate F
I3: Silver nitrate
C: Placebo (dis-
tilled water)
2 years
Initial
caries pro-
gression
to DEJ on
BW
Sign fewer in
all I compared
to C
Low
Large drop-
out
Table 6.3 continued
343
K A P I T E L 6 • b E h A n d L I n g Av T I d I g A K A r I E s s K A d o r
Author
Year,
reference
Country
Study design Blinding
Reprodu-
cibility test
Patient
population
No
Sex
Age
Baseline
prevalence
Type of lesions
studied
Diagnostic
criteria
Drop-out
Interven-
tion (I)
Control (C)
Obser-
vation
time
End-
points
Results
Study
quality and
relevance
Comments
Hyde
1973 [12]
Canada
RCT
Blinded
examiner
No reliability
test
N: 377
Age and sex
not stated
Caries in pri-
mary dentition.
Approximal
initial caries
Not stated
Approximal sur-
faces permanent
1st molars
Radiographic:
own criteria
255 (67%)
I1: Stannous F
I2: Phosphate F
I3: Silver nitrate
C: Placebo (dis-
tilled water)
2 years
Initial
caries pro-
gression
to DEJ on
BW
Sign fewer in
all I compared
to C
Low
Large drop-
out
K A R I E S – d I A G N O S T I K , R I S K B E d ö M N I N G O C H I C K E - I N vA S I v B E H A N d L I N G
344
Table 6.4 Treatment of early root surface caries lesions.
Author
Year,
reference
Country
Study
design
Blinding
Reliability test
Patient
population
No
Sex
Age
Inclusion criteria
Baseline
prevalence
Type of lesions
studied
Diagnostic
criteria
Drop-out
Interven-
tion (I)
Control (C)
Obser-
vation
time
Endpoints
Results
10>10>
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