Non-Cochrane · intervention · PM33413327
Infiltration and sealing for managing non-cavitated proximal lesions: a systematic review and meta-analysis.
Chen Yuanyuan, Chen Dongru, Lin Huancai · BMC oral health · 2021 · PubMed · doi:10.1186/s12903-020-01364-4
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
16
current version
GRADE rated
3
No studies
0
Included studies
22
linked below
No studies 0 · 0%Ungraded 13 · 81.3%Very low 0 · 0%Low 0 · 0%Moderate 3 · 18.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with non-cavitated proximal (approximal) caries lesions; only studies with a single dominant caries-risk level (>80% of patients) retained for risk classification; mixed/unspecified caries-risk populations excluded | 830 patients aged 4.6 to 45 years with 2124 non-cavitated proximal lesions; 5 studies primary dentition, 12 studies permanent dentition (n=17 studies) |
| Intervention | Micro-invasive treatments: resin infiltration and sealing | Resin infiltration with Icon (11 studies) and sealing with resin sealant, GIC or polyurethane tape (7 studies) (n=17) |
| Comparison | Non-invasive treatments (e.g., placebo, flossing, fluoride application, remineralisation, dietary advice) | Non-invasive/control: placebo, flossing, fluoride varnish/application, oral hygiene instruction, dietary advice (n=17) |
| Outcomes | Radiographic caries lesion progression (primary outcome from radiographical readings) | Radiographic lesion progression assessed by independent reading, pairwise reading or digital subtraction radiography (DSR) (n=17) |
| Study designs | Split-mouth randomised controlled trials (RCTs); reviews, in situ, in vitro, case reports, protocols and meeting abstracts excluded | Split-mouth RCTs (n=17; 22 articles) |
| Timing | Not specified (no restriction on follow-up, publication type, language, year or region) | Follow-up 6 to 84 months |
Search date: 6 April 2020 (from inception). Databases: Cochrane Library; PubMed; Embase; OpenGrey; ProQuest Dissertations & Theses Global; Web of Science Conference Proceedings Citation Index-Science (CPCI-S); plus manual/reference searching
Questions and results
Micro-invasive treatment (resin infiltration or sealing) vs Non-invasive / control treatment
Population: Patients with non-cavitated proximal (approximal) caries lesions (primary or permanent dentition)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: moderate to high In the moderate to high caries-risk subgroup, micro-invasive treatment reduced the odds of lesion progression (OR 0.17, 95% CI 0.10 to 0.29; ungraded subgroup). Source: Abstract; Results (Fig. 6) · same question in other reviews | OR 0.17 [0.10, 0.29] | 4 studies | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: low In the low caries-risk subgroup, micro-invasive treatment reduced the odds of lesion progression (OR 0.24, 95% CI 0.08 to 0.72; ungraded subgroup). Source: Abstract; Results (Fig. 6) · same question in other reviews | OR 0.24 [0.08, 0.72] | 2 studies | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Primary dentition In the primary dentition, micro-invasive treatment reduced the odds of proximal lesion progression (OR 0.30, 95% CI 0.20 to 0.45; ungraded subgroup). Source: Results (Fig. 5); Characteristics of the included studies · same question in other reviews | OR 0.30 [0.20, 0.45] | 5 studies | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up Micro-invasive treatment (infiltration or sealing) probably reduces the odds of proximal caries lesion progression compared with non-invasive treatment (OR 0.23, 95% CI 0.18 to 0.30; moderate certainty). Source: Abstract; Results (Efficacy of infiltration and sealing; Fig. 4); Appendix 2.1 SoF; Appendix 2.2 GRADE evidence profile · same question in other reviews | OR 0.23 [0.18, 0.30] 432 per 1000 vs 149 per 1000 | 17 studies · 830 participants | Moderate Downgraded: risk of bias |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: low to moderate In the low to moderate caries-risk subgroup, micro-invasive treatment reduced the odds of lesion progression (OR 0.38, 95% CI 0.18 to 0.81; ungraded subgroup). Source: Abstract; Results (Fig. 6) · same question in other reviews | OR 0.38 [0.18, 0.81] | 1 study | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: moderate In the moderate caries-risk subgroup, the difference between micro-invasive and non-invasive treatment was not significant (OR 0.32, 95% CI 0.01 to 8.27; ungraded subgroup). Source: Abstract; Results (Fig. 6) · same question in other reviews | OR 0.32 [0.01, 8.27] | 1 study | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: high In the high caries-risk subgroup, micro-invasive treatment reduced the odds of lesion progression (OR 0.14, 95% CI 0.07 to 0.28; ungraded subgroup). Source: Abstract; Results (Fig. 6) · same question in other reviews | OR 0.14 [0.07, 0.28] | 3 studies | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Permanent dentition In the permanent dentition, micro-invasive treatment reduced the odds of proximal lesion progression (OR 0.20, 95% CI 0.14 to 0.28; ungraded subgroup). Source: Results (Fig. 5); Characteristics of the included studies · same question in other reviews | OR 0.20 [0.14, 0.28] | 12 studies | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · All caries-risk levels (caries-risk subset) In the 9-RCT caries-risk subset, micro-invasive treatment reduced the odds of lesion progression overall (OR 0.20, 95% CI 0.14 to 0.28; ungraded subgroup). Source: Results (Fig. 6) · same question in other reviews | OR 0.20 [0.14, 0.28] | 9 studies | Ungraded |
Resin infiltration (Icon) vs Non-invasive treatment
Population: Patients with non-cavitated proximal caries lesions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Radiographic proximal caries lesion progression Longest available follow-up Resin infiltration probably reduces the odds of proximal lesion progression compared with non-invasive treatment (OR 0.21, 95% CI 0.15 to 0.29; moderate certainty). Source: Abstract; Results (Fig. 4); Appendix 2.1 SoF; Appendix 2.2 GRADE evidence profile · same question in other reviews | OR 0.21 [0.15, 0.30] 396 per 1000 vs 121 per 1000 | 11 studies · 549 participants | Moderate Downgraded: risk of bias |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: low In the low caries-risk subgroup, resin infiltration reduced the odds of lesion progression (OR 0.24, 95% CI 0.08 to 0.72; ungraded subgroup). Source: Abstract; Results (Fig. 7) · same question in other reviews | OR 0.24 [0.08, 0.72] | 2 studies | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: moderate to high In the moderate to high caries-risk subgroup, resin infiltration reduced the odds of lesion progression (OR 0.20, 95% CI 0.10 to 0.39; ungraded subgroup). Source: Abstract; Results (Fig. 7) · same question in other reviews | OR 0.20 [0.10, 0.39] | 3 studies | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: moderate In the moderate caries-risk subgroup, the difference between infiltration and non-invasive treatment was not significant (OR 0.32, 95% CI 0.01 to 8.27; ungraded subgroup). Source: Abstract; Results (Fig. 7) · same question in other reviews | OR 0.32 [0.01, 8.27] | 1 study | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: low to moderate In the low to moderate caries-risk subgroup, resin infiltration reduced the odds of lesion progression (OR 0.38, 95% CI 0.18 to 0.81; ungraded subgroup). Source: Abstract; Results (Fig. 7) · same question in other reviews | OR 0.38 [0.18, 0.81] | 1 study | Ungraded |
Radiographic proximal caries lesion progression Longest available follow-up · Caries risk: high In the high caries-risk subgroup, resin infiltration reduced the odds of lesion progression (OR 0.14, 95% CI 0.05 to 0.37; ungraded subgroup). Source: Abstract; Results (Fig. 7) · same question in other reviews | OR 0.14 [0.05, 0.37] | 2 studies | Ungraded |
Sealing (resin sealant, glass ionomer cement, or polyurethane tape) vs Non-invasive/control treatments (flossing, fluoride varnish/toothpaste, or dietary advice; placebo in one trial)
Population: Patients with non-cavitated proximal caries lesions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Radiographic proximal caries lesion progression Longest available follow-up Sealing probably reduces the odds of proximal lesion progression compared with placebo (OR 0.27, 95% CI 0.18 to 0.42; moderate certainty). Source: Abstract; Results (Fig. 4); Appendix 2.1 SoF; Appendix 2.2 GRADE evidence profile · same question in other reviews | OR 0.27 [0.18, 0.42] 502 per 1000 vs 214 per 1000 | 7 studies · 320 participants | Moderate Downgraded: risk of bias |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | No | no |
| 3Choice of study designs explained | Yes | No | no |
| 4Comprehensive literature searchcritical | Yes | Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | NRSI: N/A · RCT: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: Yes | NRSI: N/A · RCT: Yes | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 22
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Bagher 2018 matched by author and year (probable) | 1 other review | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Alkilzy 2009 / Alkilzy 2011 matched by author and year (probable) | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Alkilzy 2011 Sealing proximal surfaces with polyurethane tape: three-year evaluation DOI:10.1007/s00784-010-0457-z | this review only | not stated | not extracted yet | not extracted yet |
| Ammari 2018 / Jorge 2019 Efficacy of resin infiltration of proximal caries in primary molars: 1-year follow-up of a split-mouth randomized controlled clinical trial DOI:10.1007/s00784-017-2227-7 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Arslan 2020 The Effect of Resin Infiltration on the Progression of Proximal Caries Lesions: A Randomized Clinical Trial. PMID:31476757 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Arthur 2018 Proximal carious lesions infiltration—a 3-year follow-up study of a randomized controlled clinical trial DOI:10.1007/s00784-017-2135-x | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Basili 2017 Preventive and Therapeutic Proximal Sealing: A 3.5-Year Randomized Controlled Clinical Trial Follow-Up DOI:10.1159/000470851 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Ekstrand 2010 Treatment of Proximal Superficial Caries Lesions on Primary Molar Teeth with Resin Infiltration and Fluoride Varnish versus Fluoride… DOI:10.1159/000275573 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Foster Page 2017 Resin Infiltration of Caries in Primary Molars in a Community Setting: 24-Month Randomized Controlled Trial Findings DOI:10.1177/2380084417699400 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Gomez 2005 A 2-year clinical evaluation of sealed noncavitated approximal posterior carious lesions in adolescents DOI:10.1007/s00784-005-0010-7 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Jorge 2019 Randomized controlled clinical trial of resin infiltration in primary molars: 2 years follow-up DOI:10.1016/j.jdent.2019.103184 | this review only | not stated | not extracted yet | not extracted yet |
| Martignon 2006 Efficacy of Sealing Proximal Early Active Lesions: An 18-Month Clinical Study Evaluated by Conventional and Subtraction Radiography DOI:10.1159/000094282 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Martignon 2010 Sealing Distal Proximal Caries Lesions in First Primary Molars: Efficacy after 2.5 Years DOI:10.1159/000321986 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Martignon 2012 Infiltrating/Sealing Proximal Caries Lesions DOI:10.1177/0022034511435328 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Meyer-Lueckel 2012 Randomized Controlled Clinical Trial on Proximal Caries Infiltration: Three-Year Follow-Up DOI:10.1159/000341807 | this review only | not stated | not extracted yet | not extracted yet |
| Meyer-Lueckel 2016 Pragmatic RCT on the Efficacy of Proximal Caries Infiltration DOI:10.1177/0022034516629116 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Paris 2010 / Meyer-Lueckel 2012 / Paris 2020 Resin Infiltration of Caries Lesions DOI:10.1177/0022034510369289 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Paris 2020 Seven-year-efficacy of proximal caries infiltration – Randomized clinical trial DOI:10.1016/j.jdent.2020.103277 | this review only | not stated | not extracted yet | not extracted yet |
| Peters 2018 / Peters 2019 Resin infiltration: An effective adjunct strategy for managing high caries risk—A within-person randomized controlled clinical trial DOI:10.1016/j.jdent.2018.09.005 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Peters 2019 Efficacy of Proximal Resin Infiltration on Caries Inhibition: Results from a 3-Year Randomized Controlled Clinical Trial DOI:10.1177/0022034519876853 | this review only | not stated | not extracted yet | not extracted yet |
| Trairatvorakul 2011 Effect of Glass-ionomer Cement on the Progression of Proximal Caries DOI:10.1177/0022034510381265 | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
| Vaghela 2017 matched by author and year (probable) | this review only | Radiographic proximal caries lesion progression | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Microinvasive interventions in the management of proximal caries lesions in primary and permanent teeth- systematic review and… (2025) | 1 | 0.03 |