Comparative evaluation of resin infiltration and fluoride varnish treatment for moderate to high caries risk adults: A randomized controlled trial.

Purpose: To evaluate the arresting effect of micro-invasive (resin infiltration) and non-invasive (fluoride varnish) treatment options on non-cavitated proximal lesions in individuals with moderate to high risk of caries. In addition, the study evaluated the effect of repeated dental examinations and oral hygiene motivation on daily flossing, brushing frequency, dietary habits, and gingival status.

Methods: The study was a randomized, controlled, prospective, and parallel-designed clinical trial. 60 adults were enrolled and randomly allocated in a 1:1 ratio to the treatment groups. Cariogram was used to assess the caries risk. The advising instruction for daily habits and oral hygiene by individual risk illustration was given to all participants. Two experienced examiners visually evaluated the severity and activity of the lesions by using the International Caries Detection and Assessment System and Nyvad Activity Assessment respectively. Radiographic scoring of the lesions was performed on bite-wing radiographs by the same examiners. The gingival index was used to check the gingival status of the patients at the initial and control sessions. After examination, resin infiltration (Icon) was applied to 30 subjects, while the other 30 received fluoride varnish (Clinpro White Varnish). The follow-up time was 18 months with 6-month intervals.

Results: According to the Pearson Chi-Square test, there was no difference in the arresting effect of resin infiltration and fluoride varnish (P= 0.491). Both treatment groups exhibited a notable arresting effect on non-cavitated lesions, achieving a success rate of 98% (55 out of 56) during the 18-month evaluation period. However, one lesion of a subject who received resin infiltration was observed to progress from an E2 score to cavitation. Furthermore, at the end of 18 months, the subjects' motivation for oral hygiene had increased, and gingival index score decreased from 2 to 1 in 15% of the subjects.

Clinical significance: Both resin infiltration and fluoride varnish yielded satisfactory results in the treatment of non-cavitated proximal lesions in individuals with moderate to high risk of caries. Repeated motivational instructions were beneficial for patients in maintaining their daily oral hygiene habits and gingival health.