Ultraconservative sealed restorations: three-year results

Area of Science:

• Restorative Dentistry
• Cariology
• Dental Materials Science

Background:

• Traditional caries treatment involves removing the carious lesion and preparing a cavity, often requiring anesthesia and significant tooth structure removal.
• Ultraconservative approaches aim to minimize tooth structure removal and patient discomfort while effectively managing caries.
• Sealed composite restorations placed over caries (CompS/C) represent a novel ultraconservative treatment strategy.

Purpose of the Study:

• To evaluate the feasibility of using sealed composite restorations (CompS/C) to arrest caries without traditional cavity preparation.
• To compare the clinical performance of CompS/C restorations with ultraconservative sealed amalgam restorations (AGS) and traditional unsealed amalgam restorations (AGU).

Main Methods:

• A clinical study comparing CompS/C, AGS, and AGU restorations over a three-year period.
• Minimal tooth preparation involving an enamel bevel was performed, typically avoiding the need for anesthetic injections.
• Evaluations included caries arrest, marginal integrity, and sealant retention rates.

Main Results:

• CompS/C restorations successfully arrested caries for three years.
• AGS restorations demonstrated improved marginal integrity compared to AGU restorations.
• Complete sealant retention was comparable between CompS/C and AGS for two years, with CompS/C showing a 16% higher retention rate at Year 3.

Conclusions:

• Ultraconservative sealed composite restorations are feasible for arresting caries without extensive cavity preparation.
• CompS/C restorations offer a promising, tooth-conserving alternative for caries management.
• The CompS/C approach shows excellent long-term sealant retention, potentially surpassing sealed amalgam restorations.