Slower than expected tooth decay in placebo group and insufficient recruitment.

This is a three year single site clinical evaluation of a FDA approved (510(k):K100062) lesion penetrating resin used to infiltrate and hamper progression of proximal carious lesions. The purpose of this study is to compare lesion progression infiltrated with (Icon, Hamburg, Germany) to a similar sized lesion in the same patient treated with a placebo. The study is designed as a randomized, controlled, prospective clinical trial with a three year follow-up evaluation period.

The clinical site will enroll 150 subjects (in the age range of 19 years or older) with 2 study lesions. The patients will be evaluated at six time points over a period of 3 years. Lesion status and caries risk will be monitored at 6-month intervals, while radiographic evaluation will be conducted at 12-month intervals at 1-, 2- and 3-year recall visits.

Introduction Dental caries is the most widespread of all diseases. It causes destruction of tooth structure by dissolving the enamel on the outside of the tooth first and then progressing into the inside of the tooth. While it is possible to use traditional dental fillings to replace diseased tooth structure, it is far better to slow down or reverse the disease process so that no fillings are needed. One of the most difficult places to use preventive or non-surgical treatment is the contact area between teeth. Recently there is evolving interest in using composites to infiltrate enamel and dentin areas that have just begun to be destroyed by caries. The infiltration technique arrests the lesion progression by sealing the porous surface and restores the damage avoiding ongoing acidic damage of tooth structure.

Objective Assess the clinical efficacy s of using Icon to infiltrate initial lesions below the tooth surfaces that exist on the contact surfaces between posterior teeth as a means of stabilizing diseased tooth structure and arresting further lesion development.

Materials and Methods One hundred fifty volunteers (19+ years) with two early lesions in posterior teeth will be enrolled into a clinical trial to evaluate the clinical efficacy of infiltrating the lesions as compared to current watch-and-wait approaches that are combined with good oral hygiene and fluoride application. Each subject will have a treated lesion and a control lesion. Only small early lesions without clinical signs of surface cavitation will be selected. The control lesions will be stabilized through a normal preventive regimen, while the treatment lesions will be infiltrated with a resin. Lesion status will be monitored every six months by clinical examination and as well using annual radiographs.

Clinical Significance Infiltrating a caries lesion is a potential effective strategy to strengthen damaged tooth structure and to reduce caries progression without any surgical intervention.

Inclusion Criteria:

• Be age 19 years and older

• Have at least two vital carious teeth with caries ranging from enamel to just into dentin.

  • If the lesion is not on a 3rd molar
  • If the lesion is not developmental.
  • If the lesion is not cavitated

• Be a regular dental attendee able to return for assessments

• Be in good medical health and able to tolerate the dental procedure

• Have no chronic periodontitis which could compromise tooth retention.

• Have normal salivary function.

• Have normal bone levels

• No lingering cold sensitivity

• No periapical sensitivity

• No sensitivity to percussion

Exclusion Criteria:

• Do not meet the inclusion criteria
• Are not able to tolerate the time required for the study
• There is a history of an adverse reaction to any materials used in the study
• They are irregular dental attendees
• They maintain an unacceptable standard of oral hygiene.
• They have chronic periodontitis
• There is severe salivary gland dysfunction or reduced salivary flow is observed
• They are unable to return for recall appointments

Baseline through 12 months.