Loss of dental tissue after restoration or sealing of occlusal carious lesions: 3-4-year results of randomized clinical trials

CONTEXT: Although preservation of the tooth structure is quoted as the main advantage of sealing of carious lesions, there are no long-term studies comparing the maintenance of dental tissue after restoration or after caries sealing. AIM: To measure the radiographically visible loss of dental tissue after conventional restoration and sealing of carious lesions. SUBJECTS AND METHODS: This study was a secondary analysis of two randomized controlled clinical trials, one conducted in Brazil and another in Belgium, which evaluated two different therapies for the treatment of occlusal carious lesions in permanent teeth: sealant (SE) without previous carious tissue removal or restoration (RE) with total removal of carious dentin. The greater depth and width of sealed carious lesions and restorations were compared. STATISTICAL ANALYSIS: The independent t-test was used to compare therapies at different time points, while the paired t-test was used to compare the same therapy over time. RESULTS: Carious lesions in the RE and SE groups showed similar measurements at baseline (P > 0.05). Over time, significantly greater loss of tooth structure was observed in the RE group than in the SE group. No increase in lesion depth or width was observed in the SE group, suggesting no progression of sealed lesions. CONCLUSION: Sealing of carious lesions resulted in greater preservation of dental tissue.