Sealing vs. Filling: An 11-Year Trial Revisits the Caries Conundrum
A landmark 11-year randomized controlled trial provides robust, long-term evidence on managing occlusal dentin caries. The study compared the outcomes of 341 resin sealings against 152 composite restorations in permanent molars of young patients. After more than a decade, 58% of sealings and 81% of restorations remained in place without needing major retreatment. While sealings had a higher annual failure rate (4–7%) compared to restorations (1%), a significant 33% of sealings were eventually replaced by a restoration, successfully postponing more invasive treatment. Critically, the survival rate of repaired sealings matched that of new ones, and no teeth required endodontic treatment, underscoring the safety of the sealing approach for deep lesions.
Why it might matter to you: This long-term data strengthens the evidence base for a minimally invasive strategy in restorative dentistry, directly relevant to decisions on cavity preparation and caries removal. For clinicians, it offers a validated protocol to delay or avoid definitive composite restorations in selected cases, potentially preserving more tooth structure. The findings support integrating resin sealants as a viable, long-term treatment option within adhesive dentistry, influencing both clinical guidelines and patient counseling.
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