The effect of resin infiltration on proximal caries lesions in primary and permanent teeth. A systematic review and meta-analysis of clinical trials

Introduction/objectives: This systematic review aimed to critically appraise the evidence on resin infiltration for the clinical management of proximal caries lesions in primary and permanent teeth. Data: Search terms included resin infiltration, micro-invasive and proximal caries. Potentially eligible studies involved proximal caries lesions treated with resin infiltration. Risk of bias assessment was performed using the Cochrane risk of bias tool and the quality of evidence was assessed with GRADE. Sources: Electronic Database search of published and unpublished literature was performed in April 22, 2018 within the following databases: MEDLINE via Pubmed, Cochrane Central Register of Controlled Trials, LILACS via BIREME, Open Grey, Clinical Trials.gov and National Research Register. Study selection: Of 135 articles initially retrieved, 10 were eligible for inclusion in the systematic review comprising the results of 9 studies, while 5 randomized controlled trials (RCTs) (6 articles) with unclear risk of bias contributed to the meta-analyses. Random effects meta-analyses were implemented and lesion progression treatment effects were estimated through Odds Ratios (ORs) along with associated 95% Confidence Intervals (95% CIs). Conclusions: Overall, there was strong evidence that proximal caries lesion progression was less likely to occur in permanent teeth following treatment with resin infiltration plus oral hygiene measures as compared to non-invasive methods (oral hygiene instructions) for follow up 18 months to 2 years (3 studies: OR = 0.14; 95% CI: 0.08, 0.25; P < 0.001) as well as 3 years (4 studies: OR = 0.15; 95% CI: 0.06, 0.36; P < 0.001). The quality of the evidence was rated as moderate to low respectively.