Evidence-based Update of Pediatric Dental Restorative Procedures: Preventive Strategies

Abstract

Background: There has been significant advances in the understanding of preventive restorative procedures regarding the advantages and disadvantages for restorative procedures; the evidence for conservative techniques for deep carious lesions; the effectiveness of pit and fissure sealants; and the evidence for use of resin infiltration techniques.

Aim: The intent of this review is to help practitioners use evidence to make decisions regarding preventive restorative dentistry in children and young adolescents.

Study design: This evidence-based review appraises the literature, primarily between the years 1995-2013, on preventive restorative strategies. The evidence was graded as to strong evidence, evidence in favor, or expert opinion by consensus of authors Results: The preventive strategy for dental caries includes individualized assessment of disease progression and management with appropriate preventive and restorative therapy. There is strong evidence that restoration of teeth with incomplete caries excavation results in fewer signs and symptoms of pulpal disease than complete excavation. There is strong evidence that sealants should be placed on pit and fissure surfaces judged to be at risk for dental caries, and surfaces that already exhibit incipient, non-cavitated carious lesions. There is evidence in favor for resin infiltration to improve the clinical appearance of white spot lesions.

Conclusions: Substantial evidence exists in the literature regarding the value of preventive dental restorative procedures.

Keywords: dental materials; evidence-based dentistry; pediatric dentistry; preventive dentistry.