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Abstract This in-vivo study was performed to evaluate the efficacy of resin infiltration (ICON®) and fissure sealant (FissealTM) versus fluoride varnish (Duraphat) in arresting or reversing initial occlusal carious lesions in permanent teeth after one-year clinical follow-up. Ten patients of both sexes with an age ranging between (15-25) years were selected to participate in the present study. Each patient was examined with DIAGNOcam and ICDAS visual criteria to select teeth having ICDAS Code 1 and Code 2 to be sure that the caries is limited to enamel of the occlusal surface. Forty teeth were used in the study that were distributed as four teeth in each patient and were divided into four groups according to the material used for the treatment. The carious lesions of group I were infiltrated with ICON® resin infiltrant, those of group II were sealed with a resin-based fissure sealant (FissealTM) and those of group III were painted with Duraphat fluoride varnish while those of group IV were left without treatment (control groups). All groups were subjected to a clinical follow up schedule representing three follow up periods (baseline, after 6 and 12 months) during which, the efficacy of each material in arresting caries progression was assessed radiographically through the subtraction of pixel grey value measurements using bitewing digital radiographs. 1st subtraction, showing the effect of the materials in the first evaluation period (subtracting the baseline values from those after 6 months), 2nd subtraction showing the effect of the materials in the 2nd evaluation period (subtracting values of 6 from those after 12 months). The 3rd subtraction (subtracting the baseline values from those afterCH.VII Summary & Conclusions 90 12 months) revealed the final effect of the tested materials. The marginal integrity of the tested materials was examined under the scanning electron microscope using epoxy resin replicas of randomly selected patients. The results of current study revealed a slight progression in group I (treated with Icon®) followed by group II (treated with FissealTM) then group III (treated with Duraphat) while group VI (left without treatment) showed a sever progression at the different evaluation periods. No significant difference between group I and group II was recorded denoting nearly similar effect of ICON® resin infiltrant and FissealTM fissure sealer on the initial lesions caries progression. This was confirmed by SEM images showing complete marginal adaptation of the materials in both groups. However, group III showed complete loss of the material represented by a pseudo gap formation. Statistical analysis recorded that both groups were significantly different from group III revealing weak effect of fluoride varnish in retarding the caries progression. None of the treatment modalities reversed or arrested initial occlusal carious lesion progression thus the current hypothesis was rejected. |