Long-term follow-up of inactive occlusal caries lesions: 4-5-year results

Objective To assess the clinical behavior of inactive caries lesion on the occlusal sites of permanent molars over 4–5 years and to estimate the risk for progression of caries-inactive sites compared with sound ones. Methods Clinical examinations were conducted at baseline ( n = 258) and after 4–5 years and included the recording of dental plaque and dental caries at the occlusal surfaces and the eruption stage of each permanent molar. Results One hudred ninety-three schoolchildren were followed (response rate of 74.8%), totalizing 1152 teeth. Of the children, 30.6% ( n = 59) presented at least one molar containing an active lesion, filling, or that had been extracted; according to the activity criterion, inactive lesions presented around a twofold increased risk for caries progression than sound surfaces (OR = 2.34 95%CI = 1.51–3.62). Thirteen percent ( n = 25) of the children presented at least one molar progressing to dentine cavity, filling, or extraction; according to the severity criterion, inactive caries lesions presented a significantly higher risk for progression when compared with sound surfaces (OR = 2.69, 95% CI = 1.50–4.83). Conclusion The vast majority of lesions (85–90%) identified as inactive enamel caries at baseline did not progress over 4–5 years. Despite this fact, it was possible to detect an increased risk for caries progression in caries-inactive occlusal sites compared with the sound ones. Clinical relevance Considering the low progression rates, inactive caries lesions do not need a specific caries-controlling treatment and should be monitored longitudinally in the same manner as sound surfaces.