PEDIATRIC DENTISTRY V 42 / NO 2 MAR / APR 20

RANDOMIZED CONTROL TRIAL

Two-Year Split-Mouth Randomized Controlled Clinical Trial on the Progression of Proximal

Carious Lesions on Primary Molars After Resin Infiltration
Caroline Simão Sarti, MSc, PhD1 • Mariana Boessio Vizzotto, MSc, PhD2 • Leonardo Villar Filgueiras, MSc3 • Clarissa Calil Bonifácio, MSc, PhD4 •
Jonas Almeida Rodrigues, MSc, PhD5

Abstract: Purpose: The purpose of this split-mouth, randomized, controlled clinical trial was to assess the progression of early proximal carious
lesions on primary molars after resin infiltration. Methods: Twenty-eight children presenting two primary molars with proximal carious lesions
detected radiographically (on the outer half of the enamel up to the outer one-third of dentin) were included. Baseline assessments consisted
of standard digital bitewing radiographs, Visual Plaque Index (VPI), Gingival Bleeding Index (GBI), and visual examination of caries. Proximal
lesions were randomly allocated into two groups: (1) resin infiltration (test) and (2) no infiltration (control). Reassessments were performed after
two years. Lesion progression was considered when the radiographic score increased. Results: A significant difference in lesion progression was
observed between test (54.1 percent) and control (79.2 percent) groups after two years (McNemar’s test, P=0.03). Logistic regression for matched
pairs showed that the test group had an 82 percent lower risk of caries progression  (odds ratio equals 0.18, 95%CI 0.29 to 0.31). Conclusions:
Infiltrating proximal lesions decreases radiographic caries progression in primary molars after a two-year follow-up period. (Pediatr Dent 2020;
42(2):110-5) Received August 6, 2019 | Last Revision January 27, 2020 | Accepted January 30, 2020
KEYWORDS: DENTAL CARIES, RESIN INFILTRATION, PRIMARY TEETH

The proximal surface is a susceptible site for the development
of carious lesions due to its anatomy and the difficult access
for oral hygiene and salivary protection.1 Children that have a
high caries experience present a higher caries progression rate
on the proximal surfaces, mainly those located in the outer
half of the dentin. In addition, children with greater caries
experience have a higher risk of developing new proximal
lesions on healthy surfaces.2
To control the progression of carious lesions on proximal
surfaces, microinvasive approaches have been used as a treat-
ment option in noncavitated lesions, which involves the appli-
cation of sealant or infiltrant on the dental surface.3,4 A review
reported that microinvasive treatment, regardless of the material
used, was superior in controlling the progression of the prox-
imal lesions compared to treatment with fluorotherapy and
flossing.5
The use of resin infiltration is considered a promising tech-
nique that can reduce tooth mineral loss in proximal lesions.
In addition, resin infiltrant treatment requires less patient co-
operation than flossing.6 Clinical trials have demonstrated that
infiltrating proximal lesions combined with fluoride varnish
1 Dr. Sarti is a pediatric dentist, 2Dr. Vizzotto is an assistant professor, 3Dr. Filgueiras
is a dentist, and 5Dr. Rodrigues is an associate professor, all in the Pediatric Dentistry
Division, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Su, Brazil;
and 4Dr. Bonifácio is an assistant professor, Academisch Centrum Tandheelkunde
Amsterdam (ACTA), Amsterdam, The Netherlands.
Correspond with Dr. Rodrigues at jorodrigues@ufrgs.br
HOW TO CITE:
Sarti CS, Vizzotto MB, Filgueiras LV, Bonifácio CC, Rodrigues JA. Two-
year split-mouth randomized controlled clinical trial on the pro-
gression of proximal carious lesions on primary molars after resin
infiltration. Pediatr Dent 2020;42(2):110-5.
application is effective in treating these lesions in primary teeth
when compared to fluoride varnish only.7,8
A systematic review that analyzed the effect of infiltrating
lesions on proximal carious lesions in permanent and primary
teeth observed that the application of resin infiltrant com-
bined with oral hygiene measures is more effective in controlling
lesion progression than oral hygiene measures alone. Only one
study included in this review involved children. The authors
suggested that further long-term randomized controlled clinical
trials are necessary to incase this evidence, particularly in pri-
mary molars.9
Considering the need for randomized controlled clinical
trials in primary teeth, the purpose of this split-mouth study
was to compare the radiographic progression of early prox-
imal carious lesions on primary molars after resin infiltration
(test) to no infiltration (control) after two years of follow-up.
Methods
This split-mouth, randomized, controlled clinical trial was
approved by the Local Ethics Committee of Federal University
of Rio Grande do Sul, Porto Alegre, Brazil. Written informed
consent was obtained from the parents or legal guardians of
all children who agreed to participate. This study was con-
ducted in full accordance with the World Medical Associ-
ation Declaration of Helsinki.
Sample. The sample size was calculated based on the pro-
portion of proximal caries progression observed in a previous
split-mouth study10 using SPSS Statistics 21 statistical software
(SPSS Inc., Chicago, Ill., USA) for two paired outcomes with
a one-to-one allocation ratio, assuming normality, for a two-
sided test. Assuming a proportion of 37 percent progression
(control) and seven percent progression (test), with α equals
0.05, based on a two-sided test and a power of 80 percent, a
total of 22 pairs of lesions would be needed. Considering a
dropout rate of 30 percent, it was determined that 28 children
should be recruited in the study. The study occurred between

110 INFILTRATION OF PROXIMAL CARIES LESIONS


2014 and 2016 in the Pediatric Dental Clinic at Federal
University of Rio Grande do Sul, Porto Alegre, Rio Grande
do Su, Brazil.
Participants. For this study, 189 healthy three- to eight-
year-olds, with at least two pairs of adjacent primary molars
with proximal contact, were considered eligible. Inclusion cri-
teria included the presence of least two radiographically de-
tected contralateral carious lesions on proximal surfaces in
their primary molars (on the outer half of the enamel up to the
outer one-third of dentin). Exclusion criteria included unco-
operative behavior, primary molars that should exfoliate in less
than two years (more than two-thirds root resorption), fluorosis,
and/or hypoplasia. Among 189 children, 28 lived in an area
with a fluoridated water supply, met the inclusion criteria, and
had their signed informed consent.
Baseline assessments. Clinical baseline data included two
bitewing radiographs and clinical evaluations performed by one
experienced dentist. Standardized bitewing radiographs from
the 28 selected children were obtained using an X-ray machine
Odontomax 70/7p (Astex, São Paulo, São Paulo, Brazil) and
an Emmenix Film Holder (Hager & Werken, Duisburg, North
Rhine-Westphalia, Germany). The digital images were obtained
using a phosphor plate size zero (20 × 30 mm active area) from
the VistaScan digital system (Dürr Dental, Beitigheim-Bissingen,
Baden-Württemberg, Germany). Images were scanned imme-
diately after acquisition and stored using a VistaScan  Perio
Plus scanner (Dürr Dental) and DBSWIN software (Dürr
Dental). An independent and experienced radiologist scored
the images according to the following criteria: E1 equals radio-
lucency confined to the outer half of the enamel; E2 equals
radiolucency involving the inner half of the enamel; D1 equals
radiolucency in the outer third of the dentin; D2 equals radio-
lucency in the middle third of the dentin; and D3 equals
radiolucency in the inner third of the dentin.10
The presence of visible plaque was evaluated using the
Visible Plaque Index (VPI), scored as zero equals no visible
plaque, or one equals visible plaque. Gingival bleeding was
evaluated using the Gingival Bleeding Index (GBI), scored as
zero equals no bleeding after gentle probing or one equals
bleeding after gentle probing.11 Children’s visual examination
of carious lesions was carried out after teeth cleaning. Dental
caries was recorded based on two indexes of evaluation of caries
extent/severity and activity: (1) International Caries Detec-
tion and Assessment System (ICDAS)12 complemented by (2)
Nyvad Criteria.13 Lesions were classified in scores as follows:
one equals active enamel noncavitated lesion; two equals in-
active enamel noncavitated lesion; 3a equals active enamel
breakdown (enamel small active cavity); 3i equals inactive
enamel breakdown (enamel small inactive cavity); four equals
shadow in the dentin; 5a equals active cavitated dentin lesion;
and 5i equals inactive cavitated dentin lesion.
Active lesions were white, opaque, and rough in the
enamel and yellowish and soft in the dentin, whereas inactive
lesions were shiny and smooth in the enamel and dark and
hard in the dentin.13 The examiner was trained and calibrated
for the criteria of a visual examination of carious lesions. The
training session included the clinical examination of 15 pa-
tients who did not participate in the study.
Children’s caries experience was scored using the decayed,
missing, and filled primary teeth (dmft) index. The “d” compo-
nent was defined as caries in a cavitated stage (scores three
and five). The “m” component was defined as extracted teeth
due to caries, and the “f ” component was defined as restored
PEDIATRIC DENTISTRY V 42 / NO 2 MAR / APR 20
surfaces due to caries. The median of the dmft index was cal-
culated, and children were classified as moderate caries ex-
perience (dmft of five or less) or high caries experience (dmft
greater than five). Tooth type (first or second molar), side
(right or left), and arch (maxillary or mandibular) were also
recorded.
Randomization and intervention. The unit of random-
ization was the proximal lesion in a primary tooth. Each child
who participated in this study had two proximal lesions: one
randomly allocated in the test group and one in the control
group. They were randomly allocated using permuted blocks
generated via SPSS software by a researcher independent of
the study. If more than two lesions were eligible, two of them
were selected by chance.
Lesions allocated in the test group were infiltrated once at
baseline using the ICON System (DMG, Hamburg, Germany),
according to the manufacturer’s instructions, by one experi-
enced pediatric dentist. These instructions called first for
cleaning the proximal surface with floss; local anesthesia was
provided, and a rubber dam was applied. A special dental wedge
was then inserted in the proximal region for better access to
the proximal area; at this time, the presence of enamel break-
down was registered. Next, 15 percent hydrochloric acid was
applied to the lesion for 120 seconds. The surface was rinsed
and dried for 30 seconds. The surface was dehydrated with 95
percent ethanol and air-dried using a three-in-one air syringe
for 30  seconds. Then, ICON infiltrant resin (triethylene-
glycol-dimethacrylate-based resin, camphoroquinone, and
additives) was applied for 180  seconds. The excess material
was removed with dental floss. Light-curing was performed
for 40  seconds (using an LED light; Schuster, Santa Maria,
Rio Grande do Sul, Brazil), and ICON infiltrant resin was
applied again for 60 seconds and light-cured for 40 seconds.
Lesions allocated in the control group were not infiltrated.
All children received standard-of-care preventive measures,
as usual, in the Pediatric Dental Clinic at Federal University
of Rio Grande do Sul. They consisted of individualized treat-
ment for caries activity based on oral hygiene instructions
(toothbrushing using fluoridated toothpaste and flossing in-
structions) and dietary recommendations at the baseline.
Moreover, since the included children were in active caries
activity status, one week after lesions infiltration three sessions
of professional fluoride application (acidulated fluoride gel 1.23
percent) with a toothbrush were conducted over a seven-day
interval.14
Outcome and follow-up. The main outcome was the
radiographic caries progression in the test and control groups.
Clinical parameters (dmft, VPI, GBI, caries experience, tooth
type, side, and arch) of the participants were collected.
Digital radiographs of both proximal surfaces (test and
control) were taken by the same blinded, calibrated, and experi-
enced radiologist. A total of 56 radiographs from the six-month
follow-up recalls were used for intraexaminer reproducibility
assessment, and an unweighted kappa value of 0.78 was ob-
tained. This examiner assessed all digital radiographs in a
random order, regardless of the lesion group and period of
assessment (baseline or follow-up), using the same equipment
and methods as described earlier. To evaluate clinical param-
eters, one calibrated examiner performed all examinations at
baseline, six months, one year, and two years (intraexaminer
agreement for dental caries equals 0.70).
Lesion progression was considered when the radiographic
score increased, regardless of the score that the lesion had
INFILTRATION OF PROXIMAL CARIES LESIONS 111
PEDIATRIC DENTISTRY V 42 / NO 2 MAR / APR 20

progressed to. If any carious lesion progressed to evident visual The clinical parameters (VPI, GBI, caries experience,
cavity at any of the follow-up evaluations, a restorative treat- tooth type, side, and arch) at baseline and follow-up period
ment was provided and the lesion was considered progressed are presented in Table 1. At two years, no significant decrease
in the study. was observed in the VPI compared to the baseline (P=0.68).
Statistical analysis. Analyses were performed considering Half of the children demonstrated a high caries experience at
the child (matched pairs). Radiographic lesion progression be- the baseline (50 percent). The GBI index presented a signifi-
tween the baseline and follow-up period was analyzed using cant decrease after two years.
McNemar’s test. Furthermore, the effect of the intervention Table 2 presents the radiographic progression of the in-
was calculated from the relative risk reduction (RRR) – efficacy. cluded lesions after a two-year follow-up period; a statistically
The differences between VPI and GBI at baseline and significant difference in caries progression was observed in the
follow-up were assessed by Wilcoxon t-test. The differences be- test group (54.1 percent) versus the control group (79.2 per-
tween caries experience at the baseline and follow-up were cent). After a two-year follow-up period, a radiographic pro-
assessed via McNemar’s test. The significance level in all tests gression of six enamel breakdown lesions in the test group up
was set at a P‑value of 0.05. Statistical analyses were conducted was observed. A risk ratio of 68.4 percent (95% CI equals
with SPSS Statistics 21 software. 42.6 to 79.5) and an efficacy (RRR) of 32 percent (95% CI
Conditional logistic regression (matched pairs) analysis was equals 9.8 to 57.3) were found for the infiltrant associated
used to estimate the odds ratio (95 percent confidence interval with acidulated phosphate fluoride gel.
[95% CI]) of proximal caries progression. The analyzed vari- Table 3 presents the logistic regression analysis for matched
ables at tooth level were tooth type (first or second molar), pairs to estimate the odds ratio of proximal caries progression
side (right or left), arch (upper or lower), treatment group (test after the two-year follow-up period, according to the follow-
or control), enamel cavity (presence or absence), VPI, and ing variables: tooth type (first or second molar); side (right
GBI. The significance level was set at five percent. For this or left); arch (maxillary or mandibular); treatment (control or
analysis and power of the sample, RStudio 1.1.442 software
(Boston, Mass., USA) was used.
Table 1. BASELINE AND FOLLOW-UP
Results CLINICAL PARAMETERS
At baseline, 28 children were evaluated: 15 girls (53.6 percent) Baseline±(SD) 2-year
and 13 boys (46.4 percent), with a mean age of 6 years-old follow-up±(SD)
(±1.23 standard deviation). After icon wedge placement, eight
lesions in the test group presented enamel breakdown at the VPI * 31.40±20.3 25.31±14.4
baseline but remained in the study. GBI * 12.74±15.8 5.82±3.6
Throughout the study, four children withdrew their partici-
pation (Figure). The dropout rate was 10.7 percent. For this Baseline (%) 2-year
reason, after two years, 24 patients were reassessed (total equals follow-up (%)
48 lesions: 24 test group lesions and 24 control group lesions).
High 13 (46.4) 12 (50.0)
Moderate 15 (53.6) 12 (50.0)
Tooth type
Assessed children for eligibility
First molar 26 (46.4) 19 (39.6)
2014/2016
(n=189) Second molar 30 (53.6) 29 (60.4)
Side
Excluded (n=56) Right 30 (53.6) 24 (50.0)
Enrollment â Not meeting inclusion criteria
(n=56) Left 26 (46.4) 24 (50.0)
Included 28 children
Randomized lesions
Arch
(n=56)
Maxillary 28 (50.0) 26 (54.1)
â â Mandibular 28 (50.0) 22 (45.9)
Allocation
Allocated to Test Group Allocated to Control Group
(n=28 lesions)
– Received topical application
(n=56)
– Received topical application
* Mean index±(SD). VPI=Visible Plaque Index; GBI=
Gingival Bleeding Index.
of fluoride, flossing, diet of fluoride, flossing, and diet
counselling and infiltrant counselling † Children (%).

2 years Follow Up
â â Table 2. RADIOGRAPHIC LESION PROGRESSION AFTER
Lost to follow up (4 children) Lost to follow up (4 children) TWO YEARS OF FOLLOW-UP
– Did not attend the recall (0) – Did not attend the recall (0)
– Exfoliated teeth (n=0) – Exfoliated teeth (n=0) Follow-up Arrestment Progression P-value *
n (%) n (%)
â â
Test (n=24) 11 (45.9) 13 (54.1)
Analysed Analysed Analysed
n = 24 teeth 24 children n = 24 teeth 2 years Control 4 (20.8) 20 (79.2) 0.03
(n=24)

Figure. CONSORT flowchart of the participants’ progress through the trial phases. * P-value obtained from McNemar’s test.

112 INFILTRATION OF PROXIMAL CARIES LESIONS

 PEDIATRIC DENTISTRY V 42 / NO 2 MAR / APR 20

infiltrant); and presence of enamel cavity. A significant asso-

Table 3. ASSOCIATION BETWEEN PREDICTOR ciation was found only for the variable treatment.
VARIABLES AND CARIES PROGRESSION Table 4 shows the distribution of the test and control
AFTER TWO YEARS OF FOLLOW-UP lesions at the baseline and two-year follow-up as well as a per-
Variable Proximal caries progression centage of progression according to the radiographic scores
and group. Nine lesions in the test group and nine lesions in
Odds 95% confidence P-value* the control group had progression into the dentin (D2 or D3).
ratio interval All these cavities received restorations.
Tooth type
Discussion
First molar 1.00 In this split-mouth, randomized, controlled clinical trial, after
Second molar 0.36 0.07 – 1.72 0.20 two years of follow-up, 24 children contributed with two
Side
lesions each, randomly allocated: one to the test group and
another to the control group. Both groups had the same oral
Right 1.00 environment, making it easier to control many potential con-
Left 1.00 0.22 – 4.53 1.00 founding factors, such as the oral hygiene habits of patients.15
Arch Among 28 children included at baseline, four withdrew
their participation in the study before completing the two-
Maxillary 1.00
year follow-up. This dropout rate (10.7 percent) is lower than
Mandibular 2.40 0.36 – 15.55 0.36 those observed in similar studies.7,8
Group The first split-mouth design study published using resin
Control 1.00 infiltrant in high-caries risk children (decayed, missing, and
filled surfaces less than four) associated infiltration with fluoride
Test 0.18 0.29 – 0.31 0.04 †
varnish.7 After a one-year follow-up, it reported a radiographic
Enamel small cavity progression of 23 percent in the test group and 62 percent
Absence 1.00 in the control group.7 The authors concluded that resin infil-
Presence 2.50 0.35 – 17.40 0.57 tration associated with fluoride varnish was promising for
controlling proximal lesion progression. 7 At the two-year
* P-value obtained from Logistic regression for matched pairs. follow-up, a significant difference in the progression rate was
† Statistically significant. observed between the test group (54.1 percent) and the control
group (79.2 percent), resulting in
an efficacy of 32 percent and resin
Table 4. RADIOGRAPH ASSESSMENT OF CARIES PROGRESSION FROM THE BASELINE AND infiltrant associated with acidulated
AT TWO YEARS BETWEEN THE TEST AND CONTROL GROUPS* phosphate fluoride gel. A previous
study compared resin infiltrant
Test Group (n=24) Control Group (n=24) with only flossing on the lesion
progression in proximal caries in
Baseline 2 years Baseline 2 years primary teeth. Radiographic pro-
Lesions Threshold Lesions (%) Threshold Lesions Threshold Lesions (%) Threshold gression was observed in 11.9 per-
cent of the lesions in the test group
1 E1 0 E1 and in 33.3 percent of the lesions
0 E2 0 E2 in the control group after one year
1 (7.7) D1 2 (10.0) D1 of follow-up.4 The authors reported
4 E1 6 E1
efficacy of 64.3 percent for resin
1 (7.7) D2 2 (10.0) D2
infiltrant.
1 (7.7) D3 2 (10.0) D3 Lesions of the test group pre-
2 E1 0 E1 sented an 82 percent lower chance
0 E2 0 E2 of progression than the lesions
1 (7.7) D1 1 (5.0) D1 of the control group (odds ratio
3 E2 5 E2
equals 0.18, 95% CI 0.29 to
0 D2 2 (10.0) D2
0.31). Similar results were ob-
0 D3 2 (10.0) D3 served in a previous study that
0 E1 1 E1 compared sealing proximal lesions
2 E2 0 E2 and flossing instructions, where
3 D1 6 D1
efficacy of 25 percent was found
17 D1 13 D1 after 2.5 years.16 Another clinical
4 (30.7) D2 3 (15.0) D2 trial that evaluated the effective-
5 (38.4) D3 6 (3.0) D3 ness of resin infiltration with
fluoride varnish versus fluoride
* Caries progression from baseline to follow-up according to each radiographic threshold. E1=radiolucency confined to varnish alone in lesions extending
the outer half of the enamel; E2=radiolucency involving the inner half of the enamel; D1=radiolucency in the outer
third of the dentin; D2=radiolucency in the middle third of the dentin; and D3=radiolucency in the inner third of
only to the enamel reported a sig-
the dentin. Shadow cells show the number of lesions (percentage) that progressed according to each threshold per
10 nificant difference in radiograph
group. progression of 40 percent in the

INFILTRATION OF PROXIMAL CARIES LESIONS 113

PEDIATRIC DENTISTRY V 42 / NO 2 MAR / APR 20
test group and 72 percent in the control group before the
two-year follow-up.8 These results are comparable with those
found in the present study at two years, even though the
authors of the present study included most lesions in the dentin
and had no application of fluoride varnish.
Lesion progression could be observed in both the test and
control groups. This could be explained by the fact that most
lesions at the baseline (17 [70.8 percent] in the test group and
13 [56.5 percent] in the control group) were at the D1 radio-
graphic stage and that dentin proximal lesions show faster
radiographic progression than enamel lesions. 17 Furthermore,
early enamel lesions are reported to be completely infiltrated
by resin while advanced enamel lesions present an incomplete
and inhomogeneous infiltration when observed by optical
coherence tomography.18 Another likely reason for progression
in the control group is the fact that acidulated phosphate
fluoride gel cannot effectively remineralize early enamel prox-
imal carious lesions.19,20
Furthermore, the high caries progression of lesions in both
groups may also be related to the fact that most of the children
(92.9 percent) in this study were from a low socioeconomic
level. According to Tickotsky et al. (2017),18 children at a low
socioeconomic level present an accelerated radiographic pro-
gression of proximal carious lesions in primary teeth.
Previous studies that tested resin infiltrant did not report
the presence of enamel breakdown on the proximal surfaces.
Since the inclusion criterion of most studies on the efficacy of
resin infiltrant is the presence of radiolucency up to the outer
dentin, it can be expected that some lesions might have small
cavities when included in the studies. 20 The present study’s
authors decided not to exclude lesions presenting an enamel
breakdown in the test groups to more closely match the daily
practice of dentists and also because children had already re-
ceived anesthesia, rubber dam, and icon wedge placement
when enamel breakdown was observed. In general patient care,
most clinicians do not separate proximal surfaces if no evident
and visible cavity is observed. The authors observed that 75 per-
cent of lesions with enamel breakdown at the baseline and those
treated with resin infiltrant presented a radiographic progres-
sion at the two-year follow-up. Therefore, the observation of
small cavities on proximal surfaces may indicate a higher risk of
lesion progression, even if these lesions were infiltrated.
Similar to other studies, the blinding of the operator or the
child was not possible because the infiltration technique is dif-
ferent from the noninvasive technique.4,8 Nonetheless, the exam-
iner of the main outcome (radiographic caries progression) did
not participate in the clinical phase and was blind concerning
the test and control lesions, and to the period (baseline or follow-
up). This was possible because the infiltrant does not have
radiopacity; thus, it is not possible to detect it via radiography.
An improvement of oral hygiene habits was observed at
the two-year follow-up. The GBI had a mean decrease from
12.74 percent to 5.82 percent (P=0.04). These results showed
adhesion to the oral hygiene instructions; however, this re-
duction was not enough to avoid caries progression on some
proximal surfaces. Previous studies have reported difficulties
of children and/or guardians in plaque control and flossing
proximal surfaces.6,16 As a protocol, all children and parents re-
ceived dietary counseling and oral hygiene and flossing instruc-
tions at the baseline. Besides that, we observed difficulty in
the participants in maintaining sufficient oral hygiene. More
effective ways to motivate children and parents to manage oral
hygiene are still needed.
114 INFILTRATION OF PROXIMAL CARIES LESIONS
Considering the temporary character of the primary teeth,
the primary outcome (radiograph progression of the lesions) is
not always relevant to the patients. It depends on the patient’s
age and caries risk. Progression to an evident visual cavity that
needs to be restored is also significant. This should be con-
sidered when a treatment has to be indicated.
Conclusions
Based on this study’s results, the following conclusions can
be made:
1. The application of a resin infiltrant in proximal lesions
decreases radiographic caries progression in primary
molars.
2. Even when children adhered to oral health instruc-
tions, caries progression was observed.
3. Infiltration of proximal carious lesions in primary
molars is a practical and effective treatment for children.
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