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Caries infiltration is a micro-invasive treatment to arrest non-cavitated caries lesions. The method is based on the penetration of low-viscosity light-curing resins, so called infiltrants, into the pores within the enamel lesion. That way, diffusion pathways for cariogenic acids are occluded, resulting in a reduction or even arrest of lesion progression. A positive side-effect of caries infiltration is that lesions change their optical properties and appear similar to sound enamel. Therefore, caries infiltration can also be used to camouflage aesthetically disfiguring white spot lesions on buccal surfaces.
Clinical Relevance: Resin infiltration is a micro-invasive treatment to arrest and to camouflage non-cavitated proximal caries lesions that virtually bridges non-invasive and restorative treatment options.
Article
The caries decline observed in many nations in the past decades has led to the clinical observation that today's adolescents and young adults present many fewer open cavities compared with the generation of their parents or grandparents. However, a high number of caries lesions in earlier stages, particularly in proximal surfaces, can still be observed in these patients. This shift to earlier stages should not be misinterpreted to suggest that these individuals do not need therapeutic (non-invasive) intervention anymore, because many of the non-cavitated lesions progress to cavitated stages.1,2 Rather, these epidemiological changes present a challenge not only to diagnose but also to manage these lesions to avoid their further progression.
The treatments of choice for early non-cavitated caries lesions are non-invasive interventions that support the natural repair processes of the oral cavity. However, these approaches usually depend on good compliance and a sustained change of a patient's habits (eg oral hygiene, diet) and therefore seem to have only limited effectiveness. Invasive treatment may bring the tooth into a ‘death spiral of restorations’ in which more and more tooth tissue gets lost when restorations are often replaced, even resulting in loss of tooth vitality or even extraction of the tooth.3 For this reason, the first restorative intervention should be postponed as long as possible. Particularly for proximal lesions, the collateral damage during cavity preparation is high because relatively large amounts of sound tissue have to be removed to get access to the lesion. Therefore, for proximal caries lesions radiographically extending around the enamel dentine junction, the treatment decision is often difficult. Similar to caries sealing of occlusal surfaces, caries infiltration aims to bridge non-invasive and restorative interventions for proximal caries lesions, providing a minimum of tissue destruction, with the objective of arresting the caries process (Figure 1).
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