Comparative evaluation of ICON resin infiltration and bioactive glass adhesive for managing initial caries lesions using quantitative light-induced fluorescence: a randomized clinical trial.

Introduction: Various approaches have been developed for the treatment of initial caries lesions (ICLs). ICON resin infiltrant is considered the gold standard for its superior aesthetic recovery; however, it is relatively expensive. Hi-Bond Universal is a bioactive glass adhesive that may promote remineralization and serve as a cost-effective alternative treatment.

Aim: This clinical trial compared the efficacy of Hi-Bond Universal and ICON in improving the aesthetic appearance of ICLs assessed by quantitative light-induced fluorescence (QLF).

Methods: A split-mouth design was used, with ICLs in two different quadrants of each participant. One quadrant was treated with ICON resin infiltration following the manufacturer's instructions, while the other received the bioactive glass adhesive. QLF imaging was performed at baseline (T0) and one-month post-treatment (T1) to assess remineralization. Three parameters were measured: lesion area, fluorescence loss (ΔF), and the deepest point of the lesion (ΔFmax).

Results: Both materials showed statistically significant improvement in QLF parameters (ΔF, ΔFmax, and lesion area) from baseline T0 to T1 (p < 0.001). The mean changes in ∆F, ∆Fmax, and lesion area were -5.34 and -13.30, -589.06 px² respectively for the Hi-Bond group, compared to -6.34, -15.12, -586.22 px² for ICON group. No significant difference was proven between the two groups (p > 0.05).

Conclusions: Both the bioactive glass adhesive Hi-Bond Universal and the resin infiltration ICON effectively promoted the aesthetic recovery of ICLs for over one month. Hi-Bond Universal may serve as a viable alternative to ICON, particularly in cases where cost is a limiting factor.

Clinical Significance: This study suggests that Hi-Bond Universal, a bioactive glass adhesive, offers similar efficacy to ICON resin infiltration in managing ICLs. Given its lower cost, Hi-Bond Universal may provide a practical and effective alternative in routine clinical settings, especially where affordability is a concern.