You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Progression of non-cavitated lesions in dentin through a nonsurgical approach: a preliminary 12-month clinical observation
Abstract 1:
Objective : Considering the minimally invasive approach to dentistry , the scientific community has focused on non-invasive treatments for caries lesions . The aim of this study was to evaluate the efficacy of a nonsurgical approach to arrest occlusal non-cavitated dentin lesions through glass ionomer sealing . Methods : In this controlled clinical trial , 51 teeth with clinical ly non-cavitated occlusal caries radiographically located beneath the enamel-dentine junction ( radiolucent area ) were selected among patients presenting a moderate to high risk of caries . The teeth were r and omly divided into two groups : an experimental group receiving an application of Vidrion-R ( SS White ) glass ionomer and a control group not su bmi tted to any clinical intervention .  Caries progression was monitored by clinical and radiographic examination at 4-monthly intervals over a period of one year . In addition , marginal integrity of the sealant was evaluated in the experimental group . Results : Clinical examination showed no statistical difference between the groups ( P=.13 ) . On the other h and , sealed teeth presented lower caries progression when analyzed by radiographic examination ( P=.004 ) . Conclusion : A glass ionomer sealant over non-cavitated occlusal caries lesions in dentin may not be sufficiently effective in arresting their progression


Title 2:
Evaluation of non-invasive treatment applied to occlusal surfaces.
Abstract 2:
The purpose of this study was to evaluate the efficacy of non-invasive methods of treatment for active incipent occlusal caries . Anamnesis , professional prophylaxis , and visual inspection were used to classify 250 Brazilian pre-school-children . First permanent decayed molars ( n=98 ) from thirty-one subjects ( 6 years+ 6 months ) were selected and divided into three groups . Group 1 : fissure sealants with resin-modified glass ionomer - Vitremer ( n=29 ) ; Group 2 : fluoride varnish -Duraphat ( n=36 ) and control group : tooth brushing and 0.2 percent NaF weekly mouthwashes ( n=33 ) . Four clinical evaluations were carried out over three , six , nine , and twelve months . Caries activity and progression were observed through clinical and radiographic evaluation . The results were analyzed by Fisher = s Exact test . After twelve months , the results showed 100 percent of arrestment of caries activity for Group 1 , 83.3 percent for group 2 , and 72.7 percent for control group . At the same time , the results showed 0 percent of caries progression for group 1 , 5.5 percent for Group 2 , and 6.1 percent for control group . Group 1 showed a better inactivation property than the other groups ( p<0.05 ) . There were no statistically significant differences in caries progression among these groups ( p>0.05 ) . It was concluded that this non-invasive methods were able to arrest the progression of occlusal caries , but fissure sealant showed better results in controlling caries activity


Title 3:
Randomized Trial on Fluorides and Sealants for Fissure Caries Prevention
Abstract 3:
To investigate the effectiveness of topical fluorides in preventing fissure caries , we conducted a r and omized controlled trial with parallel groups . In total , 501 children ( 1,539 molars , 3,078 sites ) , mean age 9.1 years , who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited . They were r and omly allocated among four groups : ( 1 ) resin sealant , single placement ; ( 2 ) 5 % NaF varnish , semi-annual application ; ( 3 ) 38 % silver diamine fluoride ( SDF ) solution , annual application ; and ( 4 ) placebo control . Follow-up examinations were conducted every 6 months by a masked examiner . After 24 months , 485 children ( 97 % ) were examined . Proportions of pit/fissure sites with dentin caries in the sealant , NaF , SDF , and control groups were 1.6 % , 2.4 % , 2.2 % , and 4.6 % , respectively . A multi-level logistic regression analysis accounting for the effects of data clustering and confounding factors showed that fissures in any of the three treatment groups had significantly lower risks of carious cavity development into dentin than did controls ( p < 0.05 ) . We concluded that placement of resin sealant , semi-annual application of NaF varnish , and annual application of SDF solution are all effective in preventing pit and fissure caries in permanent molars ( Clinical Trials.gov number CT01446107 )


Title 4:
Arrest of non-cavitated dentinal occlusal caries by sealing pits and fissures: a 36-month, randomised controlled clinical trial.
Abstract 4:
OBJECTIVE This study aim ed to evaluate the progression of sealed non-cavitated dentinal occlusal caries in a r and omised controlled clinical trial . MATERIAL S AND METHODS Sixty teeth with non-cavitated dentinal occlusal caries were selected in patients with a high risk for caries . Patients were r and omly divided into two groups so that each group included 30 teeth . Patients in the experiment group were given oral hygiene instructions and a fissure sealant . Patients in the control group were given oral hygiene instructions only .  Caries progression and sealant loss were monitored over a period of 36 months by clinical and radiographic examinations . RESULTS Clinical and radiographic progression of caries was significantly more frequent in the control group than in the experiment group . Three teeth lost their sealant and showed caries progression , but this was apparent only at the 12-month follow-up . At the 24- and 36-month recall appointments , neither sealant loss nor caries progression were observed . CONCLUSION The pit and fissure sealant utilised in this study was shown to be effective in arresting carious lesions at 36 months


Title 5:
Clinical performance of a laser fluorescence device for detection of occlusal caries lesions.
Abstract 5:
Children and adolescents must be examined often for occlusal caries . Diagnosis of fissure caries is difficult especially when the tooth surface appears seemingly intact . It has been shown that using traditional clinical methods , as little as 20 % of teeth with fissure caries under intact surfaces were correctly recognised as such . Therefore , new methods for increasing the accuracy of diagnosis have been sought for years . Recently , a new device , based on fluorescence measurements , was introduced . The purpose of this study was to test the device under in vivo conditions in order to provide recommendations for its use in the dental office . Seven general dental practitioners examined a total of 332 occlusal surfaces in 240 patients .  Caries extent was determined for each site after operative intervention ( = ' gold st and ard ' ) . Clinical inspection and analysis of bitewing radiographs exhibited statistically significant lower sensitivities ( 31 - 63 % ) than did the DIAGNOdent device ( sensitivity > or = 92 % ) . It is recommended that the laser device is used in the decision-making process in relation to the diagnosis of occlusal caries as a second opinion in cases of doubt after visual inspection
Radiographic and fluorescence-based methods led to more overtreatments , especially in population s with low prevalence .
The suitability of detection methods differed significantly between population s , and the cost-effectiveness was greatly influenced by the treatment initiated after lesion detection .
The accuracy of a detection method relative to a “ gold st and ard ” did not automatically convey into better health or reduced costs .