Effectiveness of a pit and fissure sealant in the prevention of caries: three-year clinical results.

With use of the half-mouth technique, a pit and fissure sealant was applied to the permanent first molars of 200 children between 6 and 8 years of age in a community with fluoridated water in Colombia, South America. Complete retention of sealant at 12, 24, and 36 months after application was 91.6%, 88.9%, and 87.5%, respectively. Partial retention of sealant was 5.8%, 7.1%, and 8.5% at the same intervals. The incidence of caries in all sealant-treated teeth at 36 months was 8% vs 53% in untreated paired teeth. Of the 238 teeth that completely retained sealant, only one tooth had occlusal caries at 36 months. No statistically significant difference in complete retention between maxillary and mandibular molars was noticed at any examination. The study confirms that this cold-cured pit and fissure sealant is effective in protecting the occlusal surfaces of teeth against caries for at least three years.     

Long term retention of sealants applied by inexperienced operators in Minneapolis

A clinical trial of 4047 single applications of Nuva Seal placed on the occlusal surfaces of primary molars, permanent first and second molars and premolars by 250 dental students showed that the sealants were not well retained. The sealant was fully retained on 86% of all permanent posterior teeth at 3 months, on 76% at 6 months, 58% at 12 months, 52% at 24 months and 41% at 36 months. At 4 years, complete sealant coverage was shown by 14% of primary molars, 25% of permanent molars and 68% of premolars. Permanent mandibular molars and premolars were superior to permanent maxillary molars and premolars in fully retaining sealants. Following sealant failure, i.e. providing partial coverage or missing, permanent maxillary molars and premolars were more prone to occlusal caries than permanent mandibular molars and premolars. At 4 years, caries was diagnosed in 40% of applications to permanent molars and in 9% of applications to premolars. Twelve instances of caries under apparently intact sealants were seen.     

Four-year clinical evaluation of a pit and fissure sealant.

The clinical retention of a single application of a pit and fissure sealant was evaluated on the teeth of children to determine the influence that this protective coating, or its loss, would have on caries activity during a four-year period. The sealant was fully retained on 50% of all paired permanent teeth at 48 months. Of the 689 pit regions that retained the sealant, 95% were rated as having severe loss of substance, only 5% as slight loss, and none with no loss of substance. It also was found that 53% of all paired permanent control teeth judged cariesfree at the baseline examination were found to be carious, whereas only 30% of the treated teeth examined were carious. The corresponding relative reduction in caries rates was, therefore, 43%. The actual number of teeth estimated to be saved by the sealant treatment at 48 months, as measured by net gain per 100 teeth treated, was 23. The net gain per child was estimated as 2.7 teeth saved from caries (full mouth), with a positive treatment benefit in 69% of the children. When the sealant remained intact, there was a pronounced reduction in caries initiation--the percent effectiveness being 84%.     

A comparative study of two pit and fissure sealants: three-year results in Augusta, Ga.

A total of 254 children were examined 36 months after a single application of sealant. In 128 children, 201 permanent first molars were treated with Delton, and, in 126 children, 205 permanent first molars were treated with Nuva-Seal. Delton was completely retained on 80% of all paired permanent first molars, partially retained on 10%, and completely lost on 10% of the study teeth. Nuva-Seal was completely retained on 60% of all paired permanent molars, partially retained on 21%, and completely lost on 19% of the study teeth. Delton was 69% effective in preventing occlusal caries on permanent first molars three years after a single application. Nuva-Seal was 39% effective in preventing occlusal caries on permanent first molars three years after a single application. Both sealants have been shown to prevent dental caries on permanent first molars of children three years after a single application.     

A two-year clinical trial comparing the retention of two fissure sealants.

A clinical evaluation of an experimental resin sealant (ICI 209085) was made by comparing it with a previously investigated and well recognized material (Light Cured Tinted Delton). The two materials were bilaterally placed in 117 pairs of teeth (48 premolars and 69 molars) in 60 children aged 6-14 years. The children were re-examined after 6, 12 and 24 months. The overall rates of full retention were 97.4% in teeth sealed with the experimental sealant and 96.6% in those sealed with the control sealant, while the corresponding figures for partial retention were 2.6% and 3.4%. From none of the teeth were the sealants totally lost. No carious lesions developed in the sealed fissures during the trial. It is concluded that the experimental sealant is comparable with the control sealant with respect to retention and caries prevention.     

Clinical success and potential failure after single application of a pit and fissure sealant: a four-year report.

A single application of a filled chemically initiated BIS-GMA sealant to permanent first molars of children ranging in age from 5 to 8 years covered the original sites in 52.4% of the 185 teeth examined after four years. Retention of sealant is greater in mandibular (64.7%) than in maxillary (42.0%) molars. The rate of loss of sealant was greatest during the first year (20%), then less than 10% per year at the second, third, and fourth recalls. In comparison with two similar studies, the retention of sealant was 20% to 30% greater. Using the parameters of percent effectiveness, net gain, and DMF scores per 100 test and control teeth, the data from the current study indicate a continued positive effect substantially greater than that in other similar studies. Complete loss of sealant does not appear to predispose that surface to caries any more than its contralateral paired surface. However, a partial loss of sealant because of abrasive wear that results in the exposure of the terminal ends of a fissure is a potential failure in that it creates an environment conducive to caries. Thus, even the well-applied sealant does not necessarily constitute permanent obturation of pits and fissures. Periodic clinical observation is necessary to determine the success or potential failure of the sealant treatment.     

Glass ionomer cement fissure sealants applied by operative dental auxiliaries — retention rate after one year

A glass ionomer cement was applied as a fissure sealant to 115 maxillary and 117 mandibular permanent molars. The operators were student school dental therapists working in normal training conditions. Retention rates (93 per cent complete retention after 6 months, and 82.5 per cent complete retention after 12 months) were comparable with those obtained with Bis-GMA resin sealants in other studies.
Maxillary teeth accounted for 21 of the 35 teeth which lost sealant partly or completely. The linguo-occlusal fissure of maxillary first permanent molars was the commonest site of sealant loss. Only 2 of the teeth which lost sealant were carious at the follow-up assessments.     

Clinical effectiveness of an autopolymerized fissure sealant after 2 years

The clinical effectiveness of Delton fissure sealant was studied in 205 children, ages 6--10 years (mean age 71/2). 993 children in grades 1, 2, 3 and 4 were screened and subjects were selected if there was evidence of previous dental caries in the mouth, and a pair of contralateral maxillary or mandibular first permanent molar teeth were free of caries. Two pedodontists independently examined the children in a mobile van equipped with two operatories, and each applied sealants to approximately half of the subjects. After 11 months, in 186 subjects there were 10 sealants partially lost, five experimental teeth carious or filled and 53 control teeth carious or filled. After 24 months, in 175 subjects there were four sealants completely lost, 12 sealants partially lost, 11 experimental teeth carious or filled and 89 control teeth carious or filled. Consequently, sealant retention was 92% after 11 months and 85% after 24 months. Percent effectiveness in caries reduction was 90% after 11 months and 88% after 2 years.     

Study of a fissure sealant in mentally retarded Canadian children

The occlusal fissure of 812 permanent and primary posterior teeth of 160 retarded children were sealed with a fluid resin which was polymerized with an ultra-voilet lamp. A half mouth technique was used to evaluate the effectiveness of the sealant in the prevention of fissure caries. The 1st year, the sealant was retained intact on 73 percent of the permanent teeth and on 64 percent of the primary teeth. After 2 years, the sealant was retained intact on 61% of the permanent teeth and on 40% of the primary teeth. The retention of the fissure sealant was better on premolars than molars both in the 1stand in the 2nd year. A single application of the fissure sealant was effective in reducing fissure caries up to 2 years.     

A filled pit and fissure sealant: 18-month results.

One hundred and forty-three patients ranging in age from 5 to 8 years participated in a pit and fissure sealant study using a half-mouth design. At the end of 18 months, for all permanent first molars, there was a 75.9% effectiveness with a net gain of 82, which was statistically significant. The sealant was present on the surfaces to which it was applied in 74% of the teeth. Application time was 8 minutes per quadrant and 5.5 minutes per tooth. The effect of treatment was similar to that reported for an unfilled BIS-GMA sealant in patients with similar teeth and similar ages. Loss of sealant from the permanent maxillary first molars did not appear to contribute to the initiation of dental caries. However, in 6 of 38 mandibular tooth surfaces, sealant loss may have been a factor.     

Clinical evaluation of a medium-filled flowable restorative material as a pit and fissure sealant

This clinical study evaluated the retention rate and caries protection of a medium-filled (46% volume) flowable restorative material (CuRay-Match, OMNII Oral Pharmaceuticals, West Palm Beach, FL 33409, USA) compared to an unfilled sealant (Delton, Dentsply Caulk, Milford, DE 19963, USA). Using a half-mouth design, sealants were applied on randomly assigned caries-free first and/or second permanent molars of 32 children ranging in age from 6-11 years. A total of 118 teeth were etched, dried and sealed. Teeth were evaluated at one, six and 18-month intervals. After one month, 52 teeth sealed with unfilled sealant were intact compared with 46 sealed with a medium-filled resin, and after six months, 36 teeth sealed with an unfilled sealant were intact compared with 27 that were sealed with a medium-filled resin. After 18 months, 29 teeth were still fully sealed with an unfilled sealant, whereas 18 were sealed with a medium-filled resin. The difference between the two groups was not statistically significant. Regarding caries development, four teeth sealed with a medium-filled material and five teeth sealed with an unfilled sealant were decayed after 18 months. These results indicate that a medium-filled flowable restorative material did not perform better in retention rate and caries increment when compared to an unfilled conventional sealant. However, the effect of the additional techniques, such as the use of bonding agent and fissurotomy on retention rates should be evaluated in further studies.     

Twenty-four month clinical evaluation of fissure sealants on partially erupted permanent first molars: glass ionomer versus resin-based sealant

BackgroundGlass ionomer sealants are an alternative to resin-based sealants, especially for use in partially erupted permanent molars. The authors conducted a study to compare the retention, marginal staining and cariostatic properties of a glass ionomer sealant with those of a resin-based sealant during a 24-month period.MethodsWe included in this study 39 patients aged 5 through 9 years who had bilateral partially erupted first permanent molars. One of us (S.B.) placed a resin-based sealant (Delton Plus FS+, Dentsply Professional, York, Pa.) (group D) on a partially erupted first molar in one quadrant of the maxilla or mandible and a glass ionomer sealant (GC Fuji Triage White, GC America, Alsip, Ill.) (group T) in the other quadrant. Two masked and calibrated investigators (S.A.A., J.C.) evaluated the sealants for retention, marginal staining and carious lesions at three, six, 12 and 24 months. The authors used a multinomial regression for statistical analysis (P < .05).ResultsThe recall rate was 69.2 percent at 24 months. Two sealants from group D and three from group T were lost completely. Complete retention rates at 24 months were 40.7 and 44.4 percent for groups D and T, respectively. The authors found no statistically significant difference in retention rates between groups at each recall examination (P > .05). For marginal staining, sealants in the resin-based group exhibited statistically higher marginal staining than did sealants in the glass ionomer group (P < .05). Although the authors detected no caries in teeth in group T, teeth in group D in which the sealant was lost completely experienced demineralization.ConclusionsResin-based and glass ionomer sealants exhibited similar retention rates at 24 months. However, marginal staining was lower in the glass ionomer group, and the authors found no caries in teeth in this group. Consequently, glass ionomer sealants may be a better choice when salivary contamination is expected.Clinical ImplicationsSealing during tooth eruption presents a particular challenge owing to difficulty in isolating the tooth. Glass ionomers may be a better material for sealing partially erupted molars.     

The retention of pit and fissure sealants placed in primary school children by Dentl Health Services, Victoria

The benefit of a public sector sealant programme for children in Australia is yet to be established. This study evaluated sealants placed by therapists of the School Dental Service in Victoria, between 1989 and 1994, on permanent teeth of children in 15 primary schools in Melbourne. Seven hundred and seventy four children aged 6–12 years were examined in school dental clinics by six calibrated examiners. A total of 5363 sealants placed on 2875 permanent teeth (including 2616 first molars, 91 per cent of sample) up to four and a half years previously was examined. Values for complete and partial sealant retention were highest for premolars (86 per cent, 9 per cent respectively, total 95 per cent); similar for occlusal surfaces of maxillary and mandibular first molars (63 per cent, 30 per cent; 62 per cent, 32 per cent respectively) and buccal pits of mandibular molars (66 per cent); and low for pits/fissures of Carabelli's cusps of maxillary molars (44 per cent). Cross-sectional examination up to 24 months for both maxillary and mandibular first molars indicated average values of 67 per cent complete retention, 27 per cent partial retention, 6 per cent missing; thereafter complete retention decreased and partial retention increased. Sealant failures in the six months post-placement were attributed to technique failure. Regardless of sealant retention, caries experience was low under partially retained or missing sealants (4.5 per cent) and completely retained sealants (0.4 per cent). It is concluded that the SDS sealant programme is a sound preventive dental public health approach.     

自酸蚀粘接剂在乳磨牙窝沟封闭中的应用

目的: 分别采用自酸蚀法和磷酸酸蚀法对乳磨牙进行窝沟封闭,观察18个月内窝沟封闭剂保留率和龋病预防情况。方法: 选择75例3~4岁幼儿、共计300颗第二乳磨牙,采用自身半口对照方式,随机选择一侧为实验组,使用3M自酸蚀粘接剂进行酸蚀,另一侧为对照组,使用GLUMA酸蚀凝胶酸蚀,行窝沟封闭术,记录操作时间,术后6、12、18个月复查封闭剂的保留情况和患龋情况。结果: 实验组1颗牙的封闭时间为(103±10) s ,对照组1颗牙的封闭时间为(210±24) s ,差异有显著性(P<0.05)。封闭后6、12、18个月复查,实验组的封闭剂保留率分别为98.67%、97.33%、92.67%,高于对照组的97.33%、96.67%、90% ,患龋率分别是0%、0.67%、2.67%,低于对照组的0.67%、1.33%、4% ,但无统计学意义。结论: 使用自酸蚀粘结剂进行乳磨牙窝沟封闭,可缩短操作时间,降低对患儿依从性的要求,适合临床推广。     

Clinical evaluation of a flowable resin composite and flowable compomer for preventive resin restorations

This clinical study evaluated the retention and caries protection of a flowable resin composite (Flow Line) and a flowable compomer (Dyract Flow) used in preventive resin restorations as compared to the conventional preventive resin technique which uses a resin composite (Brilliant) and a sealant (Concise). This study observed 205 permanent molars with small carious cavities less than 1.5 mm in width, which were obtained from 165 children aged 7 to 15 years. Flowable resin composite was used to treat 75 teeth, and 71 teeth were treated with flowable compomer in both cavities and caries-free fissures. For the control group, 59 teeth were treated with resin composite in cavities and sealant in caries-free fissures. The teeth were evaluated at 3, 6, 12, 18 and 24-month intervals. After three months, all 205 treated teeth were completely intact. After six months, 66 of the 71 teeth treated with flowable resin composite and 65 of the 70 teeth treated with flowable compomer were complete, compared to 57 of the 58 teeth treated with the conventional preventive resin technique. After 12 months, 60 of the 67 teeth treated with flowable resin composite and 61 of the 67 teeth treated with flowable compomer were complete, compared to 51 of the 55 teeth treated with the conventional preventive resin technique. After 18 months, 53 of the 61 teeth treated with flowable resin composite and 54 of the 62 teeth treated with flowable compomer were complete, compared to 47 of the 53 teeth treated with the conventional preventive resin technique. After 24 months, 49 of the 58 teeth treated with flowable resin composite and 45 of the 57 teeth treated with flowable compomer were complete, compared to 42 of the 52 teeth treated with the conventional preventive resin technique. There were no statistically significant differences in retention rates among all groups after 3, 6, 12, 18 or 24-months (p>0.05). One tooth treated with flowable resin composite and one tooth treated with flowable compomer developed caries after 18 and 24 months, respectively, resulting from partial loss at "caries-free fissures." Five teeth developed caries in the conventional preventive resin group; one after 12 months, two after 18 months and one after 24 months, due to loss at cavities. The final caries occurred after 24 months, resulting from partial loss at "caries-free fissures." The differences in caries development among the three groups were not statistically significant (p>0.05). This study suggested that flowable resin composite and flowable compomer could be used for preventive resin restorations. Meanwhile, a vigilant recall should be followed-up due to the risk of failure for flowable materials in "caries-free" fissures. The repair should be performed immediately, in case the preventive resin restoration develops a fracture or loss.     

Retention of sealants over carious and sound tooth surfaces

Bacteriologic and clinical studies suggest that sealants can be used therapeutically on incipient caries of the enamel. The present study was designed to explore this approach further by determining whether there is a difference in retention rates on sound or carious tooth surfaces sealed for the first time as well as resealed surfaces. A total of 1766 teeth were sealed for subjects 12-14 yr of age of which 120 were judged to be carious. Mouths were divided sagittally on a random basis and an ultraviolet light activated resin with a filler or an autopolymerizing resin without a filler was placed on contralateral surfaces of all molar and premolar teeth. The effects of sealant type, caries status, arch and tooth type on retention over a 2-yr period were tested using Mantel-Haenszel statistics. At the end of 1 yr, 88% of the teeth sealed with the autopolymerizing resin were judged to be completely intact compared to 82% of the teeth filled with the ultraviolet light resin. At the end of the second year the retention rates were 84% and 75% respectively. The retention rates for carious and sound teeth at the end of both years were almost identical. Overall, premolars had a 15% more favorable retention rate than molars. There were minimal differences between arches although maxillary premolars had approximately a 5% higher retention rate than mandibular premolars. The reverse was true for molar teeth. Retention of sealants at the end of the second year (resealed after 1 yr) was 4% less than comparable teeth sealed initially.     

Pattern of sealant retention in children receiving a combination of caries-preventive methods: three-year results.

Sealant retention varied according to site of the tooth. Figures for intact sealant were particularly low for permanent first molars among first graders and for permanent second molars among sixth graders at the end of three years. Although a large percentage of these teeth needed sealant reapplications, the percentages of teeth that were lost to caries were as low as 12.2% and 12.8%, respectively. Deciduous molars had the best rate (60.9%) of complete retention and also the highest percentage (20.2%) of loss caused by caries. However, in sixth graders, the premolars had the highest percentage (46.7%) of complete retention and, at the same time, the lowest caries rate (5.6%). The sealant retention pattern has remained the same during the three-year period.     

窝沟封闭剂联合涂氟预防儿童第一恒磨牙龋病效果的临床研究

目的 研究窝沟封闭剂联合涂氟对儿童第一恒磨牙的防龋效果。方法 选取2020年6月上海浦东新区宣桥镇3所小学450名一年级学生作为研究对象。按照自身半口对照方法分为对照组和实验组。对照组为左侧上下颌第一恒磨牙，共900颗，采用窝沟封闭剂；实验组为右侧上下颌第一恒磨牙，共900颗，采用窝沟封闭剂联合涂布含5%氟化钠的多乐氟，两组均随访2年。观察并记录两组牙齿预防后6个月、1年和2年后的封闭剂保存情况及龋病、邻面龋发生率。结果 预防后6个月、1年、2年，实验组牙齿封闭剂保存完整率（100.00%、100.00%、94.90%）显著高于对照组（100.00%、82.40%、74.70%），差异具有统计学意义（P<0.05）。实验组第一恒磨牙龋病和邻面龋的发病率为7.30%和2.40%，显著低于对照组的11.10%和8.00%，差异具有统计学意义（P<0.05）。结论 应用窝沟封闭剂联合涂氟可显著降低封闭剂脱落率，降低儿童第一恒磨牙龋病及邻面龋的发生率，用于儿童第一恒磨牙龋病的预防中具有显著作用。     

Effectiveness of visible light fissure sealant (Delton) versus fluoride varnish (Duraphat): 24-month clinical trial

Abstract The present study compares visible-light Delton with Duraphat fluoride varnish for the prevention of occlusal caries in permanent first molars. A clinical trial was carried out in three groups of 6–8-yr-old schoolchildren: a sealant group (100 children), in which Delton light-polymerized fissure sealant was applied to permanent first molars; a varnish group (98 children), in which Duraphat was applied to permanent first molars; and a control group (116 children). Replacement (sealant) and reapplication (varnish) was carried out every 6 months. Percent effectiveness at 24 months (percentage of saving from caries taking molars as analysis unit) for those molars initially healthy and with complete occlusal eruption was analyzed. 272, 252 and 238 molars met the inclusion criteria in the control, varnish and sealant groups, respectively. Of these, 45.2%, 28.2% and 10.5% developed caries after 24 months. The effectiveness was greater in the sealed molars than in the varnished molars (62.7%i).     

窝沟封闭技术预防第一恒磨牙龋病的效果观察

目的评价窝沟封闭技术预防第一恒磨牙龋病的效果。方法选择155名7～8岁儿童,其中80名儿童305颗第一恒磨牙进行窝沟封闭作为实验组,75名儿童287颗第一恒磨牙不作任何处理视为对照组,分别于封闭后6个月和12个月观察其新生龋的发生情况。结果实验组6个月和12个月后的发病率分别为0．98％和2．30％,对照组的发病率分别为10．45％和19．16％,两组经统计学处理,差异有高度统计学意义（P〈0．01）,实验组的龋病发病率明显低于对照组。结论窝沟封闭可以有效地降低儿童第一恒磨牙新生龋的发生;窝沟封闭是一种无痛、无创伤、安全简便且有效的防龋技术。