Effectiveness of fissure sealant 3 years after application.

Findings 3 years after the application of a fissure sealant revealed that of the 166 sealed permanent first molars, 7.8% of the sealants were missing or partly missing, 14.5% were in fair condition, and 77.8% had remained in good condition. During the 3-year test period, 7.8% of the sealed permanent molars had become carious, while 63.3% of the respective control teeth had decayed. The teeth which had sealants in good condition showed no caries, whereas 92.3% of the teeth which had sealants missing or partly missing showed carious fissures. The net gain in the study was 104, and the percentage effectiveness of the method was 88.1%. The treatment effect was found to be very significant when analyzed on the basis of homologous paired test-control teeth (P less than 0.001). The sealing of pits and fissures was found to have a positive treatment effect on 60.2% of the subjects when evaluated on an individual basis (0.1 less than P less than 0.05).     

Caries reduction 1.5 years after application of a fissure sealant as related to dietary habits

abstract — Findings 1.5 years after the application of the sealant revealed that among the 200 sealed permanent first molars, 2.5% of the sealants were lost or partly missing, while 95% of the sealants remained in good condition. During the test period, 7 of the 200 sealed permanent fissures had become carious, while 64 of the respective control fissures had decayed. The percentage effectiveness of the prevention by the present method was 85%. Four out of five molars that had lost the sealants became carious, but of the 190 molars having sealants in good condition, only three were diagnosed as carious. All teeth reported as contaminated with saliva at the sealing session had lost the material. No correlation could be found between the type of food eaten or oral hygiene habits of the subjects and the retention of the sealants.     

Caries reduction over 5 years from a singie application of a fissure sealant

ABSTRACT – This paper is a continuation of three previously published papers giving a long-term clinical evaluation of an ultraviolet hght polymerizable fissure sealant method. The present findings revealed that of the 156 permanent teeth available for study 5 years after initiation, 59.6% retained the sealants in good condition, while 25.6% of the sealants were missing or partly missing. During the test period, 37 (32.2%) of the 115 sealed permanent first molars had become carious, while 92 (80.0%) of the respective paired controls had decayed. An analysis of the efficacy of the treatment on the test-control tooth pairs showed a net gain of 55 and a percentage effectiveness of 59.8%. The sealed teeth were found to be highly significantly less decayed than the respective controls ( P < 0.001). Of the individual subjects, 73.4% were found to have benefited from the treatment.     

Caries reduction over 5 years from a single application of a fissure sealant.

This paper is a continuation of three previously published papers giving a long-term clinical evaluation of an ultraviolet light polymerizable fissure sealant method. The present findings revealed that of the 156 permanent teeth available for study 5 years after initiation, 59.6% retained the sealants in good condition, while 25.6% of the sealants were missing or partly missing. During the test period, 37 (32.2%) of the 115 sealed permanent first molars had become carious, while 92 (80.0%) of the respective paired controls had decayed. An analysis of the efficacy of the treatment on the test-control tooth pairs showed a net gain of 55 and a percentage effectiveness of 59.8%. The sealed teeth were found to be highly significantly less decayed than the respective contols (P less than 0.001). Of the individual subjects, 73.4% were found to have benefited from the treatment.     

Retention of a fissure sealant with caries reduction in Finnish children after six months

abstract — The purpose of this study was to test the retention as well as the caries reduction potential of a fissure sealant under Finnish dietary conditions. The 150 children who served as subjects were selected on the basis of having at least one pair of sound permanent molars. Two hundred first molars, 43 premolars and 119 primary molars were sealed, while the respective tooth from the other side of the jaw was left untreated and used as the control. The findings after 6 months revealed that all 362 sealants persisted. Among the sealants of the first permanent molars, 99% were in excellent condition. All sealants of the permanent premolars and of the primary molars were excellent. Among the permanent control molars 43 (22%) showed carious fissures while among the sealed permanent molars, only 3 (1.5%) had carious fissures. This gives a 93% reduction of the fissure caries. Both the control and the sealed premolars were all sound. None of the sealed primary molars were decayed compared to 7.6% decayed on the control side.     

Abstracts from other journals

The aim of the present study was to clinically evaluate fissure sealants on the occlusal fissures and buccal pits of permanent first and second molars after 20 and 15 years, respectively. The population consisted of 72 children, each of whom had had their four first molars sealed between 1977 and 1980. At the annual examinations, all caries-free, newly erupted second molars were sealed. When sealant was applied to the second molars, the first molars were checked and sealant was reapplied to those that had deficient sealants. At the follow-up, when the subjects were 26–27 years of age, 27 in the original group had moved from the community. Thus, the present result is based on 45 subjects. One hundred and fifty-three sealed first molars and 161 sealed second molars were available for inspection. At the follow-up examination of the first molars 20 years after sealant had been applied, 65% showed complete retention, 22% partial retention without caries, and 1306 caries or restoration in the occlusal fissures or buccal pits. At the 15-year follow-up of the second molars, the corresponding figures were 65%, 30% and 5%, respectively. Of the restored or carious molars, significantly more were found in the mandible than in the maxilla ( P  < 0.001). This longitudinal study showed that pit and fissure sealants, applied during childhood, have a long-lasting, caries-preventive effect.     

On the retention and effectiveness of fissure sealant in permanent molars after 15-20 years: a cohort study

The aim of the present study was to clinically evaluate fissure sealants on the occlusal fissures and buccal pits of permanent first and second molars after 20 and 15 years, respectively. The population consisted of 72 children, each of whom had had their four first molars sealed between 1977 and 1980. At the annual examinations, all caries-free, newly erupted second molars were sealed. When sealant was applied to the second molars, the first molars were checked and sealant was reapplied to those that had deficient sealants. At the follow-up, when the subjects were 26-27 years of age, 27 in the original group had moved from the community. Thus, the present result is based on 45 subjects. One hundred and fifty-three sealed first molars and 161 sealed second molars were available for inspection. At the follow-up examination of the first molars 20 years after sealant had been applied, 65% showed complete retention, 22% partial retention without caries, and 13% caries or restoration in the occlusal fissures or buccal pits. At the 15-year follow-up of the second molars, the corresponding figures were 65%, 30%, and 5%, respectively. Of the restored or carious molars, significantly more were found in the mandible than in the maxilla (P<0.001). This longitudinal study showed that pit and fissure sealants--applied during childhood--have a longlasting, caries-preventive effect.     

不同酸蚀方法对3M-Z350纳米流动树脂年轻恒牙窝沟封闭的效果

目的:应用全酸蚀黏结剂和自酸蚀黏结剂结合3M-Z350流动树脂对年轻恒磨牙进行窝沟封闭术,观察3a内封闭剂保留率和龋病预防情况.方法:选择308例6～8岁儿童已完全萌出第一恒磨牙1232颗,采用自身半口对照方法.随机选择一侧为实验组(A组),采用自酸蚀黏结剂处理牙面后,以流动树脂进行窝沟封闭;另一侧为对照组(B组),应用磷酸酸蚀法结合流动树脂进行窝沟封闭.定期复查封闭剂保留情况和患龋情况.采用 SPSS 13.0软件包对数据进行统计学处理.结果:术后1、2、3a复查,A组窝沟封闭剂保留率低于B组,龋病发病率高于对照组,除第1年龋病发病率外,其余数据均有显著差异(P＜0.05).结论:自酸蚀黏结剂结合流动树脂进行窝沟封闭,虽然可简化操作步骤,降低患者依从性的要求,但远期材料保留率、预防年轻恒牙窝沟龋的发生率仍不及磷酸酸蚀法结合流动树脂进行窝沟封闭.     

Microleakage and sealant penetration in contaminated carious fissures

Objectives

The aim of the present in vitro study was to evaluate the effect of an adhesive system on microleakage and sealant penetration depth in carious fissures after different surface contamination circumstances.

Methods

Extracted third molars (n = 128) with small occlusal cavitated carious lesions were randomly divided into eight experimental groups and sealed under four different surface conditions. 1, Dry conditions; 2, water contamination; 3, saliva contamination; 4, saliva contamination and air-drying. Two sealant protocols were applied, one using a fissure sealant (Teethmate F) and one using an additional adhesive system (SA primer and Photo Bond). The control group consisted of sound third molars (n = 16), that were sealed under dry conditions. After thermocycling (n = 500 cycles), teeth were immersed in 1% methylene blue for 24 h, sectioned and digitally photographed. Microleakage was evaluated on a three-point rating scale and analysed using a Chi-square test. Additionally, the presence of caries and incomplete sealant penetration was scored from photographs and analysed using logistic regression.

Results

A statistical significant difference regarding microleakage scores was present between sealed carious and sealed sound fissures. The use of an adhesive system in case of water contamination significantly reduced microleakage (p < 0.05). With regard to sealant penetration depth, there were significant differences present for carious sealed fissures, use of an adhesive system prior to sealing, and water and saliva contamination.

Conclusions

Use of an adhesive system improved the effectiveness of sealants placed after water contamination in carious fissures. However, sound fissures showed less microleakage and better penetration abilities than carious fissures.     

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.     

Pit and fissure sealants: results at five and ten years.

AIM: This was to evaluate the efficacy of pit and fissure sealant (FS) using two different application techniques for caries prevention assessed at five and ten years. METHODS: The study was conducted using Delton(R) pit and fissures sealant applied with either rubber dam (RD) (Group A: 50 children, 200 first permanent molars, 120 second permanent molars) or cotton wool rolls (CR) (Group B: 50 children, 200 first permanent molars, 112 second permanent molars). At five and ten years FS were evaluated for retention, loss and incidence of occlusal and proximal carious lesions recorded. STATISTICS: The data were analysed with the Chi- square test comparing the results obtained for first permanent molars and second permanent molars at five and ten years. RESULTS: There was no statistical difference between results in the two groups (p< or =0.05). The highest retention rate, 81.7%, was found for second permanent molars sealed under RD at the five year assessment. The lowest, 64.3% also for second molars sealed under CR humidity control at ten years. CONCLUSIONS: Pit and fissure sealants are a valid preventive approach that can be applied with similar results with rubber dam or cotton rolls.     

Retention of Ultra Seal XT third generation fissure sealant in systematic pedodontic care

The aim of the present study was to clinically evaluate Ultra Seal XT third generation light cured fissure sealant on the occlusal pits and fissures of permanent first and second molars for a period of two years. The examined population consisted of 112 Hungarian school-children, aged 8 to 14 years who presented for treatment at the Department of Dentistry for Children and Orthodontics in Budapest. The 1120 participants had a total of 247 permanent molars sealed. All teeth were monitorized and controlled after 6 months, 1 year and 2 years. Retentivity of fissure sealants were after 6 months 92.7%, one year 87.8%, two years 79.9%. These results are in accordance with data of literature. This longitudinal study showed that modern pit and fissure sealants can be applied during childhood in systematic pedodontic care. It has high retentivity and a directly proportional optimal caries-preventive effect.     

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.     

Randomized, controlled trial comparing the retention of a flowable restorative system with a conventional resin sealant: one-year follow up

This clinical trial evaluated the retention rate of a flowable restorative system (Bond 1 + Flow-It!) used as a pit-and-fissure sealant compared with a conventional filled resin sealant (Fluroshield) over a 1-year period. METHOD: Using a half-mouth design, 160 sealants (80 in primary and 80 in permanent teeth) were placed on sound first/second primary molars and first permanent molars of 40 children aged between 4 and 7 years. For both primary and permanent dentitions, half the teeth (n = 40) were sealed with Fluroshield and half (n = 40) with Bond 1 + Flow-It! Teeth were evaluated at baseline, 6- and 12-month intervals. RESULTS: For both materials, there was no total loss of sealants placed on either the primary or permanent molars over 1 year. From Fluroshield sealants placed on primary teeth, 33 were completely intact after 6 months and 31 after 1 year. From those placed on permanent molars, no loss of material was observed after 6 months, while partial loss was noticed on 5% of teeth at 1-year recall. For Flow-It! resin applied on primary molars, partial loss of material was observed in only 1 sealant after 6 months and in 2 sealants after 1 year. On permanent teeth, 100% retention rate was observed over a 1-year follow up. There was a statistically significant difference (P < 0.01) between the sealing materials on primary but not permanent teeth, and, overall, Flow-It! sealants presented a higher retention rate at both 6-month and 1-year evaluations. Significant differences (P < 0.01) between baseline and the other evaluation periods were also observed. CONCLUSION: It may be concluded that the flowable restorative system yielded optimal retention on both primary and permanent molars. Its retention rate was significantly higher than that of the conventional pit-and-fissure sealant on primary teeth.     

Do light cured ART conventional high-viscosity glass-ionomer sealants perform better than resin-composite sealants: A 4-year randomized clinical trial

Objective

The hypotheses tested were: the cumulative survival rates of dentin caries lesion-free pits and fissures of ART conventional high-viscosity glass-ionomer sealants with light-curing (high-intensity LED) and glass-carbomer sealants are higher than those of conventional ART sealants and resin-composite sealants after 4 years.

Methods

The randomized controlled clinical trial covered 405 children (mean age 8-years). Three dentists placed sealants in pits and fissures of high caries-risk children. Evaluation by two independent evaluators was conducted after 0.5, 1, 2, 3 and 4 years. The Kaplan–Meier survival method, ANOVA and t-test were used in data analyses.

Results

1304 first permanent molars were sealed. 12.3% of children and 15.4% of sealants dropped out. 46 re-exposed pits and fissures, 39 (occlusal) 7 (free smooth surfaces), in 42 children developed a dentin carious lesion. The cumulative survival of dentin caries lesion-free occlusal pits and fissures in ART plus LED group (98%) was statistically significantly higher than in the resin-composite group (96.4%) and in the glass-carbomer group (94.5%). The cumulative survival of dentin caries lesion-free occlusal pits and fissures in the glass-carbomer group was statistically significantly lower than that in the conventional ART group (97.3%). For the free smooth surfaces, there was no statistically significantly difference among the four sealant groups.

Significance

Light-cured ART conventional high-viscosity glass-ionomer sealants prevented the occurrence of dentin cavities best.     

Comparison of Two Types of Pit and Fissure Sealants in Reducing the Incidence of Dental Caries Using a Split-Mouth Design

ObjectivesTo evaluate the effectiveness of two pit and fissure sealants (PFS) in reducing the incidence of dental caries in schoolchildren.Material and MethodsA randomized split-mouth experimental design was used in a sample of 140 subjects assigned to two groups. The sealants used were Clinpro©3M and BeautiSealant©Shofu placed in first permanent molars (FPMs). Each sealant was compared to molars in the controls to determine effectiveness over a period of 6 months. The study had a 12.9% loss to follow-up. No statistically significant differences (p>0.05) were observed for sex, age, baseline dmft, or type of sealants. Nonparametric tests were used for statistical analysis.ResultsAverage dmft index at baseline was 4.10±3.16. Lower incidence of caries was observed in FPMs with pit and fissure sealants (p<0.01), regardless of the type used. When sealants remained intact there was a lower caries incidence compared to sealants partially or completely missing – but differences were only significant for FPM 16. Caries incidence was higher for BeautiSealant sealed teeth than for Clinpro’s, but only statistically significant in FPMs 16, 36 and 46 (p< 0.05). Caries incidence was higher in those cases with a higher baseline dmft but it only reached statistical significance in FPMs 26 and 36. Relative risks for dental caries were lower in sealed teeth (p<0.01).ConclusionsPit and fissures sealants are an effective preventive treatment to reduce caries during a 6-month follow-up in schoolchildren 6 to 8 years of age, regardless of the type of sealant used. The sealant brand that showed greater effectiveness in terms of prevention and retention was Clinpro©3M.     

The effectiveness of sealants in managing caries lesions

A barrier to providing sealants is concern about inadvertently sealing over caries. This meta-analysis examined the effectiveness of sealants in preventing caries progression. We searched electronic databases for comparative studies examining caries progression in sealed permanent teeth. We used a random-effects model to estimate percentage reduction in the probability of caries progression in sealed vs. unsealed carious teeth. Six studies, including 4 randomized-controlled trials (RCT) judged to be of fair quality, were included in the analysis (384 persons, 840 teeth, and 1090 surfaces). The median annual percentage of non-cavitated lesions progressing was 2.6% for sealed and 12.6% for unsealed carious teeth. The summary prevented fraction for RCT was 71.3% (95%CI: 52.8%-82.5, no heterogeneity) up to 5 years after placement. Despite variation among studies in design and conduct, sensitivity analysis found the effect to be consistent in size and direction. Sealing non-cavitated caries in permanent teeth is effective in reducing caries progression.     

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.     

Short-term retention of glass-ionomer fissure sealants

In some studies, rapid loss of glass-ionomer sealants has been reported. The aim of this study was, therefore, to examine the retention rate of 4 month old glass-ionomer sealants (Fuji III). The sealants were applied in 93 newly erupted molars and premolars. After four months, 75% of the sealants were totally present, 22% partially lost and 3% totally lost. No caries was observed. Impressions were taken from occlusal surfaces showing total or partial loss of sealants, and the casts were examined using a stereomicroscope or SEM. Examination revealed that in most of these cases, the material was still left in the bottom of the fissures. This may partly explain why glass-ionomer sealants have prevented caries even after they appear to have been lost. In order to examine the penetration of the sealant into the fissures, 28 teeth were sealed in vitro, bisected and examined using a stereomicroscope. In 19 cases, the sealant had penetrated whole fissure, in 7 cases two thirds of the fissure and in 2 cases one third of the fissure or less.     

Sealed primary molars are less likely to develop caries

BackgroundThe authors examined the association between light-polymerized resin-based fluoride-releasing sealants and the development of pit-and-fissure caries on primary molars.MethodsIn this 3-year retrospective study, the authors reviewed the dental records of 297 children (1,352 teeth) younger than 6 years who were at high caries risk. Sealant placement or nonplacement on primary molars in the outpatient clinic and operating room setting was recorded, and random-effects logistic regression analysis accounting for the effect of data clustering was performed to measure caries incidence over time.ResultsThe odds of developing pit-and-fissure carious lesions on sealed primary molars were 0.055 times (95% confidence interval [CI], 0.011 to 0.285; P = .001) and 0.013 times (95% CI, 0.001 to 0.159; P = .001) the odds of that on nonsealed primary molars in the outpatient clinic and in the operating room, respectively. In molars that became carious, those sealed were associated with longer time to caries development in both the outpatient clinic (2.69 years, 95% CI, 2.08 to 3.29) and operating room (1.97 years, 95% CI, 1.45 to 2.48).ConclusionsSealed primary molars were less likely to develop pit-and-fissure caries when placed in both the clinic and operating room settings.Practical ImplicationsDental sealants on primary molars should be considered for children at high caries risk.