A field trial of resin-based and glass-ionomer fissure sealants: clinical and radiographic assessment of caries

Abstract – Objective: The purpose of the present study was to provide further data for comparison of retention and caries‐preventive effect of a resin‐based sealant (Delton^®), and a glass–ionomer sealant (Fuji III^®). Methods: The study was conducted in the municipality of Værløse located 15 km north of Copenhagen, Denmark in the period 1996–2001. The study comprised 153 children aged 8–13 years with a total of 364 site‐pairs. Caries was diagnosed both clinically and radiographically, and sealant retention was diagnosed clinically. Sealants were placed either by one of four dentists, who had the responsibility for the children's dental care, by a dental hygienist or a dental assistant. Mean follow‐up time was 38–39 months for sites on first permanent molars and 28–29 months for sites on second permanent molars. Results: The retention rates were consistently, and considerably lower for Fuji III^® than for Delton^®. Relative risks of caries in Delton^®‐sealed teeth over Fuji III^®‐sealed teeth was 0.435 (95% CI 0.150–0.846) based on the clinical diagnosis, and 0.559 (95% CI 0.342–0.905) based on the radiographic diagnosis. The ratio of the relative risks (clinical over radiographic diagnosis) was close to 1 (0.778; 95% CI 0.272–1.481). Conclusion: In the present study, Delton^®‐sealed teeth had a lower risk than Fuji III^®‐sealed teeth of developing caries, independent of the caries diagnostic method used.     

Retention and caries preventive effects of a GIG and a resin-based fissure sealant

Abstract Fissure sealing using partially filled resins is an established caries preventive practice. Glass ionomer cement (GIC) sealants may offer additional advantages due to their ability to bond chemically to enamel and release fluoride. The aim of this study was to compare the caries preventive effect and retention of a GIC and a resin-based sealant. Ketac-fil® was tested against a chemically cured resin-based material (Delton®) using a split mouth design. Perth (Western Australia) schoolchildren (n= 465), mean age 7 yr±0.72 (S.D.), received sealants on the occlusal surfaces of sound homologous permanent first molar pairs. Test (GIC) and control (resin) sealants were systematically allocated to left and right sides based on the child's month of birth, and were placed by dental therapists. After 3.64±0.11 yr, 415 children were examined by different clinicians, and the clinical status of the teeth and the extent of sealant retention recorded. Sealants were deemed retained when at least 2/3 of the fissure pattern was still sealed. In 252 tooth pairs, neither sealant was retained to this extent. In 71 pairs, the GIC was not retained and the resin sealant retained. In 40 pairs the reverse occurred (McNemar's test, χ²= 8.66, P < 0.005). Net gain (additional lesions prevented by the test agent per 100 treatments) was 6.1%(95% CI 3.3%, 8.9%). Effectiveness of the GIC was 80.6% (95% CI 59.6%, 90.7%). The relative risk of caries in test teeth was 0.19 (95% CI 0.09, 0.40). The study suggests that complete retention of GIC sealant is not necessary for caries prevention in newly erupted permanent first molars.     

Retention of a glass ionomer cement and a resin-based fissure sealant and effect on carious outcome after 7 years

Abstract– The aim of this study was to compare the retention and caries preventive efficacy of glass ionomer (Fuji III; GIC) and light-cured resin-based (Delton; LCR) fissure sealants. One hundred and sixty-six 5–14-year-old schoolchildren received sealants on their newly erupted first or second molars; a split mouth design was used. Previously reported 2-year results showed low retention rates for GIC sealants, but no difference in the caries increment between the groups. The same persons were invited to a dental check-up 6.1 to 7.8 (mean 7.1) years after the application of sealants; 111 persons (66.8% of the original group) participated in the study. The retention of sealants, and the caries status of occlusal surfaces and adjacent proximal surfaces was recorded. On the sealed occlusal surfaces, 10% of GIC and 45% of LCR sealants were totally and 9% of GIC and 20% of LCR sealants partially present. Twenty-three (23.5%) of the occlusal surfaces sealed with GIC and 16 (16.5%) of those sealed with LCR were carious or filled. Compared to LCR sealants, the effectiveness of GIC sealants was –44% (95% CI –71%, 16%) and net gain –7% (95% CI –18%, 4%). The relative risk of caries occurring was –44 (95% CI 0.96, 2.14).     

Effects of glass ionomer cement, resin-based pit and fissure sealant and HF applications on occlusal caries in a developing country field trial

Abstract The aim of this community-oriented study was to evaluate different methods to prevent fissure caries. The following products and measures were tested: 1) glass ionomer cement (GIC) applied by dentist; 2) same material applied by short term (3 days) trained personnel (teachers); 3) application of a 0.5% HF solution three times; 4) an established autopolymerized resin based sealant (Delton). The study was performed in Bangkok, Thailand, a city in a developing country experiencing increasing caries prevalence. Children with at least three sound permanent molars from two age groups, 7–8 and 12–13-yr-olds respectively were chosen from very low to medium socioeconomic level families. 1264 children were systematically assigned to experiment or control groups based on school and DMFT. For the younger age group, the 2 yr mean DFS occlusal increment in the Control group was 0.66 surfaces. Significantly lower increments were observed in the GIC experimental group: O.I7 surfaces applied by the teachers and 0.32 applied by dentist, corresponding to 74% and 52% reductions, respectively. The mean increment in the HF group was 0.44 surfaces, a 33% reduction in relation to the Control group. For the 12–13-yr-olds, the mean occlusal surface DF increment was 0.70 surfaces in the Control group. Almost no occlusal increment was found in the Delton group, 0.05 DFS, a 93% reduction. In the GIC Dentist group, the DFS increment was 0.48 and in the Teacher group 0.56, corresponding to 31% and 20% reduction, respectively. A slight and nonsignificant increase of caries in relation to the Control group was observed in the HF group. Retention of Delton sealant was high, 92% after 6 months, retention of the GIC sealants was low. At the 6-months checkup, only 2–8% of these sealants were still present and also after reapplication, a majority was lost.     

Evaluation of fissure sealing with a diluted composite sealant and an UV-light polymerized sealant after 36 months' observation

abstract – The idea of fissure sealing has found wide acceptance in caries prevention. The present investigation was initiated to evaluate the retention of a diluted composite material used as a fissure sealant, compared with the retention of an UV-light polymerized sealant. After an observation period of 3 years, it seems justified to assume that a diluted composite sealant is a fully acceptable alternative to an UV-light polymerized sealant, and the former material seemed to have some advantages: a simpler polymerization procedure, an apparently better wear resistance due to ceramic filler particles, and an easier recognition because of a slight discoloration.     

Comparison of glass-ionomer and resin-based fissure sealants: a 2-year clinical trial

Abstract – In recent years, the interest in the use of glass-ionomer materials as fissure sealants has increased. The aim of this study was to compare the retention and caries-preventive effect of glass-ionomer (Fuji III) and resin-based light-cured (Delton) fissure sealants. Three health center dentists applied the sealants to 166 children; glass-ionomer sealants on one side and resin-based sealants on the contralateral side of the mouth. After 2 yr, one pair of molar teeth in the mouths of 151 children was compared. Twenty-six percent of glass-ionomer and 82% of resin-based sealants were totally present ( P < 0.001). During the 2 yr, in both groups 4.6% of the sealed surfaces became carious. The results show that the retention of glass-ionomer sealants is markedly inferior to the resin-based sealants. In this study, however, no difference in caries increment on the sealed surfaces was observed. This may be due to the different mechanism of caries prevention for the sealant materials, or to the overall low caries activity of the participants.     

Effect of operator variability and patient age on the retention of fissure sealant resin: 3-year results

Abstract Results of a 3-year clinical trial of Delton fissure sealant resin are reported. 41 % of first molar fissures remained fully sealed after 3 years. Significant differences were found between the levels of resin retention produced by the two operators and retention was significantly better on mandibular molars than on maxillary molars. In a separate group of 11-year-old children 77% of fissures were full)’sealed after 3 years.     

�ѹ���շ�ȣ

窝沟封闭作为一种无痛、无害、无创伤的技术,是预防窝沟龋的有效方法。操作步骤包括:清洁、酸蚀、冲洗和干燥、涂布封闭剂、固化、检查。窝沟封闭的防龋效果与封闭剂的保留率直接相关,窝沟封闭的相关操作技术、材料的性能都是与窝沟封闭效果密切相关的因素。     

A 24-month evaluation of fissure sealing with a diluted composite material

abstract — The idea of pit and fissure sealing has found wide acceptance in caries prevention. The present investigation evaluates the retention of a diluted composite material (Concise Enamel Bond system®) used as a pit and fissure sealant. On the basis of a clinical evaluation in 69 children of the retention of the material in pits and fissures for 24 months, it seems justified to assume that a diluted composite material is an acceptable alternative to other fissure-sealing materials.     

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.     

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。     

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.     

氟保护漆与玻璃离子水门汀窝沟封闭剂的防龋效果比较

目的:比较氟保护漆与玻璃离子水门汀窝沟封闭剂预防年轻第一恒磨牙窝沟龋的临床效果。方法:622例6～8岁儿童,随机分为3组,A试验组207例、335颗牙;B试验组205例、327颗牙和对照组210例、354颗牙。对A组儿童第一恒磨牙应用氟保护漆,每半年1次,对B组儿童第一恒磨牙应用玻璃离子水门汀窝沟封闭剂,对照组为空白对照。试验期3a,采用SPSS10.0软件包经χ2检验比较3组的龋病发病率。结果:3a后,A、B实验组龋病发生率均低于对照组,有显著差异(P<0.01),而A、B2组龋病发生率无显著性差异。结论:氟保护漆与玻璃离子水门汀窝沟封闭剂均有良好的防龋效果。     

Demineralisation and remineralisation of dentine caries, and the role of glass-ionomer cements

In accordance with the principles of modern operative dentistry, to conserve tooth structure and to use therapeutic restorative materials, an understanding of the carious process in dentine and the biological properties of glass-ionomer cements (GICs) are necessary. Delineation of the outer necrotic from the inner vital and remineralisable carious dentine allows for the preservation of tooth structure. This delineation is not possible when relying on visual and tactile perceptions, but requires the use of a caries detecting dye. GICs are ideal dentine substitutes because of their anticariogenic properties, stable long-term ionic bonding, and ability to assist the process of remineralization. The range of usage of these restorative materials continues to expand with the development of improved products.     

Follow-up study of sealing and filling with composite resins in the prevention of occlusal caries

A diluted composite resin (Concise diluted with Concise Enamel Bond) was used for fissure sealing and filling in 896 permanent first molars of 281 children, initially 5--7 years of age. Ordinary fissure sealing was used for fissures with no apparent caries, while a filling method was used after an explorative drilling with a small round bur (Ash No. 1/2) in fissures with incipient caries. On the basis of clinical evaluation every 6 months, the frequency of total retention of the composite material after different observation periods was calculated using the life table method. The rate of success in the fissure sealing group was 94.8% after 6 months, falling to 75.2% after 30 months. The corresponding data for the filled teeth were 92.6 % and 83.5%. It would seem that diluted composite resin is well suited for the prevention of caries in pits and fissures.     

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.     

自酸蚀和磷酸酸蚀窝沟封闭术的临床比较

目的应用自酸蚀法和磷酸酸蚀法对低龄高危患龋儿童进行窝沟封闭术,以比较窝沟封闭剂的保留率和龋齿预防情况。方法选择不超过42月龄、患龋牙数不低于4颗的高危患龋儿童43例为研究对象;试验牙为第一乳磨牙患龋患儿的第二乳磨牙,窝沟较深或早期脱矿但没有缺损的第二乳磨牙及第一乳磨牙,共选择试验牙138颗。采用自身半口对照方法,随机选择一侧试验牙应用自酸蚀法,另一侧应用传统磷酸酸蚀法进行窝沟封闭术,分别设为试验组和对照组。定期复查封闭剂保留情况和患龋情况。结果3个月复查时2组窝沟封闭剂的完好保留率没有统计学差异,6、12和18个月复查时自酸蚀组窝沟封闭剂完好保留率低于磷酸酸蚀组,龋齿发生率高于磷酸酸蚀组（P<0.05）。龋坏主要发生在封闭剂脱落的窝沟内,2组均出现了邻面龋。结论自酸蚀法窝沟封闭术的完好保留率低于磷酸酸蚀法,临床上应慎重应用。如果在低龄易患龋齿的儿童中应用该方法,需密切观察。     

窝沟封闭和氟保护漆预防学生恒牙龋的疗效观察

目的比较窝沟封闭和氟保护漆预防学生年轻第一恒磨牙窝沟龋的效果。方法应用两种材料对300名小学生进行上下颌第一恒磨牙同体对照封闭试验,左侧使用光固化窝沟封闭剂,右侧使用氟保护漆,于0.5、1.0、2.0年观察3次龋病发生情况。结果 0.5、1.0、2.0年左右侧第一恒磨牙龋齿发生率均无统计学意义。结论窝沟封闭和氟保护漆均有良好的防龋效果。     

第一恒磨牙窝沟封闭3年临床效果观察

目的通过3年随访观察窝沟封闭技术预防8岁儿童第一恒磨牙龋的临床效果。方法试验组805人,对照组245人,分别进行口腔检查,对试验组符合适应证的2 190颗第一恒磨牙进行窝沟封闭,分别于1、2、3年后复查试验组封闭剂保留情况和两组第一恒磨牙患龋状况,计算封闭剂保留率和比较两组第一恒磨牙患龋率。结果试验组3年随访封闭剂保留率分别为78.35%、69.56%、69.31%,第一恒磨牙患龋率分别为9.45%、9.91%、10.87%,龋均分别为0.10、0.11、0.12,而对照组3年随访第一恒磨牙患龋率分别为14.29%、17.26%、18.95%,龋均分别为0.15、0.20、0.21。对3年的患龋率分别进行比较,两组间差异均有统计学意义,第2、3年龋均两组间差异有统计学意义。结论窝沟封闭在第一恒磨牙防龋应用中效果好。