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Kamath V, Hebbal M, Ankola A, Sankeshwari R, Jalihal S, Choudhury A, Soliman M, Eldwakhly E. Comparison of Retention between Conventional and Nanofilled Resin Sealants in a Paediatric Population: A Randomized Clinical Trial. J Clin Med 2022; 11:jcm11123276. [PMID: 35743349 PMCID: PMC9224720 DOI: 10.3390/jcm11123276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study compared conventional-resin-sealant versus nanofilled-sealant retention at different intervals. Methods: A double-blinded split-mouth randomized control trial was performed on sixty-two children aged from six to nine years. Participants with one pair of contralateral permanent first molars with deep fissures or noncavitated carious lesions were randomly selected for sealant application. Conventional resin sealant was applied on one molar and nanofilled sealant on the contralateral molar. Evaluations were performed at one, three, six, twelve and eighteen months to check for retention. The chi-squared test, McNemar test, Wilcoxon signed-rank test and Friedman test were used for statistical analysis. Results: Conventional resin sealant showed complete retention in 91.4%, 86.2%, 74.1%, 62.1% and 55.2% of the teeth, and nanofilled sealant showed complete retention in 89.7%, 81%, 77.6%, 69% and 67.2% of the teeth, at the end of 1 month, 3 months, 6 months, 12 months and 18 months evaluation, respectively. Each sealant exhibited a statistically significant change (p < 0.05) in the retention rate during the evaluation period. However, when both the sealants were compared with each other, there was no statistically significant difference in any phase. At the end of 18 months, caries development was observed in 13.8% of the teeth sealed with conventional sealant, and in 10.3% of the teeth sealed with nanofilled sealant. Conclusion: At eighteen months, the nanofilled resin sealant exhibited complete retention in 12% more teeth than the conventional sealant. However, the difference was not statistically significant. The nanofilled resin sealant yielded an acceptable performance in sealing the occlusal pits and fissures of mandibular permanent first molars, compared to conventional pit-and-fissure sealants.
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Affiliation(s)
- Vinayak Kamath
- Department of Public Health Dentistry, Goa Dental College and Hospital, Bambolim 403202, India;
| | - Mamata Hebbal
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
| | - Anil Ankola
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, Belagavi 590010, India; (A.A.); (R.S.); (S.J.); (A.C.)
| | - Roopali Sankeshwari
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, Belagavi 590010, India; (A.A.); (R.S.); (S.J.); (A.C.)
| | - Sagar Jalihal
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, Belagavi 590010, India; (A.A.); (R.S.); (S.J.); (A.C.)
| | - Abhra Choudhury
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, Belagavi 590010, India; (A.A.); (R.S.); (S.J.); (A.C.)
| | - Mai Soliman
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
| | - Elzahraa Eldwakhly
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
- Correspondence: ; Tel.: +966-547-345-731
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Jiménez-Díaz J, Curtze-Scotts G, Barahona-Fuentes G. Retention rate of resin sealants in dental enamel with structural alterations: a systematic review. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.01.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resin sealants have been used preventively and therapeutically in tooth enamel. The latter can present different conditions in its structure. In this sense, adhesive retention in enamel has ample evidence of its effectiveness, but not in enamel with structural alterations. In this way, it is relevant to know the adhesive retention of these materials and how they behave over time in enamel with variations in its composition. To determine the retention rate of resin sealants in tooth enamel with structural alterations. The study is part of a systematic review following the PRISMA protocol. Articles published between 2010 and 2020 on the retentive behavior of resin sealants in dental with structural alterations were examined. The electronic search was carried out in Web of Science, Scopus, PubMed and Medline. Those articles that used resin sealants in dental enamel with structural alterations were incorporated in clinical trials. Results: Eight articles were found. These were stratified according to the application surface; (i) carious surface, (ii) surface with fluorosis and (iii) surface with hypomineralization of the molar incisor. It was evidenced that the retention rate of resin sealants on decayed enamel is 80% on average, in enamel with dental fluorosis 67.5% and enamel with hypomineralization of the molar incisor 72% 2 years after their application. The retentive behavior of resin sealants on enamel with structural alterations is adequate for the three application surfaces. However, further studies are required regarding dental fluorosis and molar incisor hypomineralization. The most significant evidence on the retention rate was found on various surfaces.
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Affiliation(s)
| | | | - Guillermo Barahona-Fuentes
- Grupo de Investigación en Salud, Actividad Física y Deporte ISAFYD, Universidad de Las Américas, sede Viña del Mar, Chile
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Ramesh H, Ashok R, Rajan M, Balaji L, Ganesh A. Retention of pit and fissure sealants versus flowable composites in permanent teeth: A systematic review. Heliyon 2020; 6:e04964. [PMID: 33005790 PMCID: PMC7519376 DOI: 10.1016/j.heliyon.2020.e04964] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/24/2020] [Accepted: 09/15/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To summarize the available clinical evidence on the relative effectiveness of retention of resin-based pit and fissure sealants (PFS) with that of flowable composites on occlusal surfaces of permanent teeth when evaluated in clinical trials. SOURCES Electronic searches were performed in PubMed and Cochrane Library for the identification of relevant studies, from their inception until February 2020 and an additional search was done with the reference lists of included articles. STUDY SELECTION The review protocol followed the PRISMA guidelines and was registered in PROSPERO (CRD42018112805). The risk of bias of the studies was independently appraised using the revised Cochrane Risk of Bias tool (RoB 2.0). DATA Ten articles were considered relevant for qualitative synthesis. The data extracted from two of the included articles showed statistically significant difference between the two materials based on their retention potential, of which one article favored superior retention of flowable composites and one article favored higher retention of PFS and the other eight studies showed no significant difference between the two materials. CONCLUSION The current review has shown evidence suggesting the effective retention of resin-based pit-and-fissure sealants and flowable composites when applied to prevent occlusal caries in permanent molars, however, this evidence is of low quality. Carefully designed long-term clinical trials are required to support the results of this review. CLINICAL SIGNIFICANCE This is an important topic that would be of significant interest in the field of preventive dentistry, where sealants are the primary recommended method to prevent caries. The clinical efficacy of sealants is directly linked to their potential to retain and this systematic review focuses on comparing the relative effectiveness of resin-based pit-and-fissure-sealants with flowable composites in permanent teeth.
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Affiliation(s)
- Hasini Ramesh
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Institute of Higher Education & Research (SRIHER), India
| | - Rupa Ashok
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Institute of Higher Education & Research (SRIHER), India
| | - Mathan Rajan
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Institute of Higher Education & Research (SRIHER), India
| | - Lakshmi Balaji
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Institute of Higher Education & Research (SRIHER), India
| | - Arathi Ganesh
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Institute of Higher Education & Research (SRIHER), India
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Kühnisch J, Bedir A, Lo YF, Kessler A, Lang T, Mansmann U, Heinrich-Weltzien R, Hickel R. Meta-analysis of the longevity of commonly used pit and fissure sealant materials. Dent Mater 2020; 36:e158-e168. [PMID: 32061445 DOI: 10.1016/j.dental.2020.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/19/2019] [Accepted: 02/04/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This systematic literature review and meta-analysis compared the clinical retention of primed or adhesively bonded sealants to that of conventional sealant materials. METHODS A search of the MEDLINE, EMBASE and CENTRAL databases identified 3707 abstracts published prior to 12/31/2017, of which 335 clinical publications were analysed in detail. A total of 67 studies included information about sealant retention after 24, 36, or 60 months of follow-up. A meta-analysis using a random effects model was conducted to calculate the pooled estimate of the retention rates for the five groups of sealants. Subgroup moderator analysis was performed to compare the pooled retention rate estimate (RRE) of primed sealants against those of the other groups. RESULTS Primed sealants had a 2-year pooled RRE of 43.2% (95% CI: 30.5-55.8), which was significantly inferior to those of auto-polymerizing (80.8%, 95% CI: 72.2-89) and light-polymerizing sealants (68.4%, 95% CI: 60.2-76.7). Fluoride-releasing and light-polymerizing sealants had the highest 3-year pooled RREs (86.4%, 95% CI: 73.4-99.3 and 83.1%, 95% CI: 75.6-90.7, respectively). SIGNIFICANE The results of this meta-analysis suggest that primed sealants cannot be fully recommended for clinical practice due to their moderate survival rates. Auto-polymerizing, light-polymerizing and fluoride-releasing sealants continue to be considered the reference standards for pit and fissure sealants. However, future generations and developments of primed sealant materials may change this position.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany.
| | - Ahmed Bedir
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany; Institute of Medical Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Yi-Fang Lo
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Andreas Kessler
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Toni Lang
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Ulrich Mansmann
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany
| | | | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
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Singh C, Kaur K, Kapoor K. Retention of pit and fissure sealant versus flowable composite: An in vivo one-year comparative evaluation. J Indian Soc Pedod Prev Dent 2019; 37:372-377. [PMID: 31710012 DOI: 10.4103/jisppd.jisppd_122_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Pits and fissures are extremely vulnerable to the development of caries. Resin-based materials for sealing pits and fissures (pit and fissure sealants and flowable composites) are helpful in caries control by physical barrier formation, which prevents metabolic exchange between fissure microorganisms and oral environment. Retention is one of the most important prerequisites for pit and fissure sealants. Debris and pellicle might not be removed by conventional prophylaxis and etching; therefore, air abrasion (AB) for fissure preparation has been advocated for sealant retention. This in vivo study was aimed to compare the retention of resin-based pit and fissure sealant to flowable resin composition occlusal pits and fissures of all first permanent molars with and without air-abrasion over a 12-month follow-up. MATERIALS AND METHODS A randomized controlled clinical trial was done after obtaining ethical committee approval and informed and written consent. Thirty children with the age of 6-9 years, with all four caries-free first permanent molars without any hypoplasia/fracture but with pits and fissures prone to caries were included in this study. The four first molars were divided into the following four groups: Group A (tooth 16; sealant + AB), B (tooth 46; composite + AB), C (tooth 36; sealant), and D (tooth 26; composite). Assessments were made at 3, 6, 9, and 12 months for partial or total loss of sealant and caries according to Modified Simonsen's Criteria. RESULTS AND CONCLUSIONS Flowable composite was relatively better retained than sealant at 12 months' follow-up although results were statistically insignificant. AB followed by acid etching brought superior retention than acid etching. Mandibular teeth have shown relatively superior retention. Future studies should aim at investigating better techniques and materials for sealing pit and fissures.
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Affiliation(s)
| | | | - Kavisha Kapoor
- Department of Pedodontics, SGRD, Amritsar, Punjab, India
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Bagherian A, Shiraz AS. Flowable composite as fissure sealing material? A systematic review and meta-analysis. Br Dent J 2018; 224:92-97. [DOI: 10.1038/sj.bdj.2018.40] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 11/09/2022]
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Moreira KMS, Kantovitz KR, Aguiar JPD, Borges AFS, Pascon FM, Puppin-Rontani RM. Impact of the intermediary layer on sealant retention: a randomized 24-month clinical trial. Clin Oral Investig 2016; 21:1435-1443. [PMID: 27392611 DOI: 10.1007/s00784-016-1890-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 06/15/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aims of this study were to assess long-term impact of tooth eruption stages (ES) on sealant retention on occlusal surfaces previously coated with intermediary bonding layer and to determine caries prevention. MATERIALS AND METHODS Sixty-five school children were selected (aged 6-10 years), with four non-carious permanent first molar in different ES (OP (operculum present), ME (marginal edge), CE (completely erupted)). Split-mouth and single-blind study design was used. The teeth (260) were randomly selected according to treatment (sealant/technique): F (Fluroshield), H (Helioseal Clear Chroma), SF (Single Bond + F), EH (Excite + H). Sealant retention, marginal integrity, discoloration, and caries prevention were assessed after 6, 12, 18, and 24 months by calibrated examiner (Spearman = 0.91) using visual inspection. Data were submitted to the Cox proportional hazard model (survival analysis) and Likelihood ratio χ 2 test (correlation), p ≤ 0.05. RESULTS At baseline, ES was 20 % in OP, 54 % in ME, and 26 % in CE. There was no significant difference on sealant retention between the treatments (p = 0.2774). However, significant differences were found regarding the ES on sealant retention (p = 0.0041). The CE stage showed the highest retention survival rate during the 24 months. The overall sealant prevention average was found to be about 99.4 % and showed no difference between the groups. CONCLUSIONS Eruption stages affect sealant retention irregardless of the intermediate layer and type of sealant. However, there was caries prevention on tooth occlusal surfaces after 24 months, regardless of treatment. CLINICAL RELEVANCE Sealing is recommended to prevent occlusal caries of newly erupted teeth in high-caries-risk patients. However, its application is critical on moisture limited control surfaces independently of sealer material and technique.
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Affiliation(s)
- Kelly Maria Silva Moreira
- Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil
| | - Kamila Rosamilia Kantovitz
- Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil.,São Leopoldo Mandic Institute and Dental Research Center, Campinas, São Paulo, Brazil
| | - Juliana Pedrini Dias Aguiar
- Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil
| | - Ana Flávia Sanches Borges
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Fernanda Miori Pascon
- Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil
| | - Regina Maria Puppin-Rontani
- Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil.
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