Pit and Fissure Sealants-A Comprehensive Review

Survival Analysis of Glass Ionomer Cement and Resin-Based Sealant Retention: A 10-Year Follow-Up Study

Background and Objective: Sealant application is a proven method to prevent occlusal caries; however, long-term studies on this topic are scarce. This study aimed to assess the survival rate and clinical effectiveness of glass ionomer cement (GIC) and resin-based sealants (RBSs) on second permanent molars over a long-term follow-up period. Materials and methods: Sixteen patients aged 11-13 years with all four completely erupted permanent second molars were enrolled in the study. All patients attended 1-year and 3-year follow-ups; however, one participant did not respond after 10 years and was excluded from the final analyses. The oral health status evaluation was based on WHO criteria. A total of 32 teeth received an RBS (Clinpro), and a further 32 teeth were sealed with GIC (Fuji IX). The sealant retention was determined according to the Kilpatrick criteria after 1 year, 3 years, and 10 years, respectively. Statistical analysis included a chi-square test, the Kaplan-Meier method, and the Cox proportional hazard model. Results: At baseline, seven boys and eight girls participated in the study, with a mean age of 12.3 ± 0.9 years. The 1-year follow-up results revealed that 90% of the RBSs and 43.3% of the GIC sealants were completely retained, and no caries lesions were recorded (p = 0.01). The 3-year follow-up results showed that 23.3% of the RBSs and 0% of the GIC sealants demonstrated complete retention (p = 0.034). Moreover, 10.0% of the occlusal surfaces in the RBS group and 13.3% of the occlusal surfaces in the GIC group were filled (p > 0.05). A total of 6.7% of the RBSs showed complete retention. One-third of the sealed teeth (30.0% of the teeth sealed with RBSs and 36.7% of teeth applied with GIC) were filled after 10 years. The Kaplan-Meier analysis demonstrated a higher survival rate in the RBS group when compared with the GIC over the entire follow-up period (p = 0.001). Conclusions: Although the survival rate of RBSs was higher than GIC sealants, their effectiveness in preventing fissure caries in permanent second molars did not differ significantly over a 10-year follow-up.

The Assessment of Resin-Based Composite Sealants' Effectiveness in Arresting Non-Cavitated Dentin Carious Lesions (ICDAS 3)-A 12 Month Follow-Up Preliminary Study

Background and Objectives: The therapeutic management of carious lesions remains a significant focus for researchers, given their persistently high prevalence despite being largely preventable. This study aimed to compare the effectiveness of a composite resin-based sealant material in halting extended non-cavitated dentin carious lesions when used therapeutically versus preventively on caries-free teeth over a period of twelve months. Materials and Methods: out of the 236 children examined, 45 were excluded from the study due to non-compliance with the inclusion criteria. Thus, the study included 191 children aged 10-12 years, and 764 molars in total. Results: among these molars, 171 were caries-free (ICDAS II code 0), forming the Control group, while 180 molars were classified with an ICDAS II score of 3, forming the Study group. All molars were sealed and evaluated at 6- and 12-month follow-up intervals. Both intervals revealed statistically significant differences (p < 0.05) in sealant retention and carious lesion development between sound (ICDAS code 0) and decayed (ICDAS code 3) teeth. Conclusions: the findings did not support the effectiveness of sealants in halting non-cavitated dentin carious lesions classified as ICDAS II with code 3 compared to their preventive application in sound teeth classified as ICDAS II with code 0.

Micro-tensile bond strength of two pit and fissure sealants to intact enamel

Background

Sealing dental pits and fissures with resin-based sealants effectively prevents occlusal dental caries. The effectiveness of resin-based pit and fissure sealants relies on maintaining a strong bond between the sealant and the enamel.

Objective

This in-vitro study compared the micro-tensile bond strength (μTBS) of a conventional resin-based sealant (Clinpro™) and a hydrophilic resin-based sealant (Embrace™ WetBond™) when applied to intact, aprismatic human enamel.

Methods

Forty extracted permanent premolar and molar teeth were divided into two groups and paired by tightly approximating two buccal surfaces to create an artificial enamel groove (fissure). Fissure sealants (Clinpro™ and Embrace™ WetBond™) were applied to the artificial enamel 'grooves' in each group. The specimens were then cut into beams with a cross-sectional area of 1 mm2 and tested for the micro-tensile bond strength (μTBS). Fractured surfaces of samples were examined under a conventional microscope to identify the failure modes. Two specimens from each group were prepared and observed under a scanning electron microscope (SEM). Mann-Whitney U and Fischer-Freeman-Holton exact tests were used to test the statistical differences between the fissure sealants.

Results

The μTBS mean ± SD for Clinpro™ was 16.43 ± 7.08, and 10.57 ± 6.64 for Embrace™ WetBond™. There was a statistically significant difference in μTBS between Embrace™ WetBond™ and Clinpro™ (p < 0.001). There was no association between fissure sealant and failure modes (p = 0.922).

Conclusion

Clinpro™ showed higher μTBS to enamel than Embrace™ WetBond™. Further studies are needed to conclude the clinical effectiveness of these sealants.

Efficacy of Glass Ionomer Cement as Pit and Fissure Sealant in Permanent First Molars

Background/Objectives Pit and fissure caries constitute a predominant portion, approximately 90% in permanent posterior teeth and 44% in primary teeth among children and adolescents. Among various preventive modalities, pit and fissure sealants play a pivotal role in safeguarding these vulnerable areas. Categorized by materials such as glass ionomer, composites, and polyacid-modified glass ionomers, these sealants offer effective protection. This study aims to evaluate the efficacy of glass ionomer-based pit and fissure sealants in terms of retention rate at 12-month post-procedure period in permanent first molars. Methodology This study was conducted at the Department of Operative Dentistry, Nishtar Institute of Dentistry, Multan, Pakistan. Fifty-six children, aged 7 to 12 years, presenting with pit and fissure caries in permanent first molar teeth were enrolled. Glass ionomer sealant was meticulously applied to the affected pits and fissures. The efficacy was assessed after 12 months based on predefined criteria. Results The age of participants ranged from 7 to 12 years, with a mean age of 9.24 ± 1.38 years. Among the 56 patients, 23 (41.2%) were male and 33 (58.8%) were female. Sealant retention was noted in 31 (55.35%) patients, while 25 (44.65%) experienced sealant loss. In the 7 to 9-year age group, 19 demonstrated complete sealant retention, whereas in the 10 to 12-year age group, 12 exhibited complete retention. Concerning gender distribution, 17 males and 14 females exhibited complete sealant retention. Conclusion Glass ionomer-based sealants demonstrate excellent properties for pit and fissure sealing owing to their low technique sensitivity, cost-effectiveness, and favorable retention rates. Therefore, they represent an optimal choice for this preventive dental procedure.

Clinical performance of sealants under different humidity control conditions: a split-mouth 1-year randomized trial

PURPOSE

Sealants are an effective method of prevention and treatment for early caries lesions. This study analyzed the 1-year clinical performance of resin-based and ionomeric sealants applied to permanent teeth under different humidity conditions.

METHODS

The investigation was a triple-blind randomized clinical trial (RCT) with a four arms split-mouth design, divided according to the sealant protocol: (1) Resin-based sealant applied with rubber dam isolation, (2) Resin-based sealant applied with cotton rolls isolation, (3) Ionomeric sealant applied with rubber dam isolation and (4) Ionomeric sealant applied with cotton rolls isolation. Fifty-eight patients started the study (232 teeth), and 47 (188 teeth) remained until the 1-year recall. The modified USPHS criteria were used in the analyzes to investigate surface texture, retention and the presence of secondary caries lesions around the sealants; in the following periods: baseline, after 3, 6, 9, and 12 months by two calibrated examiners. Data were analyzed by the Mann-Whitney and Friedman tests.

RESULTS

There was no difference between the types of sealants (p > 0.05). The type of humidity control influenced the superficial texture (p = 0.0012) and the retention of sealants (p = 0.0023). The sealant displacement was greater under cotton rolls isolation. Only one active caries lesion in enamel was found in the 9th month.

CONCLUSION

It may be concluded that sealants effectively prevented caries, even when they were partially or totally lost, regardless of the material. The rubber dam isolation with a rubber dam promoted lower surface roughness and improved the retention rates. International Clinical Trials Registry Platform: #1111-1215-2832 (07/26/2018).

Parental Knowledge, Attitude and Practices Toward Dental Sealants as Preventive Strategy for Dental Caries in Children: A Cross Sectional Study

Aim. This study aimed to evaluate the knowledge, attitude, and practices of parents residing in Pakistan toward pits and fissure sealants in children. Materials and Methods. This descriptive, cross-sectional study was carried out between November 2022 to March 2023. An online questionnaire was distributed through various social media platforms. Independent t-test and Multiple Linear Regression analysis were performed. Results. A total of 570 participants were recruited. For protection against tooth decay, most of the participants 456(80%) believed that fissure sealants should be placed to protect teeth from decay. Placement of fissure sealants was considered to be a cost-effective measure by majority of the 480 (84.2%) respondents. Conclusion. Fissure sealants are one of the most effective preventive measures against tooth decay. The knowledge, attitude and practice of parents were some being aware of fissure sealants and some were not. It appeared to support the placement of fissure sealants for their children.

Antimicrobial photodynamic therapy for the treatment of oral infections: A systematic review

Oral infection is a common clinical symptom. While antibiotics are widely employed as the primary treatment for oral diseases, the emergence of drug-resistant bacteria has necessitated the exploration of alternative therapeutic approaches. One such modality is antimicrobial photodynamic therapy (aPDT), which utilizes light and photosensitizers. Indeed, aPDT has been used alone or in combination with other treatment options dealing with periodontal disease for the elimination of biofilms from bacterial community to achieve bone formation and/or tissue regeneration. In this review article, in addition to factors affecting the efficacy of aPDT, various photosensitizers, the latest technology and perspectives on aPDT are discussed in detail. More importantly, the article emphasizes the novel design and clinical applications of photosensitizers, as well as the synergistic effects of chemical and biomolecules with aPDT to achieve the complete eradication of biofilms and even enhance the biological performance of tissues surrounding the treated oral area.

Comparison of micromorphological changes in enamel using SEM analysis after conventional and erbium, chromium:yttrium, scandium, gallium, and garnet hard-tissue laser fissurotomy: An in vitro study

Background

Well articulated by John Knowles - "Everything has to evolve or else it perishes." With the paradigm shift of emphasis toward the prevention of dental caries, it has been proven that laser irradiation protects against both caries initiation and caries progression.

Aim

The aim of the study was to evaluate and compare the micromorphology of caries-free extracted premolars using a Scanning electron microscope (SEM) after fissurotomy by conventional fissurotomy bur and erbium, chromium: yttrium, scandium, gallium, and garnet (ER, CR: YSGG) hard-tissue laser.

Methodology

Sixty caries-free premolars extracted atraumatically for orthodontic treatment were included in the study. The samples were divided into two groups randomly (Group 1: fissurotomy by bur, n = 30, and Group 2: fissurotomy by hard-tissue laser, n = 30). Each sample was further divided into halves from the occlusal surface wherein one-half of the occlusal surface received fissurotomy procedure and the other half was control. Samples were analyzed by scanning electron microscopy (SEM) for micromorphological changes.

Results

Profile image of control samples revealed the disorganization of enamel surface at the junction of fissures forming a heterogeneous tissue and agglomeration of enamel with deep pit and fissure. On the contrary, the image of experimented samples (with laser fissurotomy) showed smooth enamel surface and homogeneous enamel subsurface with wider pit and fissure owing to self-cleansing ability.

Conclusion

On the grounds of the present study results, it could be concluded that the intervention of ER, CR: YSGG hard-tissue laser possesses self-cleansable pit and fissures for caries prevention and has the potential to irradicate the smear layer entirely for superior attachment of remineralizing agents.

Effect of Different Etching Times on Pit-and-Fissure Sealant Micro-Shear Bond Strength to the Enamel of Primary Teeth

Successful clinical use of pit-and-fissure sealants relies on the sufficient etching of the enamel, field isolation and sealant retention. The etching time changes the physical and mechanical surface properties of the etched tooth tissues; therefore, it impacts both etching depth and the bond strength of sealants to the enamel. We examined if reducing the recommended 15 s etching time of primary teeth enamel affects the micro-shear bond strength (µSBS) of pit-and-fissure sealants. The cusps of forty non-carious, extracted human primary molars were separately etched for 8, 15 or 30 s. Then, a pit-and-fissure sealant was placed and light-cured. The µSBS values were evaluated and compared among the three groups. The mean µSBS values ± standard deviations were 34.68 ± 16.93, 34.19 ± 17.35 and 36.56 ± 16.57 MPa in the cusps etched for 8, 15 and 30 s, respectively. No statistically significant differences in µSBS were observed among the three test groups. In this study, we showed for the first time that the recommended etching time of primary teeth enamel may be reduced from 15 to 8 s without compromising the µSBS of the sealant. Further evaluations in a clinical setting are warranted.

Dental caries status and its associated factors among schoolchildren aged 6-8 years in Hangzhou, China: a cross-sectional study

BACKGROUND

Dental caries prevalence reaches the first peak around 6 years old. It is necessary to take effective measures to prevent and treat caries at this stage. This study investigated the prevalence and associated factors of dental caries among schoolchildren aged 6-8 years in Hangzhou City, China.

METHODS

A cross-sectional survey was conducted in Hangzhou from October 2017 to May 2018. Oral health status of schoolchildren in 1st and 2nd grades of primary schools aged 6-8 years was examined by well-trained examiners according to the WHO criteria. Questionnaires about potential caries-related factors were distributed to their parents. ANOVA test and logistic regression were conducted for the statistical analyses (α = 0.05).

RESULTS

A total of 7959 pairs of schoolchildren and their parents were invited to participate, and 5595 were included in this study according to the eligible criteria (response rate: 70.3%). The overall prevalence and mean dmft/DMFT of dental caries in the investigated schoolchildren were 52.78% and 2.11. The prevalence and mean dmft/DMFT were 39.05% and 1.63 in the deciduous teeth, while these were 21.45% and 0.48 in the permanent teeth, respectively. For the first permanent molars (FPMs), the rate of fully eruption and pit and fissure sealing (PFS) were 79.09% and 6.60%, respectively. Multiple logistic regression showed that girl (OR = 1.12, 95% CI 1.01-1.25, p < 0.05), seldom or never brush teeth (OR = 2.36, 95% CI 1.08-5.44, p < 0.05), consuming sweet food or drink once or more time a day (OR = 1.14, 95% CI 1.00-1.29, p < 0.05; OR = 1.21, 95% CI 1.07-1.36, p < 0.05), dental visit experiences (OR = 1.58, 95% CI 1.35-1.86, p < 0.001) were positively and no tooth pain in the past 12 months (OR = 0.55, 95% CI 0.38-0.80, p < 0.05) were negatively associated with caries.

CONCLUSIONS

Dental caries was prevalent among schoolchildren aged 6-8 years in Hangzhou, and was associated with gender, frequency of toothbrushing, sweet food or drink consuming, tooth pain and dental visit experiences. A large number of fully erupted FPMs did not receive timely PFS.

In-vivo durability of Pro Seal in patients with fixed orthodontic appliances: A controlled clinical trial

BACKGROUND

This clinical trial aimed at studying the durability of an orthodontic sealant (Pro Seal) used on tooth surfaces for protection against white spot lesions.

METHODS

A total of 35 patients (18 females, 17 males; 17.57 ± 1.36 years) were recruited. Eligibility criteria included healthy patients of both sexes (age > 14 years), absence of labial caries, absence of defective enamel, absence of extensive restorations, and optimum oral hygiene. The participants received a single application of Pro Seal on the bonded teeth. The sealant covered the labial enamel surrounding the brackets. Participants were recalled monthly after sealant application, during which sealant layers were evaluated using an ultraviolet lamp. The assessment was realized using an index similar to the adhesive remnant index (ARI).

RESULTS

A total of 30 participants completed the trial. ARI values dropped significantly (P < 0.001) and reached <1.5 at T₁ on the index used. An ARI value of 2 was chosen as the threshold below which a tooth presented an insufficient sealant layer. The right and left sides of both jaws did not show any statistically significant difference (P > 0.05). ARI values of homolateral teeth revealed few statistically significant differences between upper and lower teeth. No statistically significant difference between the two sexes (P > 0.05) existed. No harm or disturbance was reported by any of the participants.

CONCLUSIONS

This study demonstrated that a single application of Pro Seal is effective for 4 weeks and should be renewed monthly. No interjaw, intrajaw, or intersex significant differences were found.

Assessment of oral health status and related factors in adolescents aged 12-15 years in the Gansu Province of China: a cross-sectional survey

BACKGROUND

The national oral epidemiological survey conducted every decade has become an indispensable means of detecting changes in oral disease patterns. This study was undertaken to investigate the oral health status and related factors in 12-15-year-old students in Gansu, China.

METHODS

According to the methodology adopted by the Fourth National Oral Health Survey, a multi-stage, stratified, random sampling method was used to select 3871 adolescents aged 12-15 years from four regions of Gansu Province for oral examination and questionnaire survey. Caries experience was measured using the Decayed, Missing, and Filled Teeth (DMFT) index; and periodontal health examination included gingival bleeding, calculus, periodontal pockets and attachment loss. The questionnaire included questions regarding sociodemographic characteristics, and oral health knowledge and behaviors. SPSS20.0 software was used for statistical analysis of the survey data.

RESULTS

The mean DMFT index was 0.83 ± 1.42. The prevalence of caries experience was 38.6%, filling rate was 1.6%, and pit and fissure sealing rate was 0.5%. Logistic regression analysis showed that female sex, rural district, older age, non-only child, frequency of dental visits, and toothache experience were the risk factors for caries experience, with OR ranging between 1.280 and 3.831 (p < 0.05). Prevalence of healthy periodontium was 29.8%. Female sex, rural district, and younger age were found to be the protective factors for healthy periodontium, with OR ranging between 1.178 and 1.414 (p < 0.05).

CONCLUSIONS

Adolescents in Gansu Province had high prevalence of caries experience along with low filling rate, and low prevalence of healthy periodontium. Therefore, it is necessary to vigorously strengthen oral health education, disease prevention and control programs in the province. This would help improve the oral health-related quality of life of these individuals.

Preparation and characterization of dental pit and fissure sealant based on calcium sodium silicate bioactive glasses.. [DOI: 10.21203/rs.3.rs-2453592/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

This study aimed to prepare a resin based dental sealant loaded with novel bioactive glass formulated from (50 wt% calcium silicate and 50 wt% sodium silicate) with different percentages of fluorapatite. Four glass batches were formulated then characterized using Fourier Transform Infrared Spectroscopy analysis, X-ray powder diffraction analysis and Transmission electron microscopy. Density, microhardness and bioactivity testing after insertion in artificial saliva were done. Four Bisphenol-A glycerolate dimethacrylate based sealant loaded with the glass batch that showed the preeminent properties and silica fillers were prepared. The prepared sealants were compared to commercial sealants regarding flow, curing depth, compressive strength and microhardness. Sealant composition that showed comparable properties to that of the commercial sealant was selected for pH changes, ion release testing after immersion in artificial saliva for different time intervals. Results indicated the structural stability, amorphous nature, and bioactive behavior with apatite forming ability of the tested glass batches. Experimental sealant revealed comparable tested properties with lower compressive strength compared to the commercial sealants at P < 0.001. The mean pH values of the tested sealants ranged from 6.75 to 6.35 with extended calcium and phosphorus ion release up to 90 days. It was concluded that the 85 wt% calcium silicate and sodium silicate with 15 wt% fluoroapatite had the best trend regarding ion release and appetite forming ability. Sealant loaded with 65 wt% bioactive glass, 10 wt% sintered nanosilica and 10 wt% nanosilica had the best acceptable mechanical properties. The novel pit and fissure sealant is a promising bioactive and ion releasing material.

A novel application of a bioactive material as a pit and fissure sealant: in vitro pilot study evaluating the sealing ability and penetration

PURPOSE

To compare the sealing ability and penetration of a bioactive material used as pit and fissure sealant to those of glass ionomer sealant.

METHODS

This was an in vitro experimental study conducted on 20 permanent teeth. For Group I of ten teeth, ACTIVA BioACTIVE-Base/Liner was applied as a sealant on pits and fissures, and the remaining ten teeth of Group II were sealed using glass ionomer cement. After thermocycling, the apex of the teeth was sealed using composite resin and they were immersed in 1% methylene blue solution, buffered at pH 7 for 24 h. Longitudinal sections were obtained from each tooth for evaluating the sealing ability and penetration, using a binocular light microscope at 4 × magnification. The obtained data were subjected to analysis using the Chi-square test and independent t test.

RESULTS

The comparison of the sealing ability and sealant penetration, between the two groups, showed statistically no significant difference (p = 0.104 and p = 1.0, respectively).

CONCLUSION

Bioactive material as a pit and fissure sealant, performed on par with glass ionomer sealant in terms of tested properties like sealing ability and penetration.

Amyloid-Mediated Remineralization in Pit and Fissure for Caries Preventive Therapy

The pits and fissures of teeth have high caries susceptibility, and sealing these areas is considered as an effective method to prevent caries. However, long-term caries prophylaxis cannot be maintained because of the negative effects derived from the technical sensitivity and disadvantages of sealing materials. Herein, a new strategy is proposed to occlude fossae by amyloid-mediated biomimetic remineralization. In contrast to conventional inward blocking from the outside of fossae, amyloid-mediated biomimetic mineralization delivers an amyloid-like protein nanofilm into the deepest zone of the fossae and induces the formation of remineralized enamel inside. Such assembly from lysozyme conjugated with poly (ethylene glycol) enriches the interface with strongly bonded ionsand directs in situ nucleation to achieve enamel epitaxial growth. Not only is the structure of the enamel-like crystalline hydroxyapatite layer but also its mechanical stability is similar to that of natural enamel. Furthermore, the layer shows good biocompatibility and antibacterial properties. On the basis of the findings, it is demonstrated that amyloid-like protein aggregation may provide an enamel remineralization strategy to modify the current clinically available methods of pit and fissure sealing and shows great promise in preventing caries.

The Assessment of Sealants' Effectiveness in Arresting Non-Cavitated Caries Lesion-A 24-Month Follow-Up

Dental sealants are excellent means to prevent pits and fissure caries. Nowadays, the application of sealants is extended to therapeutic use in arresting non-cavitated carious lesions. This relatively new concept still lacks evidence to support its routine use. The aim of this study was to evaluate the effectiveness of a resin-based sealant applied on first permanent molars with carious lesions (ICDAS 1−3), in comparison with its effectiveness when applied on sound surfaces (ICDAS 0). Included in the study were 114 children aged between six and eight years old, with a high caries risk (according to the CAMBRA system), with all four permanent molars erupted and with deep pits and fissures. A total number of 407 molars were sealed and assessed. A total of 49 were excluded (they had caries, which according to the ICDAS II classification were classified with code 4−6 or had older sealants or fillings). Out of these 407 molars, 213 were sound (code 0) and 194 had caries lesions as follows: 56 teeth classified as code 1, 79 teeth classified as code 2, and 59 teeth classified as code 3 according to the ICDAS II classification. The retention of the sealant and carious lesions were assessed clinically at 6, 12, 18, and 24 months. Regarding sealant retention, a statistically significant difference (p < 0.05) among the two types of sealed teeth, sound (ICDAS 0) and decayed (ICDAS 3), showed at 18- and 24-month follow-up intervals. Regarding caries lesions, a statistically significant difference (p < 0.05) showed between sound (ICDAS 0) and decayed (ICDAS 3) molars at 24-month follow-up. Our study results supported the resin-based sealant effectiveness in arresting incipient carious lesions, which according to the ICDAS II classification have received codes 1 and 2 but did not support sealant effectiveness in arresting caries lesions classified according to the same classification with code 3.

Comparative Assessment of Retention and Caries Protective Effectiveness of a Hydrophilic and a Conventional Sealant-A Clinical Trial

Sealants are highly efficient and the most secure method for the prevention of caries lesions from pits and fissures in recently erupted permanent teeth. The aim of this study is to clinically assess and compare the retention and evolution of caries of a moisture-tolerant resin-based sealant with a conventional hydrophobic resin-based sealant. Material and method: We have included in the study 28 children with between 6 and 8 years old. For each child we sealed 4 permanent molars (a total of 112 teeth). The study group was divided into two subgroups: the Embrace Group—consisting of 56 first permanent molars that underwent dental sealing with moisture-tolerant resin-based fissure sealant (Embrace™ WetBond™ Pulpdent, Watertown, MA, USA) and the Helioseal Group—represented by the same number of 56 first permanent molars that were sealed with conventional hydrophobic resin-based sealant (Helioseal F™, Ivoclar Vivadent Schaan, Liechtenstein). The retention and the incidence of new carious lesions of each sealant were assessed clinically at 6, 12, 18, and 24 months. Results: The 12-month follow-up assessment showed perfect integrity in 50 molars (89.28%) sealed with moisture-tolerant resin-based material (Embrace Group), and in 51 molars (91.07%) with conventional resin-based sealant (Helioseal Group). At the 24-month recall, the retention was maintained in 44 molars (78.57%) in the Embrace Group and in 45 molars (80.35%) in the Helioseal Group, respectively. The follow-up assessments showed no statistically significant differences (p > 0.5) between the two materials regarding sealant retention. First evidence of new carious lesions was present at 12 months on two molars sealed with Embrace WetBond and on one molar sealed with Helioseal. At the 24-month evaluation, the prevalence of caries in the Embrace Group was 7.14% (four caries) and 3.56% (two caries) in the Helioseal Group. Moreover, there were no statistically significant differences (p > 0.05) between the two materials regarding new caries development at any of the follow-up assessments. Conclusions: Moisture-tolerant resin-based sealant was effective in terms of retention and caries prevention.

Minocycline incorporated cobalt oxide nanoparticles in dental sealants: An in vitro study

The purpose of this study was to introduce antibacterial property to pits and fissure sealant (PFS) in order to mitigate the major clinical problems associated with PFS, such as microleakage and secondary caries. We prepared a pH reliant cobalt oxide nanoparticle incorporated with minocycline (MNC@CO) and characterized to investigate its antibacterial potential against Streptococcus sobrinus. The physiochemical, morphological, and drug release kinetics at different pH (7.4, 5.0, and 3.5) from nanoparticles were investigated. The MNC@CO were added at 2.5% and 5.0% into experimental PFS and characterized for their antibiofilm capacity, biocompatibility, and mechanical properties including compressive and flexural strength. The groups 2.5% and 5.0% has shown statistically significant antimicrobial capacity against S. sobrinus compared to control (p < .05). The highest percentage of MNC release at different pH (especially at pH 5.0 and 3.5) was observed from 5.0% MNC@CO doped PFS. The PFS doped with 2.5% MNC@CO showed a highest compressive strength (110 MPa) over a period of 70 days as compared to 5.0% MNC@CO (75 MPa) and control (80 MPa). The flexural strength of both experimental groups was lower for both time points (24 h and 30 days) than control. In conclusion, the present study found that 2.5% MNC@CO doped PFS showed considerable anti-biofilm potential without compromising mechanical properties.

Shear Bond Strength and Microleakage of Pit and Fissure Sealants Placed after Saliva-Contaminated Etched Enamel

Saliva contamination of etched enamel before sealant application is the most common reason for failure of fissure sealants, thus affecting the effect of caries prevention. This study aimed to evaluate the shear bond strength (SBS) and microleakage of resin-based fissure sealant on saliva-contaminated etched enamel after rinsing, re-etching, and applying universal adhesive. Fifty human third molars were sectioned into 2 parts and embedded in acrylic resin to obtained 100 samples. The samples were randomly assigned to 5 groups: 1, etching; 2, etching + contamination; 3, etching + contamination + rinsing; 4, etching + contamination+ re-etching; 5, etching + contamination + universal adhesive. Each group was divided into 2 subgroups: 24 h storage and 5000× thermocycling. After measuring SBS, failure mode was analyzed. In an additional 15 teeth, microleakage was tested using dye penetration method. Three more teeth were used for scanning electron microscope (SEM) observation of the enamel surface morphology in each group. The adhesive group had significantly higher mean SBS after 24 h storage, while the re-etching group were better after 5000× thermocycling. The etching, etching+ contamination+ re-etching, and etching+ contamination+ universal adhesive groups showed the least microleakage. The SEM reveals considerable variations in the enamel surface appearance within groups. Re-etching or applying universal adhesive in saliva-contaminated etched enamel before sealant can achieve satisfactory results. Considering the less operative steps and the shorter chair time, applying universal adhesive is more recommended for a pediatric patient if saliva-contamination happened before sealant application.

Moisture Tolerant Pit and Fissure Sealant: A Literature Review

Even in the 21st century, dental caries are considered a global burden, severely upsetting the health and quality of life of those affected. Apart from the fluoride use and regular oral hygiene, one of the most important prophylactic approaches against caries occurrence is the sealing of pits and fissures. Pit and fissure sealants are a core part of the preventive program in pediatric dentistry and should be considered as a key component of minimally invasive dentistry due to their broad patient benefit. The primary sealant efficacy measure is retention. If the sealant remains bonded to the tooth and offers a good seal, then it is right to expect the occurrence of caries to be diminished. Traditional pit and fissure sealants are hydrophobic. These materials are based on bisphenol A-glycidyl methacrylate (bis-GMA) and other monomers requiring a dry field which is hard to achieve in an oral environment, especially for children. This review highlights the literature on the effectiveness of moisture tolerant pit and fissure sealant, which are the hydrophilic pit and fissure sealant, and a general overview of the pit and fissure sealant materials used for sealing occlusal surfaces, its classification as well as indications and possible side effects. How to cite this article: Priscilla S, GS P, Mohandoss S. Moisture Tolerant Pit and Fissure Sealant: A Literature Review. Int J Clin Pediatr Dent 2022;15(2):233-239.

Retention rate of resin sealants in dental enamel with structural alterations: a systematic review

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.

Comparative effectiveness research of two glass ionomer cements for primary molar fissure sealing

Relevance. A glass ionomer cement (GIC) is the material for primary teeth fissure sealing in children. The research aimed to study the comparative effectiveness of two GIC pit and fissure sealants in primary molars.

Materials and methods. Sixty-one children aged 2-5 years (mean 26.99 ± 0.55 months) participated in the study after obtaining the Local Ethical Committee’s permission and the parents’ informed consents. Non-invasive fissure sealing in primary molars was performed according to split-mouth design with two GIC: Fujy-9, GC, Japan (109 teeth, FV-group) and Polyakrilin, TehnoDent, Russia (106 teeth, PV-group). Follow-ups were provided after 6, 12, 18 and 24 months. Complete retention, partial retention or complete loss (%) of the sealants and the frequency (%) of fissure caries development were calculated. The chi-square criterion was used to assess the significance of the differences between the groups at p-value < 0.05.

Results. In 6 and 12 months, all the cases demonstrated complete or partial sealant retention and the absence of pit and fissure caries. The following results were found after 24 months: complete GIC retention in 8.6% of molars in FV-group and 1.9% in PV-group, (p < 0.05), partial retention – 78.8% and 79.0% (p > 0.05) respectively, complete loss – 6.7% and 11.4% respectively (p > 0,05). Fissure carious lesions were found only after 18 and 24 months in 2.8% cases in FV-group and 3.8% cases in PV-group, p > 0,05.

Conclusions. Both studied GICs for non-invasive primary molar fissure sealing were equally highly effective for pit and fissure caries prevention in children. Annual follow-ups in children are necessary for GIC sealant repair.

Sealant Utilization and its Influence on Caries Reduction in First Permanent Molars in Saudi Female School Children

Purpose:

This study aimed to assess the utilization of fissure sealants and their influence on caries reduction in first permanent molars (FPMs) among 6-9 years old female schoolchildren in Dammam, Eastern Province of Saudi Arabia.

Materials and Methods:

First to fourth grade female children from public schools in Dammam participated in this cross-sectional study. Dental caries and fissure sealants in FPMs were examined clinically using the World Health Organization guidelines. In addition, the parents of the participants responded to a self-reported questionnaire.

Results:

The study analyzed the data of 449 children. Almost 44.3% of the participants had at least one FPM affected with caries. There were 8.7% of the participants who had fissure sealants in at least one FPM, and out of these, only 2.2% had four FPMs filled with sealants. A significantly greater proportion of participants with sealed FPMs had no caries than the lower proportion of participants without sealants who had caries (P=<0.05). The use of sealants increased significantly from first grade (10.3%) to second grade (30.8%), third grade (38.5%), and fourth grade (20.5%) (P=0.006). High monthly family income (P= 0.047) and having insurance (P=0.017) were significantly associated with increased sealant application. Nearly 21.9% of participants’ parents were aware of caries protective effects of dental sealants.

Conclusion:

The application of sealants was significantly associated with reduced caries in FPMs. Class year, monthly family income, and insurance were significantly associated with having sealants. Caries prevention programs for children should incorporate sealant application.

Hypersensitivity relief of MIH-affected molars using two sealing techniques: a 12-week follow-up

Objectives

The aim of this study was to compare the efficacy in reducing hypersensitivity in molar incisor hypomineralization (MIH)-affected molars immediately and over 12 weeks after sealing using two different materials (composite and glass ionomer). Furthermore, the retention rates of both materials were analyzed.

Methods

Thirty-nine children with two MIH-affected molars showing hypersensitivity and non-occlusal breakdowns were included. Hypersensitivity was assessed with an evaporative (air) stimulus. Both teeth were sealed by two calibrated operators using a split-mouth design with either Clinpro Sealant in combination with Scotchbond Universal (C) or Ketac Universal (K), respectively. Clinical pain assessments (Schiff Score Air Sensitivity Scale [SCASS], Visual Analog Scale [VAS]) were made at baseline (“pre”), immediately after treatment (“post”), and after 1, 4, 8, and 12 weeks. Paired t tests were calculated in each group between baseline and all other time points.

Results

Thirty-eight children with 76 molars completed all stages of the study. Regardless of the material used, the application of the sealant decreased hypersensitivity significantly immediately as well as throughout the 12-week recalls (all p values < 0.001). We found no statistically significant difference among both materials chosen in any of the time points evaluated. Furthermore, retention of both materials was comparable in both groups.

Conclusions

Both sealant materials were able to reduce hypersensitivity successfully immediately and throughout the 12-week follow-up. Furthermore, their performance was similar in terms of retention.

Clinical relevance

Hypersensitivity can be a major complaint in patients with MIH. This is the first study evaluating hypersensitivity relief of MIH-affected molars using two sealing techniques.

The results of self-etching self-adhesive flowable composite application for primary molars fissure sealing in children

Relevance. The use of light-cure sealants and flowable composites for fissure sealing in children is difficult due to the complexity of the procedure. The research aimed to study the efficiency of self-etching self-adhesive flowable composite for fissure sealing in primary molars in children.Materials and methods. The Local Ethical Committee permission and written informed voluntary consents from the parents were obtained before the study. Non-invasive fissure sealing with self-etching self-adhesive flowable composite (Constic, DMG, Germany) was performed in 48 primary molars in 48 children aged 2-5 years (mean 41.2 ± 1.3 months). After 6, 12, 18 and 24 months, the sealant’s retention (%) and frequency (%) of occlusal caries development, and 95% confidence intervals (CI) were calculated. The significance of the difference was assessed by the Student’s t-test.Results. After 6 and 12 months, complete sealant’s retention was revealed in 75.0% (CI 61.2-85.1%) and 60.4% (CI 46.3-73.0%) molars, p > 0.05; it decreased to 27.1% (CI 16.6-41.0%) and 18.7% (CI 10.2-31.9%), p > 0.05, after 18 and 24 months. Complete loss of the sealant was noted in 8.3-18.7% cases. The first caries lesion (2.1%, CI 0.4-10.9%) on the surface with the lost sealant was revealed after 12 months, after 24 months – 4.2% (CI 1.1-14.0%).Conclusions. In primary molars after non-invasive fissure sealing with self-etching self-adhesive flowable composite, complete loss of the sealant was from 8.3% to 18.7% after 6-24 months post-op, partial loss was from 8.3% to 31.3%. Occlusal caries was revealed in 6.3% cases after the sealant loss.

Glass Ionomer Sealants Can Prevent Dental Caries but Cannot Prevent Posteruptive Breakdown on Molars Affected by Molar Incisor Hypomineralization: One-Year Results of a Randomized Clinical Trial

To evaluate the preventive effect of glass ionomer cement (GIC) against dental caries and posteruptive breakdown (PEB) on molars affected by molar incisor hypomineralization (MIH). In this randomized clinical trial, 77 children aged 5-9 years with at least 1 MIH-affected molar and without PEB or dentin caries lesions (n = 228) were included and randomly allocated to one of the following groups: (1) MIH-affected molars that remained unsealed and (2) MIH-affected molars that received GIC sealants. Dental caries and PEB were clinically evaluated after 6 and 12 months. Associations between dental caries and PEB with independent variables were evaluated using logistic regression analysis (p < 0.05). The MIH-affected molars allocated to the GIC sealant group were less likely to develop dental caries compared to those allocated to the unsealed group (OR = 0.23; 95% CI 0.06-0.95). Conversely, application of a GIC sealant was not associated with prevention of PEB (p = 0.313). Furthermore, MIH-affected molars presenting yellow-brown opacities were almost 5 times more likely to develop dental caries (p = 0.013) and PEB (p = 0.001) compared to those presenting white-creamy opacities. We can conclude that GIC sealants can prevent dental caries on MIH-affected molars; however, the same protective effect was not observed for PEB.

Dental Sealant Composition-Retention Assessment in Young Permanent Molars

Tooth decay in children and adolescents remains a public health problem, despite prophylaxis and preventive measures being largely available. The aim of our study was to evaluate the clinical behavior of four dental sealants, related to first permanent molar topography and patient age (when sealant was applied for the first time). We assessed, by means of visual inspection and palpation with a dental probe, a group of 200 children, enrolled corresponding to school age-grade (mean age of 7 years at baseline) and randomly divided according to the material used as dental sealant (Admira seal©, Embrace Wet Bond©, Fotoseal©, GC Fuji Triaje©) in 4 groups (n = 50). Sealant clinical evaluation was made at 6-, 12-, 18-month intervals for dental material retention assessment. At 6 months, the sealant detached the most from 3.6 molars, and the material used was Fotoseal© (27.6%). At 12 months, Fotoseal© (48.3%) and GC Fuji Triaje© (41.4%) from 3.6 molars express detachment. At 18 months, 4.6. molars sealed with Admira Seal© (25.7%) and Embrace Wet Bond© (28.6%) lost the sealant. We noticed less detachment in maxillary molars and if sealant was applied around 7 years of age. In conclusion, sealant application on first permanent molars must be encouraged and practitioners can choose between various materials available.

Impact of a toothpaste with microcrystalline hydroxyapatite on the occurrence of early childhood caries: a 1-year randomized clinical trial

The aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite is not inferior to a fluoride toothpaste in prevention of caries in children. This double-blinded randomized control trial compared two toothpastes regarding the occurrence of caries lesions using International Caries Detection and Assessment System (ICDAS) ≥ code 1 on the primary dentition within 336 days. The test group used a fluoride-free hydroxyapatite toothpaste three times daily while control group used a toothpaste with fluoride. 207 children were included in the intention-to-treat analysis; 177 of them finished the study per protocol. An increase in caries ICDAS ≥ code 1 per tooth was observed in 72.7% of the hydroxyapatite-group (n = 88), compared with 74.2% of the fluoride-group (n = 89). The exact one-sided upper 95% confidence limit for the difference in proportion of participants with ICDAS increase ≥ 1 (-1.4%) was 9.8%, which is below the non-inferiority margin of 20% demonstrating non-inferiority of hydroxyapatite compared to the fluoride control toothpaste. This RCT showed for the first time, that in children, the impact of the daily use of a toothpaste with microcrystalline hydroxyapatite on enamel caries progression in the primary dentition is not inferior to a fluoride control toothpaste (Clinical Trials NCT03553966).

The Change in DMFT of Six-Grade Primary School Children in Shiraz two Years after Implementation of the National Oral Health Reform Plan

Statement of the Problem:

The oral health reform plan has been added to the Iran's health reform plan since the beginning of 2015. Evaluation of Iran’s oral health reform plan has rarely been conducted.

Purpose:

The aim of this study was to evaluate the change in DMFT among the six-grade primary school children of the city of Shiraz, two years after implementation of oral health reform plan.

Materials and Method:

A repeated cross-sectional study was conducted on six-grade primary school children of Shiraz in 2015 and 2017. About four hundred children were selected each year by cluster randomization sampling. The schools were randomly selected from three socioeconomically different types of schools including private schools, state schools in affluent areas, and state schools in deprived areas. The DMFT Index of selected children was compared between 2015 and 2017, and among three socioeconomically different areas. One-way ANOVA and Poisson regression tests were used for statistical analysis.

Results:

The mean DMFT of children was 1.47±1.83 in 2015 and 1.29±1.79 in 2017. There was significant difference in mean DMFT value between years 2015 and 2017 (p= 0.048). The percentage of children with untreated dental caries was 46% and 36.7% in 2015 and 2017 respectively. There was no statistically difference in DMFT of the three socioeconomically different schools.

Conclusion:

There has been significant improvement in DMFT of sixth grade school children of Shiraz two years after implementation of oral health reform plan.

Fissure caries inhibition with a CO2 9.3-μm short-pulsed laser-a randomized, single-blind, split-mouth controlled, 1-year clinical trial

OBJECTIVES

The objective of this randomized, single-blind, split-mouth controlled, clinical trial was to evaluate whether the use of a short-pulsed 9.3-μm CO₂ laser increases the caries resistance of occlusal pit and fissures in addition to fluoride therapy over 12 months.

MATERIALS AND METHODS

A total of 60 participants, average age 13.1 years, were enrolled. At baseline, second molars were randomized into test and control, and assessed by ICDAS, SOPROLIFE, and DIAGNOdent. An independent investigator irradiated test molars with a CO₂ laser (wavelength 9.3 μm, pulse duration 4 μs, pulse repetition rate 43 Hz, beam diameter 250 μm, average fluence 3.9 J/cm², 20 laser pulses per spot). Test molars received laser and fluoride treatment, control teeth fluoride alone. Fluoride varnish was applied at baseline and at 6 months. After 6 and 12 months, teeth were again assessed.

RESULTS

A total of 57 participants completed the 6-month and 51 the 12-month recall. Laser-treated surfaces showed very slight ICDAS improvements over time with ICDAS change - 1 in 11% and 8%, no changes (ICDAS change 0) in 68% and 67%, and slightly worsened (ICDAS change 1) in 19% and 24% at 6- and 12-month recalls, respectively, and worsened by two scores in 2% at both recall time points. Control teeth showed significantly higher ICDAS increases, with 47% and 25% showing ICDAS change 0, ICDAS change 1 in 49% and 55%, and ICDAS change 2 in 4% and 20% at 6- and 12-month recalls, respectively. Differences in ICDAS changes between the groups were statistically significant (P = 0.0002 and P < 0.0001; Wilcoxon's signed-rank test, exact). A total of 22% of the participants developed ICDAS 3 scores on the control teeth.

CONCLUSIONS

Microsecond short-pulsed 9.3-μm CO₂ laser irradiation markedly inhibits caries progression in pits and fissures in comparison with fluoride varnish alone.

CLINICAL RELEVANCE

The 9.3-μm CO₂ laser irradiation of pits and fissures enhances caries resistance.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT02357979.

Novel pit and fissure sealant containing nano-CaF2 and dimethylaminohexadecyl methacrylate with double benefits of fluoride release and antibacterial function

OBJECTIVE

Pit and fissure sealants with antibacterial and remineralization properties have broad application prospects in caries prevention. The objectives of this study were to: (1) develop a novel pit and fissure sealant containing CaF₂ nanoparticles (nCaF₂) and dimethylaminohexadecyl methacrylate (DMAHDM); and (2) investigate the effects of nCaF₂ and DMAHDM on biofilm response and fluoride (F) ion release for the first time.

METHODS

Helioseal F was used as a control. Bioactive sealants were formulated with DMAHDM and nCaF₂. Flow properties, enamel shear bond strength, hardness and F ion releases were measured. Streptococcus mutans (S. mutans) biofilms were grown on sealants. Biofilm metabolic activity, lactic acid production, colony-forming units (CFU), and pH of biofilm culture medium were measured.

RESULTS

Adding 5% DMAHDM and 20% nCaF₂ did not reduce the paste flow and enamel bond strength, compared to control (p < 0.05). Hardness of sealants with 20% nCaF₂ and DMAHDM was higher than control (p < 0.05). The F ion release from 20% nCaF₂ was much higher than that of commercial control (p < 0.05). The sealant with DMAHDM reduced the S. mutans biofilm CFU by 4 logs. The pH in biofilm medium of the new bioactive sealant was much higher (pH 6.8) than that of commercial sealant (pH 4.66) (p < 0.05).

SIGNIFICANCE

The new bioactive pit and fissure sealant with nCaF₂ and DMAHDM achieved high fluoride release and strong antibacterial performance. This novel fluoride-releasing and antibacterial sealant is promising to inhibit caries and promote the remineralizaton of enamel and dentin.

Ameloplasty is counterproductive in reducing microleakage around Resin Modified Glass Ionomer and Resin based fissure sealants

Objective:

To compare the microleakage around resin modified glass ionomer cement (RMGIC) based sealants and flowable resin based sealants placed with or without ameloplasty in extracted human teeth.

Methods:

This in-vitro experimental study was conducted at the Operative Dentistry Department, Dow University of Health Sciences, Karachi, Pakistan from June 2017 to December 2018. Sixty extracted human molars and premolars were assigned to four groups (n=15) each, according to the type of fissure sealant (flowable resin based sealant or resin modified glass ionomer based sealant) used and either placed with or without ameloplasty. Specimens were thermocycled and then immersed in 1% methylene blue for 24 hours. Specimens were then sectioned and examined using stereo-microscope (50X) for microleakage that was scored on an ordinal scale. Mann-Whitney U test and Ordinal regression were applied. Level of significance kept at 0.05.

Results:

There was a statistically significant difference (p-value <0.001) between the two sealant types for the microleakage scores. Sealants placed with ameloplasty demonstrated significantly higher microleakage values (p-value <0.001).

Conclusion:

Microleakage was found to be more pronounced in RMGIC based sealants compared to the resin based sealants. Ameloplasty resulted in higher leakage around the sealants irrespective of the chemistry of material.

The synergistic effects of SrF2 nanoparticles, YSZ nanoparticles, and poly-ε-l-lysin on physicomechanical, ion release, and antibacterial-cellular behavior of the flowable dental composites

Resin-based pit-and-fissure sealants (flowable resin composites) were formulated using bisphenol-A-glycerolatedimethacrylate (Bis-GMA)-triethylene glycol dimethacrylate-(TEGDMA)-diurethanedimethacrylate (UDMA) mixed monomers and multiple fillers, including synthetic strontium fluoride (SrF₂) nanoparticles as a fluoride-releasing and antibacterial agent, yttria-stabilized zirconia (YSZ) nanoparticles as an auxiliary filler, and poly-ε-l-lysin (ε-PL) as an auxiliary antibacterial agent. Based on the physical, mechanical and initial antibacterial properties, the formulated nano-sealant containing 5 wt% SrF₂, 5 wt% YSZ and 0.5 wt% ε-PL was selected as the optimal specimen and examined for ion release and cytotoxicity. The results showed an average release rate of 0.87 μg·cm^-2·day^-1 in the aqueous medium (pH 6.9) and 1.58 μg·cm^-2·day^-1 in acidic medium (pH 4.0). The maximum cytotoxicity of 20% toward human bone marrow mesenchymal stem cells (hMSCs) was observed according to the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) cytotoxicity assay and acridine orange staining test. A synergy between SrF₂ nanoparticles and ε-PL exhibited a better antibacterial activity in terms of colony reduction compared to the other samples. However, the inclusion of SrF₂ and ε-PL caused mechanically weakening of the sealants that was partly compensated by incorporation of YSZ nanoparticles (up to 10 wt%).

Pit and fissure sealants penetration capacity and their correlation with fissure morphology

Background and aims

Pit and fissure sealant placement corresponds to an effective approach of the prevention of caries on occlusal surfaces. Fissure morphology and dental material characteristics are the key factors for sealant effectiveness. The aim of this in vitro study was to compare the penetration ability of two commercially available pit and fissure sealants.

Methods

Twenty sound human premolars extracted for orthodontic purpose have been sealed according to manufacturer’s instructions as follows: Group I (n=10), light-cured unfilled resin-based sealant, Admira Seal® (Voco GmbH); Group II (n=10), resin modified glass ionomer sealant without varnish, GC Fuji Triage® (GC Corporation). The teeth have been sectioned buccal-lingually in the middle of the occlusal surface, and the sections were examined at 40× with an inverted microscope.

Results

Penetration of the sealants was found to be greater in U-type fissure pattern (91.69%) followed by V-type (75.42%), IK-type (71.24%) and then in I-type (63.98%). The depth of penetration of GC Fuji Triage® (82.85%) demonstrated to be superior to Admira Seal® (76.28%).

Conclusion

U fissure design was more common than other fissure patterns and showed significantly higher penetration for the two type of sealants evaluated. Resin modified glass ionomer sealant used in the present study perform comparably with the filled resin sealant.

Efficacy of CO lasers in preventing dental caries in partially erupted first permanent molars: a randomized 18-month clinical trial

The aim of this controlled randomized double-blinded clinical trial was to evaluate the use of a CO₂ laser with or without topical application of acidulated fluorides in the prevention of dental caries in partially erupted first permanent molars. We selected 61 healthy children at high risk of caries, all between 6 and 8 (7.1 ± 0.8) years of age and with 4 partially erupted first permanent molars. A CO₂ laser device emitting at 10.6 μm was used (0.5 W, 0.05 mJ per pulse, 10 kHz). Each first molar in an individual was randomly assigned to one treatment: (L) CO₂ laser (0.066 J/cm²); (FL) 1.23% acidulated fluoride gel and CO₂ laser (0.066 J/cm²); (V) 5% fluoride varnish, or (S) sealant (control). Patients were followed-up at 3, 6, 12, and 18 months after treatment, through direct visual examination and by an operator blinded to the treatments (kappa ≥ 0.70). The International Caries Detection and Assessment System (ICDAS-II) index was used to assess the soundness of tooth structure or the presence of white spot lesions, cavitated enamel, and/or dentin lesions. The Yildiz Visual Index was used to evaluate sealant retention. Results were evaluated using Kaplan-Meier survival analysis, and the hazard ratio of the treatments was estimated using shared frailty models with a gamma distribution, which considered the patient as a cluster. There were no significant differences among treatments compared to sealants. After 18 months, the use of a CO₂ laser with or without acidulated fluorides was shown to be effective in preventing caries on the occlusal surface of partially erupted permanent first molars in children at high risk for caries.

Dental caries experience and socio-economic status among Iranian children: a multilevel analysis

BACKGROUND

Socio-economic factors are considered as main determinants causing disparities in oral health across different countries. The aim of the present study was to investigate the associations of social and economic factors with dental caries experience among 6- and 12-year-old Iranian children.

METHODS

In this cross-sectional study, a total of 31,146 students, aged 6 and 12 years old, were enrolled from all (31) provinces in Iran. Based on the standardized World Health Organization (WHO) criteria for oral health surveys, dental caries indices in primary and permanent teeth were assessed by clinical examination in schools. Data on socio-economic status was obtained from the modified WHO questionnaire and national data bank. The decayed, missing and filled teeth (dmft/DMFT) indices for primary and permanent dentition were compared at the individual and provincial levels using multilevel regression analysis. Poisson regression analysis was used to evaluate the association of social (demographic and behavioral) determinants with dental caries indices among individuals. To assess the causes of difference in dental caries indices across provinces, justifiable economic factors were also analyzed using poisson regression analysis.

RESULTS

The mean (SE) of dmft and DMFT were 5.84 (0.05) and 1.84 (0.03), for 6-and 12-year-old children, respectively. The differences of dental caries indices were statistically significant among provinces. Higher level of parental education was negatively related to dental caries indices of both age groups. Rural residency was positively and dental flossing was reversely associated with dmft index of 6-year-old children. Negative associations were found between frequency of tooth brushing and preventive dental utilization with dmft and DMFT indices. Gross Domestic Product (GDP) index had negative and Consumer Price Index (CPI) had positive associations with dmft and DMFT indices in both age groups. However, positive relationships were observed between Gini index with DMFT index among 12-year-old children; as well as between the number of dentists per capita with dmft index among 6-year-old children.

CONCLUSION

Socio-demographic and behavioral factors were found to be associated with dental caries experience. However, economic indicators had the greatest importance.

Study protocol of the cost-effectiveness comparison of two preventive methods in the incidence of caries: A randomized, controlled clinical trial

INTRODUCTION

Dental caries is the most frequent oral disease worldwide and the main cause of tooth loss in children and young adults. One of the most frequently affected areas is the occlusal surfaces of the first permanent molars (FPM) due to their morphological complexity. At present, several preventive treatments can reduce the incidence of this disease in school populations. In Mexico, the most commonly used technologies are those derived from some presentation of fluoride; on the other hand, research on this topic has been limited.

OBJECTIVE

To determine the cost-effectiveness of two different methods for preventing the incidence of caries on the FPM of schoolchildren (6-8 years of age) from public primary schools.

MATERIAL AND METHODS

This is a randomized experimental design. Participants will be assigned to two treatment groups of 114 each. In the first group, pit and fissure sealants will be applied, whereas the second group will receive a fluoride varnish. The work will be carried out in schoolchildren that attend public elementary schools in the state of Hidalgo, Mexico. The result variable will be the incidence of caries and the total cost of each of the interventions will be calculated in order to calculate the intervention's cost-effectiveness.

CONCLUSION

This work will allow us to compare the cost-effectiveness of the pit and fissure sealants and the fluoride varnish in order to determine which offers the best results.