Pit and fissure sealants for preventing decay in the permanent teeth of children and adolescents

Finnish Office for Health Technology Assessment / FinOHTA, National Research and Development Centre for Welfare & Health / STAKES, Finn-Medi 3, Biokatu 10, Tampere, Finland, 33520.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2008; 4(4):CD001830. DOI: 10.1002/14651858.CD001830.pub3
Source: PubMed


Children who have their molar teeth covered by a sealant are less likely to have dental decay in their molar teeth than children without sealant. Sealants are coatings applied by the dentist or by another person in dental care on the grooves of mainly molar teeth. These coatings are intended to prevent the growth of bacteria that promote decay in grooves of molar teeth. The review shows that after 4.5 years the sealed permanent molar teeth of children aged 5 to 10 had over 50% reduction in decay on biting surfaces compared to teeth without sealants. One study with longer follow up showed that after 9 years only 27% of sealed tooth surfaces were decayed compared to 77% of tooth surfaces without sealant.

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    • "Subsequent clinical research compared the development of carious lesions/cavities in sealed teeth with that in non-sealed teeth as controls, mainly in split mouth trials, and established retention longevity of the sealant material functions as a beneficial factor in the prevention of caries [9] [10] [11]. A subsequent systematic review by the Cochrane collaboration , confirmed these findings [12]. *Address correspondence to this author at the SYSTEM Initiative/Department of Community Dentistry, Faculty of Health Sciences, University of the Witwatersrand, "
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    ABSTRACT: Purpose: The null-hypothesis that retention loss of resin fissure sealants predicts caries manifestation no more accurately than random values was tested. Methods: Systematic reviews were checked and electronic databases searched for clinical trials. Trials reporting on the retention of resin sealants and caries occurrence in permanent molar teeth, with minimum 24-month follow-up period, were included. Extracted data: number of sealed teeth, number of teeth without completely retained sealants, number of sealed teeth with caries. The number of teeth with complete sealant retention and absence of carious lesions/cavities was calculated; the predictive outcomes: true/false positive; false/true negative were established. Random values were generated as control-data. Diagnostic Odds ratios (DOR) were computed and tested for statistical difference. Summary Receiver Operating Characteristic curves were plotted. Results: 95 trials were found. Median DOR values were 1.21 and 0.28 for test- and control data, respectively. Wilcoxon test (z = 0.56; p = 0.58) and Sign test (z = 1.38; p = 0.17) results were statistically non-significant. The null-hypothesis was not rejected. Conclusions: Predictions based on the retention loss of resin sealants, regarding caries manifestation, was no more accurate than random guesses. Sealant retention loss appears not to be a valid predictor for clinical outcome.
    Full-text · Article · May 2013 · The Open Dentistry Journal
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    • "Increased mechanical strength of a material placed over pit and fissures can support occlusal stresses during chewing, protecting the adhesive interface and increasing long-term retention. It has been shown that long-term retention of the sealant is a crucial requirement for effective caries prevention2,3 and for arresting caries progression.4 "
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    ABSTRACT: This study aimed to evaluate the impact of extended photoactivation time on ultimate tensile strength (UTS), water sorption (WS) and solubility (WSB) of resin-based materials used as fissure-sealants. A fissure-sealant (Fluroshield) and a flowable composite (Permaflo) polymerized for 20 and 60 seconds were tested. For UTS, 20 hourglass shaped samples were prepared representing two materials and two photoactivation time (n=5). After 24-h dry-storage, samples were tested in tension using a universal testing machine at a cross-head speed of 0.5 mm/min (UTS was calculated in MPa). For WS and WSB, 20 disks with 5 mm diameter and 1 mm height (n=5) were prepared and volumes were calculated (mm(3)). They were transferred to desiccators until a constant mass was obtained (m1) and were subsequently immersed in distilled water until no alteration in mass was detected (m2). Samples were reconditioned to constant mass in desiccators (m3). WS and WSB were determined using the equations m2-m3/V and m1-m3/V, respectively. Data were subjected to two-way ANOVA and Tukey's HSD test (P<.05). There was no significant difference between materials or photoactivation times for the UTS and WS. Permaflo presented lower but negative WSB compared to Fluroshield. Extended photoactivation time did not improve the physical properties tested. Fluroshield presented physical properties that were similar to or better than Permaflo.
    Full-text · Article · Oct 2012
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    • "Resin-based dental sealants are the most common protective coating for permanent molars and have demonstrated effectiveness in preventing (evidentiary level 1a) (14, 15) and arresting the progression of dental caries (16, 17). The number of children receiving sealants during routine pediatric dental care is increasing steadily, stimulated by federal programs at the Centers for Disease Control and Prevention and the Maternal and Child Health Bureau in the USA and school-based dental programs (18). "
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    ABSTRACT: Dental sealants and composite filling materials containing bisphenol-A (BPA) derivatives are increasingly used in children. The aim of this study was to evaluate the association between salivary BPA and the number of tooth surfaces filled with dental sealant, and to determine a cutoff BPA level. Salivary BPA concentration and the number of tooth surfaces filled with dental sealant/resin were determined in 124 age and gender matched children: 62 controls had no dental sealant/resin on their tooth surfaces and 62 cases had more than 4 tooth surfaces with dental sealant/resin. Analysis of covariance (ANCOVA) and conditional logistic regression were performed after controlling for age, gender, salivary flow rate, salivary buffer capacity, frequency of snacking, and frequency of tooth brushing. Salivary BPA levels were 0.002 to 8.305 µg/L. The BPA level of control (0.40 µg/L) was significantly lower than that of case (0.92 µg/L) after controlling for confounders (P = 0.026). Although the 90th BPA percentile had an adjusted OR of 4.58 (95% CI 1.04-20.26, P = 0.045), the significance disappeared in the conditional logistic model. There may be a relationship between salivary BPA level and dental sealant/resin.
    Full-text · Article · Sep 2012 · Journal of Korean medical science
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