Occlusal caries prevention in high and low risk schoolchildren. A clinical trial. Clinical effectiveness of an autopolymerized fissure sealant after 2 years. Evaluation of non-invasive treatment applied to occlusal surfaces. Caries-preventive efficacy and retention of a resin-modified glass ionomer cement and a resin-based fissure sealant: a 3-year split-mouth randomised clinical trial. Caries-preventive effect of sealants produced with altered glass-ionomer materials, after 2 years. Sealant and fluoride varnish in caries: a randomized trial. Comparing the caries-preventive effect of two fissure sealing modalities in public health care: a single application of glass ionomer and a routine resin-based sealant programme. A randomized split-mouth clinical trial. Randomized trial on fluorides and sealants for fissure caries prevention. Effectiveness of a glass ionomer cement used as a pit and fissure sealant in recently erupted permanent first molars.
To evaluate the caries-preventive effect of a resin-modified glass-ionomer cement used as occlusal sealant (Vitremer) compared with fluoride varnish (Duraphat) application on occlusal surfaces of permanent first molars (OSPFM) in 6-8 year-old schoolchildren (n=268) at high (HR) and low (LR) caries risk.
                The children were followed-up for 24 months after being systematically allocated into six groups as follows: Control Groups HRC and LRC: children receiving oral health education (OHE) every 3 months; Groups HRV and LRV: children receiving OHE plus varnish application biannually; and Groups HRS and LRS: children receiving OHE plus a single sealant application . The baseline and follow-up examinations were performed by the same calibrated dentist under natural light, using CPI probes and mirrors, after toothbrushing and air-drying. The DMFS was used to record dental caries, in addition to the detection of initial lesions (IL). Data analysis was performed with two primary outcome measures: DMF and DMF+ IL on the OSPFM.
                After 24 months, only the HRS group showed statistically lower DMF and DMF+IL increments on OSPFM compared with HRC group. HRV group did not differ from HRC and HRS groups. For LR groups, no statistical difference (P> 0.05) was observed among the treatments. The clinical effectiveness of Delton fissure sealant was studied in 205 children, ages 6--10 years (mean age 71/2). 993 children in grades 1, 2, 3 and 4 were screened and subjects were selected if there was evidence of previous dental caries in the mouth, and a pair of contralateral maxillary or mandibular first permanent molar teeth were free of caries. Two pedodontists independently examined the children in a mobile van equipped with two operatories, and each applied sealants to approximately half of the subjects. After 11 months, in 186 subjects there were 10 sealants partially lost, five experimental teeth carious or filled and 53 control teeth carious or filled. After 24 months, in 175 subjects there were four sealants completely lost, 12 sealants partially lost, 11 experimental teeth carious or filled and 89 control teeth carious or filled. Consequently, sealant retention was 92% after 11 months and 85% after 24 months. Percent effectiveness in caries reduction was 90% after 11 months and 88% after 2 years. The purpose of this study was to evaluate the efficacy of non-invasive methods of treatment for active incipent occlusal caries. Anamnesis, professional prophylaxis, and visual inspection were used to classify 250 Brazilian pre-school-children. First permanent decayed molars (n=98) from thirty-one subjects (6 years+ 6 months) were selected and divided into three groups. Group 1: fissure sealants with resin-modified glass ionomer - Vitremer (n=29); Group 2: fluoride varnish -Duraphat (n=36) and control group: tooth brushing and 0.2 percent NaF weekly mouthwashes (n=33). Four clinical evaluations were carried out over three, six, nine, and twelve months. Caries activity and progression were observed through clinical and radiographic evaluation. The results were analyzed by Fisher=s Exact test. After twelve months, the results showed 100 percent of arrestment of caries activity for Group 1, 83.3 percent for group 2, and 72.7 percent for control group. At the same time, the results showed 0 percent of caries progression for group 1, 5.5 percent for Group 2, and 6.1 percent for control group. Group 1 showed a better inactivation property than the other groups (p<0.05). There were no statistically significant differences in caries progression among these groups (p>0.05). It was concluded that this non-invasive methods were able to arrest the progression of occlusal caries, but fissure sealant showed better results in controlling caries activity. This prospective clinical trial compared the retention rate and caries-preventive efficacy of two types of sealant modalities over a 3-year period.
                Using a split-mouth randomised design, 1280 sealants were randomly applied on sound permanent second molars of 320 young patients aged between 12 and 16 years. Half of the teeth (n = 640) were sealed with a resin-modified glass ionomer cement (RMGIC) (Vitremer™, 3M ESPE) and the other half (n = 640) with a conventional light-cure, resin-based fissure sealant (LCRB) (Fluoroshield®, Dentsply Caulk). Teeth were evaluated at baseline, 6-, 12-, 18-, 24-, 30- and 36-month intervals with regard to retention and new caries development.
                On the sealed occlusal surfaces after 3 years, 5.10% of RMGIC and 91.08% of LCRB sealants were totally intact and 6.37% of RMGIC and 7.65% of LCRB sealants were partially intact. New caries lesions were found in 20.06% of RMGIC sealed occlusal surfaces, compared to 8.91% for LCRB sealants.
                The findings of the present clinical study suggest that RMGIC should be used only as a transitional sealant that can be applied to newly erupting teeth throughout the eruptive process, whereas LCRB sealants are used to successfully prevent occlusal caries lesions once an effective rubber dam can be achieved. It can be concluded that there are differences between the RMGIC and LCRB sealants over a 3-year period in terms of the retention rate and caries-preventive efficacy. RMGIC can serve as a simple and economic sealing solution, however provisional. Due to its poor retention rate, periodic recalls are necessary, even after 6 months, to eventually replace the lost sealant. The aim of the present study was to investigate the caries-preventive effect of sealants produced with a high-viscosity glass-ionomer with an elevated powder-liquid ratio (ART), of having energy added to this glass-ionomer, and that of glass-carbomer, in comparison to that of resin composite sealants.
                The randomized controlled trial covered 407 children, with a mean age of 8 years. At a school compound three dentists placed sealants in pits and fissures of high caries-risk children. Evaluation by two independent evaluators was conducted after 0.5, 1 and 2 years. The Kaplan-Meier survival method, ANOVA and t-test were used in analyzing the data.
                1352 first permanent molars were sealed. 6.6% of children and 6.8% of sealants dropped out within 2 years. 27 re-exposed pits and fissures, 20 in occlusal and 7 in smooth surfaces, in 25 children, developed a dentin carious lesion. The cumulative survival of dentin carious lesion-free pits and fissures in the glass-carbomer sealant group was statistically significantly lower (97.4%) than those in the high-viscosity glass-ionomer with energy supplied (99%) and the resin-composite (98.9%) sealant groups. There was no statistically significant difference in the cumulative survival of dentin carious lesion-free pits and fissures, between the high-viscosity glass-ionomer with (99%) and without (98.3%) energy supplied sealant groups, after 2 years.
                The survival of dentin carious lesion-free pits and fissures was high in all sealant types. More dentin carious lesions were observed in the glass-carbomer sealant group.
                Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved. Little is known about the effect of discontinuation of sealant or fluoride varnish. The purpose of this study was to compare sealant with fluoride varnish in the prevention of occlusal caries in permanent first molars of children over a nine-year period: 4 yrs for program evaluation plus 5 yrs of discontinuation. A clinical trial was conducted on three groups of six- to eight-year-old schoolchildren: a control group (n = 45); a group (n = 37) in which sealant was applied and reapplied up to 36 mos; and a group (n = 38) in which fluoride varnish was applied and re-applied up to 42 mos. Percent caries reduction was studied in these initially healthy molars with complete occlusal eruption: 129 (control), 113 (sealant), and 129 (varnish) molars met inclusion criteria. Of these, 76.7%, 26.6%, and 55.8% had developed occlusal caries at 9 yrs, which implies caries reductions of 65.4% (SE = 8.5%) for sealants vs. control and 27.3% (SE = 10.2%) for varnish vs. control. Furthermore, the varnish program was not effective during the discontinuation period. The aim of this study was to compare the caries-preventive effect of two types of sealant modalities and to evaluate whether the caries-preventive effect is related to sealant retention. A hypothesis was tested in which a glass ionomer sealant, once applied to the occlusal surface, was able to protect the fissure from caries even if the sealant appeared lost at visual inspection.
                A 3-year randomized split-mouth trial evaluating two sealant modalities was performed at a public health centre in Finland. A chemically curing glass ionomer cement (GIC) and light-curing resin-based (RB) sealant material were applied randomly to the permanent second molars. Sealant application as a routine treatment procedure was carried out to 599 children in the age group of 12-16 years. Caries rate of the sealed teeth and sealant retention with both materials were analysed by a modified McNemar's test. The effectiveness, rate difference, and relative risk with both sealant materials were measured.
                The difference in caries rate between the two modalities was highly significant. When compared to the GIC sealant method, the effectiveness of RB sealant method was 74.1% and the rate difference 3.2% (95% CI 1.44%, 4.98%). The relative risk for RB-sealed surfaces vs. GIC-sealed surfaces of having detectable dentin caries was 0.26 (95% CI 0.12, 0.57). The retention rate of sealants was higher with RB than GIC (P < 0.001). The effectiveness of the retention rate for RB sealants was 94.8% and the rate difference 87.2% (95% CI 83.86%, 90.50%). The relative risk during the 3-year study period of having a defective or lost RB sealant was 0.052 (95% CI 0.036, 0.075) when compared to having a defective or lost GIC sealant.
                It is concluded that in preventing dentin caries a RB sealant programme including resealing when necessary was more effective than a single application of GIC. The original hypothesis was thus falsified. To investigate the effectiveness of topical fluorides in preventing fissure caries, we conducted a randomized controlled trial with parallel groups. In total, 501 children (1,539 molars, 3,078 sites), mean age 9.1 years, who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited. They were randomly allocated among four groups: (1) resin sealant, single placement; (2) 5% NaF varnish, semi-annual application; (3) 38% silver diamine fluoride (SDF) solution, annual application; and (4) placebo control. Follow-up examinations were conducted every 6 months by a masked examiner. After 24 months, 485 children (97%) were examined. Proportions of pit/fissure sites with dentin caries in the sealant, NaF, SDF, and control groups were 1.6%, 2.4%, 2.2%, and 4.6%, respectively. A multi-level logistic regression analysis accounting for the effects of data clustering and confounding factors showed that fissures in any of the three treatment groups had significantly lower risks of carious cavity development into dentin than did controls (p < 0.05). We concluded that placement of resin sealant, semi-annual application of NaF varnish, and annual application of SDF solution are all effective in preventing pit and fissure caries in permanent molars (ClinicalTrials.gov number CT01446107). This study's purpose was to evaluate the caries-preventive effect of a glass ionomer cement (GIC) used as an occlusal sealant on recently erupted permanent first molars.
                A double-blind, randomized, controlled, clinical trial was undertaken that included 36 5- to 8-year-olds (and 92 permanent first molars) who were randomly allocated to the test group (GIC) or the control group (auto-polymerized resin-based sealant [RBS]). The Mann-Whitney test was used to compare the number of new carious or filled occlusal surfaces in the 2 groups.
                After 6 months, 1 occlusal surface in the test group and 2 occlusal surfaces in the control group showed carious lesions (P=.15). In the fifth year of follow-up, 2 occlusal surfaces in the test group and 7 occlusal surfaces in the control group were filled or carious (P=.42), and the mean number of sealed surfaces that became carious or filled was 0.2 (95% confidence interval [CI]=0.02-0.70) for the GIC-sealed teeth and 0.6 (95% CI=0.20-1.30) for the RBS-sealed teeth (P=.30).
                High-viscosity glass ionomer cement can provide some level of protection against dental caries when used as a dental sealant in newly erupted permanent first molars.
The application of sealants is a recommended procedure to prevent or control caries. Sealing the occlusal surfaces of permanent molars in children and adolescents reduces caries up to 48 months when compared to no sealant, after longer follow-up the quantity and quality of the evidence is reduced. The review revealed that sealants are effective in high risk children but information on the magnitude of the benefit of sealing in other conditions is scarce. The relative effectiveness of different types of sealants has yet to be established.