Clinical evaluation of three different materials used as pit and fissure sealant: 24-months results. Clinical evaluation of glass-ionomer/resin-based hybrid materials used as pit and fissure sealants. Comparison between saliva stimulants and a saliva substitute in patients with xerostomia and hyposalivation. Fissure sealants: a 4-year clinical trial comparing an experimental glass polyalkenoate cement with a bis glycidyl methacrylate resin used as fissure sealants. Effectiveness of a glass ionomer cement used as a pit and fissure sealant in recently erupted permanent first molars. Mucogingival versus guided tissue regeneration procedures in the treatment of deep recession type defects. An investigation of the relative efficacy of Buckley's Formocresol and calcium hydroxide in primary molar vital pulp therapy. 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. Clinical and antibacterial effectiveness of three different sealant materials.
To evaluate the retention and caries experience effects of three different materials used as fissure sealants after 24 months of clinical application: a resin-modified glass ionomer cement (A), a flowable resin composite (B) and a compomer (C). One hundred and seventeen (117) teeth were sealed with material A, 119 teeth with material B and 120 teeth with material C. Children were randomly assigned. Each one received only one of the materials studied. Plaque index, dmft score and socioeconomic level were scored at baseline. The clinical exams were conducted 6, 12 and 24 months after application of the sealant. Statistical analysis (Kruskal-Wallis) revealed that there were statistically significant differences between the retention rates of groups A and B and between groups B and C after 2 years, with material B showing better results. After 2 years, 3.1% of the teeth of group A, 4.3% of group B and 6.7% of group C were Carious+Filled. There was no evidence of association between caries presence after 2 years and plaque index, dmft score and socioeconomic level. These results suggest that flowable resin composite had a satisfactory retention after this period of evaluation and all three materials were effective on occlusal caries prevention. The objective of the present study was to clinically evaluate the hybrid materials Vitremer and Dyract when used as pit and fissure sealants.
                The materials were applied in pairs on the mandibular permanent first molars of 100 children, 7 to 8 years old.
                After 12 months of sealing, the clinical evaluation presented rates of 95.9% and 85.7% of complete retention for Dyract and Vitremer, respectively, indicating a statistically significant difference. The hybrid materials presented a statistically significant protective effect against caries compared with the control group at 6 and 12 months.
                The hybrid materials were able to control occlusal caries. The purpose of this study was to assess patient preference and product efficacy of three non-prescription products for the symptomatic relief of xerostomia. The study group consisted of 80 individuals with a complaint of chronic (> six months) xerostomia and an unstimulated salivary flow rate of < 0.1 mL/min. The three products--a sorbitol/xylitol-sweetened chewing gum, a sorbitol-sweetened sour lemon lozenge, and a sorbitol/xylitol-sweetened artificial saliva substitute spray--were assigned in a permuted block randomization scheme. Each product was used for two weeks with an interval of one week between trials. The study did not identify any product to be statistically significant in terms of patient preference. Kruskal-Wallis testing revealed no statistical significance (P > 0.589) among the products. No product demonstrated marked efficacy in stimulating salivary output. ANOVA analysis followed by Tukey HSD testing revealed no significant difference between the baseline paraffin-stimulated mean flow rate and the gum- and lozenge-stimulated flow rates. The 4-year results of a fissure sealant trial are reported. Glass polyalkenoate and bis GMA sealant were applied to 590 first permanent molar teeth using a half mouth study design in a group of 228 6-8-year-old children. Similar cariostasis was observed for the two materials at the end of 4 years despite marked differences in retention. Polyalkenoate cements probably should be regarded as 'fluoride depot' materials rather than fissure sealants when used in this context. 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 objective of the study was to compare the clinical efficacy of 3 surgical approaches in the treatment of deep recession type defects. Fifty-four (54) gingival recessions > or = 5 mm were randomly assigned to 1 of the 3 treatment groups by blocking the prognostic variables. The first group was treated with a guided tissue regeneration (GTR) procedure using a bioabsorbable membrane, the second with non-resorbable membrane, and the third with a mucogingival surgical approach consisting of a connective tissue graft combined with a coronally advanced flap (bilaminar technique). No differences, in terms of baseline oral hygiene and defect characteristics, were observed among the 3 groups showing an effective blocking approach. The 1-year results indicated that 1) all treatment approaches resulted in clinically significant root coverage and attachment gain; 2) a statistically significant treatment effect (P = 0.012, ANOVA) was observed comparing the bioabsorbable (4.9+/-0.3 mm), the non-resorbable (4.5+/-0.8 mm), and the bilaminar (5.3+/-0.7 mm) groups, in terms of root coverage; 3) the difference in terms of root coverage between the bilaminar and the non-resorbable membrane groups was statistically significant while differences between the 2 GTR groups or between the bilaminar and the bioabsorbable membrane groups did not reach statistical value; 4) the 95% confidence intervals for the proportions of complete successes showed a similar pattern; 5) no statistical difference was demonstrated in the amount of attachment gain among the 3 groups (P=0.73, ANOVA). A regression model showed that the amount of root coverage was significantly affected by the initial recession depth, the procedure and smoking habits: a poorer root coverage result is expected in case of shallow recession type defects, when either bioabsorbable (P < 0.05) or non-resorbable (P < 0.001) membranes are used instead of a bilaminar technique and if the patient smokes (P < 0.01). It was concluded that the mucogingival bilaminar technique is at least as effective as GTR procedures in the treatment of gingival recession > or = 4 mm and thus recession depth is not the parameter which influences the selection of the surgical procedure. To compare the clinical and radiological outcomes following two different, single visit vital pulp therapy techniques, in cariously exposed primary molar teeth.
                A paediatric dental clinic within the Dental Hospital, Newcastle upon Tyne, UK.
                Fifty two child patients were sequentially enrolled in the clinical investigation, 26 males and 26 females with an age range of 3.3-12.5 years. Primary molar teeth requiring vital pulp therapy were randomly allocated to either the formocresol group (F) or the calcium hydroxide group (C). The total number of teeth treated was 84.
                Recruitment was on the basis of strict inclusion criteria. Coronal pulp amputation was prescribed only in teeth with vital, cariously exposed pulp tissue. Treatment was undertaken between October 1994 and December 1996. All cases were reviewed using predefined clinical and radiological criteria. The statistical tests used were logistic regression of a triple nested data structure, chi-squared analysis of equality of treatment and probability of success with relation to subject age.
                Eighty-four cariously exposed primary molars required vital pulp therapy. Forty six (55%) teeth were included in the F group and 38 (45%) allocated to the C group. Five teeth were lost to follow-up, leaving 79 teeth: forty four (56%) in group F and 35 (44%) in group C. Eighty four percent (37/44) of teeth treated with formocresol and 77 percent (27/35) treated with calcium hydroxide were classed as clinically and radiographically successful at the cut-off date, December 1997, after a mean clinical review of 22.5 months (range 6.1-38.5 months) and a mean radiographic review of 18.9 months (range 1.3-36.9 months).
                This investigation confirms the clinical efficacy of a one-fifth dilution of Buckley's Formocresol as an agent in pulp treatment of cariously exposed, vital primary molar teeth. However, calcium hydroxide in its pure, powder form is a clinically acceptable alternative when combined with strict selection criteria for this method of restorative care. There was a statistically insignificant difference in successful clinical and radiological outcome between the two treatment groups. Success was unrelated to the duration of time taken to achieve haemostasis and the presence or absence of bleeding after placement of the medicament. 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. The aim of this work is to study and compare the retention rate, caries-preventing and antibacterial effects of resin-modified glass ionomer and flowable composite in comparison to conventional fissure sealant.
                Forty-five children aged 7-10 years with newly erupted lower first permanent molars were randomly divided into three equal treatment groups. Group I: sealed by a conventional resin sealant; Group II: sealed by resin modified glass ionomer (RMGI); and Group III: sealed by flowable composite. Retention and caries status of the sealed teeth were recorded after 1 month, 6 months, year and 2 years. In addition, Streptococcus mutans counts were assessed at baseline, 1 day, 1 month, 6 months, 1 year and 2 years after sealant application. Data were analyzed by Fisher exact, chi-square and ANOVA tests.
                Group III and Group I showed significantly higher retention rates than Group II fissure sealant (p<0.05). There were no differences of the caries-preventive effects between the tested sealant materials throughout the duration of the study. Streptococcus mutans counts were significantly lower in group II compared to group I or group III up to 6 months of the study (p<0.05). After 1 year of the study the differences of Streptococcus mutans counts were not significant (p>0.05).
                This study indicated a lower retention of RMGI compared to flowable composite and resin sealant without significant difference in caries prevention or long-term bacterial inhibition.
It was disappointing that only three trials that compared three different types of materials were suitable for inclusion into this review. There were no significant differences found in all three trials for all of the outcomes assessed. Well designed, randomised controlled trials comparing the different types of filling materials for similar outcomes are urgently needed in dentistry. There was insufficient evidence from the three included trials to make any recommendations about which filling material to use.