Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: An update of systematic review evidence Sealing versus partial caries removal in primary molars: a randomized clinical trial Clinical evaluation of three different materials used as pit and fissure sealant: 24-months results. Clinical evaluation of three caries removal approaches in primary teeth: a randomised controlled trial. Clinical performance of novel resin composites in posterior teeth: 18-month results. Research gaps identified during systematic reviews of clinical trials: glass-ionomer cements Prevention of pit and fissure caries using an antimicrobial varnish: 9 month clinical evaluation. Sealing Distal Proximal Caries Lesions in First Primary Molars: Efficacy after 2.5 Years Pit and fissure sealants in high-caries-risk individuals. Pragmatic RCT on the Efficacy of Proximal Caries Infiltration Surface-Specific Efficacy of Fluoride Varnish in Caries Prevention in the Primary Dentition: Results of a Community Randomized Clinical Trial Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity: A report of the American Dental Association. Clinical evaluation of three fissure sealants: 24 month follow-up Arrest of non-cavitated dentinal occlusal caries by sealing pits and fissures: a 36-month, randomised controlled clinical trial. Retention of a glass ionomer cement and a resin-based fissure sealant and effect on carious outcome after 7 years. The success rates of a glass ionomer cement and a resin-based fissure sealant placed by fifth-year undergraduate dental students Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association.
Background This article constitutes a partial up date of the original systematic review evidence by Yengopal et al. from 15 January 2008 ( published in the Journal of Oral Science in 2009 ) with primary focus on research quality in regard to bias risk in trials . Its aim is to up date the existing systematic review evidence from the English literature as to whether caries occurrence on pits and fissures of teeth sealed with either GIC or resin is the same . Methods In addition to the 12 trials included during the original systematic review , 5 new trials were identified during the data base search ( up to 26 August 2010 ) and 2 further trials were included from a h and search and reference check . Of these , 3 trials were excluded and 16 were accepted for data extraction and quality assessment . The quality of accepted trials was assessed , using up date d quality criteria , and the risk of bias was investigated in more depth than previously reported . In addition , the focus of quantitative synthesis was shifted to single data sets that were extracted from the accepted trials . Results Twenty-six dichotomous and 4 continuous data sets were extracted . Meta- analysis and cumulative meta- analysis were used in combining clinical ly homogenous data sets . The overall outcome of the computed data sets suggest no difference between the caries-preventive effects of GIC- and resin-based fissure sealants . Conclusions This overall outcome is in agreement with the conclusions of the original systematic review . Although the findings of the trials identified in this up date may be considered to be less affected by attrition- and publication bias , their risk of selection - and detection-/performance bias is high . Thus , verification of the currently available results requires further high quality r and omised control trials Background The resin-based pit and fissure sealant is considered a successful tool in caries prevention , however there is a growing evidence of its use in controlling already established caries in posterior teeth . The aim of this clinical trial is to verify the efficacy of pit and fissure sealants in arresting dentinal caries lesions compared to partial excavation and restorative treatment in primary molar teeth . Methods Thirty six patients with occlusal cavitated primary molar reaching outer half of dentin were selected . The patients were r and omly allocated into two groups : sealant application ( experimental group – n = 17 ) and restoration with composite resin ( control group – n = 19 ) . Clinical and radiograph evaluation were performed after 6 , 12 and 18 months . The chi-square test was used to verify the distribution of characteristics variables of the sample among the groups . The survival rate of treatments was evaluated using Kaplan – Meier survival and log-rank test . Fisher ’s Exact and logistic regression tests were calculated in each evaluation period ( α = 5 % ) . Results The control group showed significantly better clinical survival after 18 months ( p = 0.0025 ) . In both groups , no caries progression was registered on the radiographic evaluations . Conclusions Sealing had similar efficacy in the arrestment of caries progression of cavitated occlusal lesions compared to partial excavation of the lesions , even though the frequency of re-treatments was significantly higher in sealed lesions . Trial registration Registro Brasileiro de Ensaios Clínicos ( ReBEC ) : To evaluate the retention and caries experience effects of three different material s 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 r and omly assigned . Each one received only one of the material s 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 material s were effective on occlusal caries prevention OBJECTIVE To evaluate the clinical performance and radiographic outcome of glass ionomer cement ( GIC ) restoration in primary molars using three caries removal techniques . BASIC RESEARCH DESIGN R and omised clinical controlled trial . CLINICAL SETTING Two st and ard dental clinics in 2 hospitals near Bangkok . PARTICIPANTS A total of 276 children , aged 6 - 11 , having dentinal caries on the occlusal and /or proximal surface extending at least one-third of dentine without signs and /or symptoms of irreversible pulpitis . INTERVENTION Children were r and omly allocated into 3 study groups with different caries removal techniques : Group 1 , partial soft caries removal at enamel-dentine junction ( EDJ ) by spoon excavation ; Group 2 , complete soft caries removal by spoon excavation ; and Group 3 , conventional caries removal by steel burs . All cavity preparations were restored with GIC ( Fuji IX , GC Corp. , Japan ) . MAIN OUTCOME MEASURES Clinical and radiographic evaluations were carried out at 6 and 12 months after restoration . RESULTS After 12 months , 89 , 89 , and 88 restorations in Groups 1 , 2 and 3 were evaluated . The cumulative survival rates of GIC restorations in Groups 1 , 2 and 3 were 83 % , 83 % , and 89 % while the cumulative survival rates of pulp were 99 % , 100 % and 98 % respectively . There were no statistically significant differences in the survival of GIC restorations  or pulp in the three groups ( p > 0.05 ) . CONCLUSION The clinical and radiographic evaluations after 12 months indicated that partial soft caries removal at EDJ followed by GIC restoration was comparable to that of ART and conventional approaches PURPOSE The aim of this study was to evaluate the clinical success potential of two nanocomposites placed in posterior teeth using an antibacterial adhesive system over 18 months . METHODS A total of 49 Class I and 47 Class II restorations were placed in the permanent teeth of thirty adult patients . The carious lesions were restored with Gr and io ( Voco ) or Filtek Supreme ( 3 M ESPE ) using a two-step self-etching antibacterial adhesive system Clearfil Protect Bond ( Kuraray ) . The restorations were finished with fine-grit diamond burs , Enhance polishing system , and Sof-Lex finishing brushes . The restorations were evaluated at baseline , 6 , 12 , and 18 months after placement using modified Ryge criteria for color stability , marginal discoloration , marginal adaptation , caries formation , anatomic form , postoperative sensitivity , surface roughness , and retention . RESULTS The changes in the parameters were assessed using the Cochran Q test and the McNemar test at a significance level of p < 0.05 . All restorations were classified as clinical ly satisfactory after 18 months . Statistical analysis demonstrated differences only in superficial roughness , with Gr and io exhibiting more surface roughness than Filtek Supreme ( p < 0.05 ) . CONCLUSION Posterior restorations built up with the novel nanocomposites using an antibacterial self-etching system showed satisfactory results at the 18-month recall appointment relative to all criteria except the surface texture in the case of Gr and io . Further evaluations are necessary for a more in-depth analysis Background To report the results of an audit concerning research gaps in clinical trials that were accepted for appraisal in authored and published systematic review s regarding the application of glass-ionomer cements ( GIC ) in dental practice Methods Information concerning research gaps in trial precision was extracted , following a framework that included classification of the research gap reasons : ‘ imprecision of information ( results ) ’ , ‘ biased information ’ , ‘ inconsistency or unknown consistency ’ and ‘ not the right information ’ , as well as research gap characterization using PICOS elements : population ( P ) , intervention ( I ) , comparison ( C ) , outcomes ( O ) and setting ( S ) . Internal trial validity assessment was based on the underst and ing that successful control for systematic error can not be assured on the basis of inclusion of adequate methods alone , but also requires empirical evidence about whether such attempt was successful . Results A comprehensive and interconnected coverage of GIC-related clinical topics was established . The most common reasons found for gaps in trial precision were lack of sufficient trials and lack of sufficient large sample size . Only a few research gaps were ascribed to ‘ Lack of information ’ caused by focus on mainly surrogate trial outcomes . According to the chosen assessment criteria , a lack of adequate r and omisation , allocation concealment and blinding/masking in trials covering all review ed GIC topics was noted ( selection - and detection/performance bias risk ) . Trial results appear to be less affected by loss-to-follow-up ( attrition bias risk ) . Conclusion This audit represents an adjunct of the systematic review articles it has covered . Its results do not change the systematic review ’s conclusions but highlight existing research gaps concerning the precision and internal validity of review ed trials in detail . These gaps should be addressed in future GIC-related clinical research OBJECTIVE The purpose of this study was to determine whether Cervitec -- a chlorhexidine -- containing varnish could reduce the development of pit and fissure caries in children . METHODS One hundred children each in age groups 7 - 8 and 12 - 14 years were selected from schools in Riyadh , Saudi Arabia . To be included in the study , each child had to have at least two sound contra-lateral first or second permanent molars with deep fissures . A split mouth method was used with one test tooth and one control within the same jaw . The left or the right side was selected r and omly for test or control . The plaque sample s from the occlusal surfaces of the test and control and the saliva sample s were collected at baseline examination and after 9 months to estimate the number of Streptococcus mutans by the strip mutans method of Jensen and Bratthall ( Jensen B , Bratthall D. A new method for the estimation of mutans streptococci in human saliva . Journal of Dental Research 1989;68:468 - 471 ) . Cervitec varnish containing 1 % chlorhexidine ( CHx ) and thymol was applied at baseline , at 3 - 4 months and at 6 months to the test tooth after isolation while the control had prophylaxis using cotton pellet in water each time the varnish was applied to the test tooth . Caries examination of the test and control followed after 9 months , according to the criteria and methods of WHO ( World Health Organization . Oral Health Surveys . Basic Methods 4th ed . , Geneva , WHO 1997 ) . The blind technique was used in the diagnosis of caries and in the examination of the S. mutans count at the end of the study . RESULTS Ninety four of the 7 - 8 year old and 86 of the 12 - 14 year old children completed the study . The results showed that the caries increment in both control groups of teeth after 9 months is significantly higher than in the test teeth ( McNemar test : chi2 = 11.60 , P < 0.001 ) . The rate of caries development in a fissure was significantly correlated to the plaque mutans score of that fissure and there was considerable reduction in the S. mutans count of the plaque in the test teeth compared with the control ( Spearman Rank Correlation : P < 0.001 ) . CONCLUSION It is concluded that the CHx varnish reduced the development of fissure caries significantly Background : The prevalence of proximal caries in primary molar teeth is high in many countries . Aims : ( 1 ) To study by means of a split-mouth design the 1- and 2.5-year efficacy of sealing proximal lesions vs. flossing instructions ( control ) on primary molar teeth . ( 2 ) To assess children ’s behaviour and pain perception during the procedure . Methods : Ninety-one 4- to 6-year-old children from Bogotá , Colombia participated . Participants had to have at least two proximal lesions scored according to the following radiographic classification system : radiolucency ( 1 ) in enamel outer half , ( 2 ) restricted to enamel-dentine junction , or ( 3 ) restricted to dentine outer third . Baseline , 1- and 2.5-year follow-up bitewing radiographs were taken . Test and control lesions were r and omly selected . After temporary separation test lesions were sealed ( adhesive ) . Parents/caregivers received a flossing leaflet for their children . Progression of the lesions was assessed by means of independent reading of conventional bitewing radiographs . Results : One-year ( n = 73 ) test vs. control lesion progression was 27.4 vs. 50.7 % , respectively ( p < 0.01 , McNemar ’s test ) , and 2.5-year ( n = 56 ) test vs. control lesion progression was 46.4 vs. 71.4 % , respectively ( p < 0.01 ) . The dropouts did not differ from those who remained in the study regarding relevant caries baseline data . More than 88 % of the participants presented positive to definitively positive behaviour and very low or low pain intensity at both first and second appointments . Conclusion : The sealing technique was superior to flossing instructions both after 1 and 2.5 years of follow-up and the majority of the participants had no anxiety or pain during the treatment This paper examines the evidence demonstrating the effectiveness of sealants in high-caries-risk children and discusses the Research Triangle Institute/University of North Carolina 's ( RTI/UNC ) systematic review . The strict RTI/UNC protocol limited the number of sealant studies that could be included . This analysis exp and ed their criteria to permit additional methods of determining caries risk ( for example , past caries experience , less than two pairs of sound first permanent molars available/child in half-mouth design s ) and outcome measures in addition to DMFS ( that is , percent sealant retention , survival rates , cost-effectiveness , changes in salivary S. mutans levels ) . Nine clinical studies with a r and omized , half-mouth , clinical trial design and seven studies with observational study design s were included . There is good evidence that  sealants can be used efficaciously and effectively in high-risk  children as long as the sealant is retained . Sealants are more effective in preventing further caries and providing cost savings in a shorter time span if placed in children who have high rather than low caries risk Proximal caries infiltration has been shown to be efficacious in hampering caries lesion progression when performed by dentists working in a university setting . The aim of this r and omized split-mouth , placebo-controlled clinical trial was to assess the efficacy of resin infiltration of proximal caries lesions being performed by several dentists in private practice s , in combination with individualized oral hygiene plus noninvasive measures compared with these alone . In this study , 87 children and young adults ( with 238 pairs of proximal caries lesions radiographically extending into the inner half of the enamel [ E2 ] or the outer third of the dentin [ D1 ] ) were r and omly allocated to either 1 of 2 treatments . Test lesions were infiltrated , and a mock treatment was performed in control lesions  by 5 German private practitioners . All patients received instructions for a noncariogenic diet , flossing and fluoridation , and individualized noninvasive interventions . The primary outcome was radiographic lesion progression ( pairwise comparison ) evaluated independently by 2 evaluators who were blinded to treatment allocation . After approximately 10 mo ( mean ± SD 307 ± 43 d ) , 92 of 148 lesion pairs in 24 of 38 treated patients who were at high caries risk could be re-evaluated clinical ly as well as radiographically using individualized bitewing holders , as at baseline ; 186 of 204 lesion pairs in 70 of 77 patients ( 35 of 38 high-risk patients ) could be evaluated after 18 mo ( mean 542 ± 110 d ) . No unwanted effects were observed . After 10 mo , progression was recorded in 2 of 92 test lesions ( 2 % ) and in 22 of 92 control lesions ( 24 % ) ( P = 0.001 , McNemar/Obuchowski test ; relative risk reduction , 91 ; 95 % confidence interval , 62%–98 % ) . After 18 mo , lesion progression was recorded in all included patients in 10 of 186 test lesions ( 5 % ) and in 58 of 186 control lesions ( 31 % ) ( P < 0.001 ; relative risk reduction , 83 ; 95 % confidence interval , 67%–91 % ) . Thus , resin infiltration seems to be more efficacious in reducing lesion progression compared with individualized noninvasive measures alone over a period of 18 mo when performed in a private practice setting by various practitioners ( German Clinical Trials Register / Deutsches Register Klinischer Studien DRKS00009963 ) Objectives : Fluoride varnish ( FV ) is efficacious in caries prevention although its effects among different tooth surfaces are poorly understood . This study sought to determine the extent to which caries-preventive effects of a community intervention that included FV application among preschool-aged children varied according to primary tooth anatomy and baseline tooth pathology . Methods : Secondary analysis was undertaken of data from a community-r and omized controlled trial among 543 3- to 5-year-old Aboriginal children in 30 Northern Territory Australian communities . Children in intervention communities received community health promotion and FV application once every 6 months . Net caries ( d3mfs ) risk and 95 % confidence limits ( CL ) were estimated for the control and intervention arms , and stratified according to tooth anatomy/location and baseline pathology ( sound , enamel opacity , hypoplastic defect or precavitated carious lesion ) . The intervention ’s efficacy was quantified using generalized estimating equation modeling accounting for study design and clustering . The assumption of efficacy homogeneity was tested using a Wald χ2 test with a p < 0.2 criterion and post hoc pairwise comparisons . Results : The intervention result ed in a 25 % reduction ( relative risk , RR = 0.75 ; 95 % CL = 0.71 , 0.80 ) in the 2-year surface-level caries risk . There was substantial heterogeneity in FV efficacy by baseline surface pathology : RRs were 0.73 for sound , 0.77 for opaque , 0.90 for precavitated , and 0.92 for hypoplastic surfaces . Among sound surfaces , maxillary anterior facials received significantly more benefit ( RR = 0.62 ) compared to pits and fissures ( RR = 0.78 ) . Conclusion : The intervention had greatest efficacy on surfaces that were sound at baseline . Among those sound surfaces , maxillary anterior facials received most caries-preventive benefit BACKGROUND An expert panel convened by the American Dental Association ( ADA ) Council on Scientific Affairs and the Center for Evidence -Based Dentistry conducted a systematic review and formulated clinical recommendations to inform primary care clinicians about the potential use of adjuncts as triage tools for the evaluation of lesions , including potentially malignant disorders ( PMDs ) , in the oral cavity . TYPES OF STUDIES REVIEW ED This is an up date of the ADA 's 2010 recommendations on the early diagnosis of PMDs and oral squamous cell carcinoma . The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid and the Cochrane Central Register of Controlled Trials to identify r and omized controlled trials and diagnostic test accuracy studies . The authors used the Grading of Recommendations Assessment , Development and Evaluation approach to assess the certainty in the evidence and to move from the evidence to the decisions . RESULTS The panel formulated 1 good practice statement and 6 clinical recommendations that concluded that no available adjuncts demonstrated sufficient diagnostic test accuracy to support their routine use as triage tools during the evaluation of lesions in the oral cavity . For patients seeking care for suspicious lesions , immediate performance of a biopsy or referral to a specialist remains the single most important recommendation for clinical practice . In exceptional cases , when patients decline a biopsy or live in rural areas with limited access to care , the panel suggested that cytologic testing may be used to initiate the diagnostic process until a biopsy can be performed ( conditional recommendation , low- quality evidence ) . CONCLUSIONS AND PRACTICAL IMPLICATION S The authors urge clinicians to remain alert and take diligent action when they identify a PMD . The authors emphasize the need for counseling because patients may delay diagnosis because of anxiety and denial Aim : This was to compare 3 different material s for fissure sealing ( FS ) after a clinical use during a 24 month period and to assess the use of flowable composite resins in combination with dentine adhesives as sealing material s. Study Design : There were 41 patients aged from 7–17 years , for whom 100 permanent molars were sealed with 3  different sealing material s. Methods : Group A , 33 teeth were sealed material Helioseal Clear Chroma ( Vivadent , Schaan , Liechtenstein ) ; Group B , 33 teeth were sealed with Teethmate F1 ( Kuraray , Kurashiki , Japan ) , and in Group C , 34 teeth were sealed with the flowable composite Tetric Flow ( Vivadent , Schaan , Liechtenstein ) . For the analysis of the degree of retention , the criteria used were : 0-complete retention , 1-loss of 1/3 of material , 2-loss of 2/3 of material , 3-complete loss of material . Clinical criteria for appearance of a new caries lesion included following values : Caries present ( + ) or caries absent ( − ) . Statistics : Chi-Square test was used for statistical analysis of retention rates between groups . Results : After the 24 month period , the highest retention rate of complete retention was established for the material Tetric Flow of 76.5 % , Helioseal Clear Croma 66.7 % , and Teethmate F1 60.6 % . The incidence of caries with Helioseal Clear Croma was 6.1 % , for Teethmate F1 3 % , with no statistically significant difference after the 24 months period ( p=0.656 ) . In the group of teeth sealed with Tetric Flow , there was not a single case of caries noted . Conclusions : The use of flowable composite resins as sealing material s is equal to other material s for fissure sealing OBJECTIVE This study aim ed to evaluate the progression of sealed non-cavitated dentinal occlusal caries in a r and omised controlled clinical trial . MATERIAL S AND METHODS Sixty teeth with non-cavitated dentinal occlusal caries were selected in patients with a high risk for caries . Patients were r and omly divided into two groups so that each group included 30 teeth . Patients in the experiment group were given oral hygiene instructions and a fissure sealant . Patients in the control group were given oral hygiene instructions only .  Caries progression and sealant loss were monitored over a period of 36 months by clinical and radiographic examinations . RESULTS Clinical and radiographic progression of caries was significantly more frequent in the control group than in the experiment group . Three teeth lost their sealant and showed caries progression , but this was apparent only at the 12-month follow-up . At the 24- and 36-month recall appointments , neither sealant loss nor caries progression were observed . CONCLUSION The pit and fissure sealant utilised in this study was shown to be effective in arresting carious lesions at 36 months The aim of this study was to compare the retention and caries preventive efficacy of glass ionomer ( Fuji III ; GIC ) and light-cured resin-based ( Delton ; LCR ) fissure sealants .  One hundred and sixty-six 5 - 14-year-old schoolchildren received sealants on their newly erupted first or second molars ; a split mouth design was used . Previously reported 2-year results showed low retention rates for GIC sealants , but no difference in the caries increment between the groups . The same persons were invited to a dental check-up 6.1 to 7.8 ( mean 7.1 ) years after the application of sealants ;  111 persons ( 66.8 % of the original group ) participated in the study . The retention of sealants , and the caries status of occlusal surfaces and adjacent proximal surfaces was recorded . On the sealed occlusal surfaces , 10 % of GIC and 45 % of LCR sealants were totally and 9 % of GIC and 20 % of LCR sealants partially present . Twenty-three ( 23.5 % ) of the occlusal surfaces sealed with GIC and 16 ( 16.5 % ) of those sealed with LCR were carious or filled . Compared to LCR sealants , the effectiveness of GIC sealants  was -44 % ( 95 % CI -71 % , -16 % ) and net gain -7 % ( 95 % CI -18 % , 4 % ) . The relative risk of caries occurring was 1.44 ( 95 % CI 0.96 , 2.14 ) AIM : To evaluate retention and caries prevention of a glass-ionomer cement ( GIC ) and a resin-based fissure sealant placed by fifth-year undergraduate dental students . METHODS : The study was conducted according to a split-mouth , r and omised clinical trial . Children with at least one pair of caries-free permanent first molars with deep pits and fissures were included in the study . The children were selected from a population that had a high risk for dental caries .  Sealant material s were applied by fifth-year undergraduate dental students on 346  fissures of the first permanent molars in 173 children . The ages of the children ranged from 7–15 years ( mean 9.4 ) . Two research ers at the clinics supervised all of the procedures . Intra-examiner reproducibility and inter-examiner reproducibility were 0.90 and 0.86 , respectively , for the clinical assessment of sealant retention and caries evaluation . RESULTS :  GIC sealants were completely lost in 31.9 % and resin-based sealants in 16.6 % ( p<0.05 ) . The total retention rates of GIC sealants and resin-based sealants were 13.8 % and 20.8 % , respectively . After 24 months , the caries increment was 3.4 % for GIC sealants and 4.8 % for resin-based sealants ( p>0.05 ) . CONCLUSIONS : The retention of GIC sealants was markedly inferior to the retention of resin-based sealants ; however , GIC when used as a pit and fissure sealant was slightly more effective in preventing occlusal caries BACKGROUND An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence -Based Dentistry conducted a systematic review and formulated evidence -based clinical recommendations for the arrest or reversal of  noncavitated and cavitated dental caries  using nonrestorative treatments  in children and adults . TYPES OF STUDIES REVIEW ED The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid , Cochrane CENTRAL , and Cochrane data base of systematic review s to identify r and omized controlled trials reporting on nonrestorative treatments  for noncavitated and cavitated carious lesions . The authors used the Grading of Recommendations Assessment , Development and Evaluation approach to assess the certainty in the evidence and move from the evidence to the decisions . RESULTS The expert panel formulated 11 clinical recommendations , each specific to lesion type , tooth surface , and dentition . Of the most effective interventions , the panel provided recommendations for the use of 38 % silver diamine fluoride , sealants , 5 % sodium fluoride varnish , 1.23 % acidulated phosphate fluoride gel , and 5,000 parts per million fluoride ( 1.1 % sodium fluoride ) toothpaste or gel , among others . The panel also provided a recommendation against the use of 10 % casein phosphopeptide-amorphous calcium phosphate . CONCLUSIONS AND PRACTICAL IMPLICATION S Although the recommended interventions are often used for caries prevention , or in conjunction with restorative treatment options , these approaches have shown to be effective in arresting or reversing carious lesions . Clinicians are encouraged to prioritize use of these interventions based on effectiveness , safety , and feasibility
The overall outcome of the computed data sets suggest no difference between the caries-preventive effects of GIC- and resin-based fissure sealants .
Background This article constitutes a partial up date of the original systematic review evidence by Yengopal et al. from 15 January 2008 ( published in the Journal of Oral Science in 2009 ) with primary focus on research quality in regard to bias risk in trials .
Its aim is to up date the existing systematic review evidence from the English literature as to whether caries occurrence on pits and fissures of teeth sealed with either GIC or resin is the same .