Evaluation of non-invasive treatment applied to occlusal surfaces. Evidence-based Clinical Practice Guideline for the Use of Pit-and-Fissure Sealants. Sealing versus partial caries removal in primary molars: a randomized clinical trial Arrest of non-cavitated dentinal occlusal caries by sealing pits and fissures: a 36-month, randomised controlled clinical trial. Use of Pit-and-Fissure Sealants. Efficacy of a non-drilling approach to manage non-cavitated dentin occlusal caries in primary molars: a 12-month randomized controlled clinical trial. Effectiveness of a glass ionomer cement used as a pit and fissure sealant in recently erupted permanent first molars. Caries-preventive Effect of Supervised Toothbrushing and Sealants Arresting caries by sealants: results of a clinical study. [Cost-effectiveness analysis of preventive methods for occlusal surface according to caries risk: results of a controlled clinical trial]. Clinical performance of a laser fluorescence device for detection of occlusal caries lesions. Comparison of The Canary System and DIAGNOdent for the in vitro detection of caries under opaque dental sealants Progression of non-cavitated lesions in dentin through a nonsurgical approach: a preliminary 12-month clinical observation Sealing proximal surfaces with polyurethane tape: three-year evaluation Clinical evaluation of three fissure sealants: 24 month follow-up Sealing occlusal caries lesions in adults referred for restorative treatment: 2–3 years of follow-up 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.
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 BACKGROUND This article presents evidence -based clinical recommendations for the use of pit- and -fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents . A guideline panel convened by the American Dental Association ( ADA ) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy , retention , and potential side effects of sealants to prevent dental caries ; their efficacy compared with fluoride varnishes ; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits- and -fissures of occlusal surfaces . TYPES OF STUDIES REVIEW ED This is an up date of the ADA 2008 recommendations on the use of pit- and -fissure sealants on the occlusal surfaces of primary and permanent molars . The authors conducted a systematic search in MEDLINE , Embase , Cochrane Central Register of Controlled Trials , and other sources to identify r and omized controlled trials reporting on the effect of sealants ( available on the U.S. market ) when applied to the occlusal surfaces of primary and permanent molars . The authors used the Grading of Recommendations Assessment , Development , and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions . RESULTS The guideline panel formulated 3 main recommendations . They concluded that sealants are effective in preventing and arresting pit- and -fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes . They also concluded that sealants could minimize the progression of non-cavitated occlusal carious lesions ( also referred to as initial lesions ) that receive a sealant . Finally , based on the available limited evidence , the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others . Conclusions and practical implication s : These recommendations are design ed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents . Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients . The authors recommend that clinicians re-orient their efforts toward increasing the use of sealants on the occlusal surfaces of primary and permanent molars in children and adolescents 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 ) : 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 BACKGROUND This article presents evidence -based clinical recommendations for the use of pit- and -fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents . A guideline panel convened by the American Dental Association ( ADA ) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy , retention , and potential side effects of sealants to prevent dental caries ; their efficacy compared with fluoride varnishes ; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits- and -fissures of occlusal surfaces . TYPES OF STUDIES REVIEW ED This is an up date of the ADA 2008 recommendations on the use of pit- and -fissure sealants on the occlusal surfaces of primary and permanent molars . The authors conducted a systematic search in MEDLINE , Embase , Cochrane Central Register of Controlled Trials , and other sources to identify r and omized controlled trials reporting on the effect of sealants ( available on the U.S. market ) when applied to the occlusal surfaces of primary and permanent molars . The authors used the Grading of Recommendations Assessment , Development , and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions . RESULTS The guideline panel formulated 3 main recommendations . They concluded that sealants are effective in preventing and arresting pit- and -fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes . They also concluded that sealants could minimize the progression of non-cavitated occlusal carious lesions ( also referred to as initial lesions ) that receive a sealant . Finally , based on the available limited evidence , the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others . Conclusions and practical implication s : These recommendations are design ed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents . Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients . The authors recommend that clinicians re-orient their efforts toward increasing the use of sealants on the occlusal surfaces of primary and permanent molars in children and adolescents BACKGROUND . Despite the efficacy of non-drilling approaches to manage non-cavitated dentin occlusal lesions ( NCDOL ) in permanent teeth , there is no data validating this type of therapy in the primary dentition . AIM . To compare the efficacy of a traditional fissure sealant in managing NCDOL in primary molars . DESIGN . This study is a r and omized controlled clinical trial with a split-mouth design . Thirty schoolchildren with two NCDOL were selected and divided into two groups . The experimental group received a resin-based fissure sealant , whereas the control group was treated with a conventional composite resin .  Treatment efficacy was evaluated after 1 year by means of clinical and radiographic examinations . RESULTS . The two treatment modalities were found to be similarly effective in managing DONCL in primary molars . CONCLUSION . For the management of non-cavitated dentin occlusal caries in primary teeth , the invasive approach can be replaced with non-drilling fissure sealing techniques PURPOSE 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 . METHODS A double-blind , r and omized , controlled , clinical trial was undertaken that included 36 5- to 8-year-olds ( and 92 permanent first molars ) who were r and omly 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 . RESULTS 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 ) . CONCLUSION 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 To investigate the effectiveness of 3 caries-preventive measures on high– and low – caries risk occlusal surfaces of first permanent molars over 3 y. This cluster-r and omized controlled clinical trial covered 242 schoolchildren , 6 to 7 y old , from low socioeconomic areas . At baseline , caries risk was assessed at the tooth surface level , through a combination of ICDAS II ( International Caries Detection and Assessment System ) and fissure depth codes . High – caries risk occlusal surfaces were treated according to daily supervised toothbrushing ( STB ) at school and 2 sealants : composite resin ( CR ) and atraumatic restorative treatment – high-viscosity glass-ionomer cement ( ART-GIC ) . Low – caries risk occlusal surfaces received STB or no intervention . Evaluations were performed after 0.5 , 1 , 2 , and 3 y. A cavitated dentine carious lesion was considered a failure . Data were analyzed according to the proportional hazard rate regression model with frailty correction , Wald test , analysis of variance , and t test , according to the jackknife procedure for calculating st and ard errors . The cumulative survival rates of cavitated dentine carious lesion – free , high – caries risk occlusal surfaces were 95.6 % , 91.4 % , and 90.2 % for STB , CR , and ART-GIC , respectively , over 3 y , which were not statistically significantly different . For low – caries risk occlusal surfaces , no statistically significant difference was observed between the cumulative survival rate of the STB group ( 94.8 % ) and the no-intervention group ( 92.1 % ) over 3 y. There was neither a difference among STB , CR , and ART-GIC on school premises in preventing cavitated dentine carious lesions in high – caries risk occlusal surfaces of first permanent molars nor a difference between STB and no intervention for low – caries risk occlusal surfaces of first permanent molars over 3 In each of 14 patients , one bilateral occlusal carious lesion was sealed and the other lesion was left open as a control . The control lesions showed patterns of sudden increases in cavity depth , as well as evidence of being active bacteriologically ; whereas , with one exception , the sealed lesions were inactive bacteriologically . The residual carious material in the sealed lesions suggested a complete cessation of the carious process . No clinical or radiologic signs were seen to suggest that the health of the sealed tooth had been compromised This study presents the results of a cost-effectiveness analysis in a controlled clinical trial on the effectiveness of a modified glass ionomer resin sealant ( Vitremer , 3 M ESPE ) and the application of fluoride varnish ( Duraphat , Colgate ) on occlusal surfaces of first permanent molars in children 6 - 8 years of age ( N = 268 ) , according to caries risk ( high versus low ) . Children were examined semiannually by the same calibrated dentist for 24 months after allocation in six groups : high and low risk controls ( oral health education every three months ) ; high and low risk with varnish ( oral health education every three months + varnish biannually ) ; and high and low risk with sealant ( oral health education every three months + a single application of sealant ) . Economic analysis showed that sealing permanent first molars of high-risk schoolchildren showed a C/E ratio of US$ 119.80 per saved occlusal surface and an incremental C/E ratio of US$ 108.36 per additional saved occlusal surface . The study concluded that sealing permanent first molars of high-risk schoolchildren was the most cost-effective intervention Children and adolescents must be examined often for occlusal caries . Diagnosis of fissure caries is difficult especially when the tooth surface appears seemingly intact . It has been shown that using traditional clinical methods , as little as 20 % of teeth with fissure caries under intact surfaces were correctly recognised as such . Therefore , new methods for increasing the accuracy of diagnosis have been sought for years . Recently , a new device , based on fluorescence measurements , was introduced . The purpose of this study was to test the device under in vivo conditions in order to provide recommendations for its use in the dental office . Seven general dental practitioners examined a total of 332 occlusal surfaces in 240 patients .  Caries extent was determined for each site after operative intervention ( = ' gold st and ard ' ) . Clinical inspection and analysis of bitewing radiographs exhibited statistically significant lower sensitivities ( 31 - 63 % ) than did the DIAGNOdent device ( sensitivity > or = 92 % ) . It is recommended that the laser device is used in the decision-making process in relation to the diagnosis of occlusal caries as a second opinion in cases of doubt after visual inspection AIM The aim of the present study was to investigate the ability of operators using The Canary System and DIAGNOdent  to detect natural pit and fissure caries under four commonly-used opaque dental sealants . METHODS Mixed sound and carious pits/fissures ( N = 105 ) selected from 40 human teeth were r and omly assigned ( 10 teeth/group ) to one of four opaque sealant groups ( Delton , Embrace WetBond , Helioseal F , UltraSeal XT Plus ) . Selected pits/fissures sites on occlusal surfaces were scanned with The Canary System and DIAGNOdent , sealed , re-scanned , and subjected to polarized light microscopy to confirm whether the scanned regions were sound or carious . Sensitivities and specificities for each detection method before and after sealant placement were calculated . RESULTS The Canary System and DIAGNOdent were able to distinguish between sound and carious tissue beneath opaque sealants with an accuracy of 76 % and 59 % , respectively . CONCLUSIONS The Canary System can serve as a clinical tool to aid dental professionals to detect and monitor the status of caries lesions and tooth structure underneath sealant . The increased likelihood of false-positive diagnoses with DIAGNOdent due to intrinsic auto-fluorescence of sealant filler and opacifying agents might limit its usefulness as an aid to detect caries underneath opaque sealants Objective : Considering the minimally invasive approach to dentistry , the scientific community has focused on non-invasive treatments for caries lesions . The aim of this study was to evaluate the efficacy of a nonsurgical approach to arrest occlusal non-cavitated dentin lesions through glass ionomer sealing . Methods : In this controlled clinical trial , 51 teeth with clinical ly non-cavitated occlusal caries radiographically located beneath the enamel-dentine junction ( radiolucent area ) were selected among patients presenting a moderate to high risk of caries . The teeth were r and omly divided into two groups : an experimental group receiving an application of Vidrion-R ( SS White ) glass ionomer and a control group not su bmi tted to any clinical intervention .  Caries progression was monitored by clinical and radiographic examination at 4-monthly intervals over a period of one year . In addition , marginal integrity of the sealant was evaluated in the experimental group . Results : Clinical examination showed no statistical difference between the groups ( P=.13 ) . On the other h and , sealed teeth presented lower caries progression when analyzed by radiographic examination ( P=.004 ) . Conclusion : A glass ionomer sealant over non-cavitated occlusal caries lesions in dentin may not be sufficiently effective in arresting their progression The purpose of this investigation was to test the safety and clinical effect of a new material for the treatment of proximal caries . In 50 patients with two proximal initial lesions , one of the lesions was r and omly chosen and sealed with a thin polyurethane-dimethacrylate foil using bonding . The other lesion received oral home care and was left as the control . In clinical follow-ups after 6 and 12 months and X-ray evaluation after 2 and 3 years , the sealants showed good retention , marginal adaptation , and color . No relevant significant differences in plaque accumulation or gingival status were found between sealed and control teeth . On the radiographs , almost all sealed and control lesions appeared stable , indicating an arrest of the lesion . In conclusion , sealing initial proximal lesions showed no clinical problems and mostly arrest of caries on bitewing radiographs 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 The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression , arrest , and regression of the sealed lesions . Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry , Copenhagen , Denmark were included . In case the patient had more than one occlusal caries lesion , r and omization between sealing and restoration was made ; otherwise , the lesion was sealed . In total , 60 resin sealants and 12 composite restorations were made . Follow-up period was 25–38 months ( mean = 33 months ) . Data were analyzed using non-parametric statistics including kappa statistics . After 2–3 years , the dropout rate was 15 % ; two patients did not show up for control and nine previously sealed lesions were restored by the patients ' general practitioners . All 12 restorations and 39 of the remaining 49 sealants were well functioning , seven ( 14 % ) sealants were repaired/replaced due to failure , and three ( 6 % ) sealed lesions were restored due to caries progression ( p > 0.05 ) . The radiographic assessment showed caries progression beneath five ( 10 % ) sealants , caries regression beneath one ( 2 % ) sealant , and unchanged depth beneath 43 ( 88 % ) sealants and all restorations ( p > 0.05 ) . The majority of the referred lesions were successfully arrested by sealants , indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults . However , a longer observation period is needed for final conclusion . Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health PURPOSE This prospect i ve clinical trial compared the retention rate and caries-preventive efficacy of two types of sealant modalities over a 3-year period . MATERIAL S AND METHODS Using a split-mouth r and omised design , 1280 sealants were r and omly 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 ™ , 3 M 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 . RESULTS 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 . CONCLUSIONS 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 best retention capacity of the material in time has been obtained from the use of RB Sealants compared to RMGI , demonstrating retention values much lower with partial loss of material at a distance of one year from the clinic .
The compomers demonstrate retention values intermediates .
The incidence of caries in a year is negligible for all sealants application .
In terms of retention , resin-based sealants ( RB Sealants ) are the material s that give more guarantees of success at 12 months , while in the same period there have n't been significant differences in caries prevention of disease among the various classes sealing material s analyzed
UNLABELLED The occlusal surface is the most affected area by dental caries and the sealing of the pits and of the fissures has been found , in time , the preventive method most effective trying to counteract the onset .
Currently , the WHO considers it as a primary preventive measure , in other words one of the most effective and least invasive available to ensure the complete protection and the total preservation of the occlusal carious by the phenomenon .
PURPOSE THE AIM OF THIS WORK HAS BEEN TO PERFORM A SYSTEMATIC REVIEW OF THE LITERATURE ON CLINICAL TRIALS OF DIFFERENT SEALING MATERIAL S , IN ORDER TO : compare their individual characteristics , highlight the reliability and the long-term efficacy and identify the most significant variables , both technological and clinics , in order to declare whether or not the success of this method prior .