Pit and Fissure Sealants in the Prevention of Dental Caries in ...

––– Sealants: Prevention of Caries –––
Citation: Grande RH, de Lima AC, Rodrigues Filho LE, Witzel MF. Clinical evaluation of an adhesive used as a fissure
sealant. Am J Dent 2000; 13(4):167–70.
Population: 38 subjects with caries-free premolars and molars, all undergoing orthodontic therapy
• Age: 11–17 years (mean 14 years)
• Sex: 23 females and 15 males
• Location: School of Dentistry, University of São Paulo, Brazil; research environment not mentioned
• Representative of schoolchildren undergoing orthodontic treatment
Intervention:
• Split-mouth design on 171 teeth (124 premolars and 47 molars)
• n = 85 teeth, OptiBond, a dual-cure glass-filled adhesive
Control: n = 86 teeth, Delton, a self-cured sealant
Outcomes: Follow-up every 3 to 6 months up to 30 months, with an average of 20.6 ± 5.3 months
Loss to follow up: 25%
Failure rate:
• OptiBond: 13%
• Delton: 37%
Time to loss of retention:
• OptiBond: 27.5 ± 0.7 months
• Delton: 22.1 ± 1.1 months
Cox proportional hazards regression model:
• Nonsignificant: age, sex and arch
• Significant: material (OptiBond better than Delton) and type of teeth (premolars about 3 times [95% confidence
interval 1.67–5.69] better than molars)
Authors’ Conclusion: Statistical analysis based on a stratified Cox proportional hazards regression model indicated
that OptiBond had better clinical performance than Delton.
Critical Appraisal:
• No data on caries incidence
• No follow-up of failures for caries development
• 25% loss to follow-up
• Insufficient duration (< 2 years)
• Retention on premolars 3 times retention on molars
Level of Evidence, Grade of Recommendation and Score on “Checklist to Assess Evidence of Efficacy of Therapy or
Prevention”: Level I; grade A for sealing teeth with OptiBond sealing retention; score 13.5/16
JCDA • www.cda-adc.ca/jcda • March 2008, Vol. 74, No. 2 • App_183xi