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

––– Azarpazhooh –––
Citation: Yildiz E, Dorter C, Efes B, Koray F. A comparative study of two fissure sealants: a 2-year clinical follow-up.
J Oral Rehabil 2004; 31(10):979–84.
Population: 59 dental students
• Age: 18–20 years
• Sex: Not mentioned
• Location: Department of operative dentistry, faculty of dentistry, Istanbul University, Capa, Istanbul, Turkey
• Representative of young adult population
Intervention: 122 fissures of first and second molars in 59 adults; fluoride-containing fissure sealants (Helioseal F)
compared with conventional sealant (Concise Light Cure White Sealant) on first and second molars of right side of
patient’s mouth (teeth 17, 16, 46 and 47)
Control: 122 fissures of first and second molars in 59 adults: contralateral teeth on left side of each patient’s mouth
used as controls (teeth 27, 26 36 and 37)
Outcomes: Recall appointments scheduled at 3, 6, 12 and 24 months after placement.
Retention:
• Full retention: 72.1% after 3 months, 46.7% after 24 months (nonsignificant)
• Total loss of Helioseal F (16.4%, 19.7%, 18% and 23% at 3, 6, 12 and 24 months, respectively) was more than total
loss of Concise Light Cure White Sealant (8.2%, 9.8%, 11.5% and 18%, respectively) (nonsignificant difference between
sealant materials for fully retained, partially lost and totally lost at any recall interval
• Better retention on first molars than on second molars (statistically significant difference at 3, 6 and 12 months;
nonsignificant at 24 months)
• Better retention on the mandibular molars (nonsignificant)
Caries development:
• No caries detected at 3 and 6 months in any sealed tooth
• Incidence of caries in teeth treated with Helioseal F vs. Concise Light Cure White Sealant was 11.5% vs. 0% at both
12-month and 24-month recalls (statistically significant)
• Among teeth treated with Helioseal F, caries incidence for upper second molar was higher than for lower first molar
teeth (statistically significant at both 12 and 24 months)
• Sealed vs. nonsealed teeth at 12-months: 5.7% vs. 15.6% (statistically significant)
• At 24 months, no change in the sealant group (5.7%), but a statistically significant increase in the control group
(from 15.6% to 25.4%)
• Highest caries incidence at 24 months: lower and upper second molar teeth among the unsealed control teeth
(nonsignificant)
Authors’ Conclusion: Based on the results of this study, the application of fissure sealants is highly effective in preventing
caries in a young adult population, and the reduction of caries development is more related to the quality of
sealant retention than to the content of the material.
Critical Appraisal:
• No blinding of examiners
• No randomization (split-mouth model)
• Care outside study was not identified or controlled for
• No control for possible confounders: number of brushing sessions, diet, exposure to fluoride, etc.
Level of Evidence, Grade of Recommendation and Score on “Checklist to Assess Evidence of Efficacy of Therapy or
Prevention”: Level II-1; grade A for sealing teeth; score 11/16
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JCDA • www.cda-adc.ca/jcda • March 2008, Vol. 74, No. 2 •