Clinical evaluation of sealants and preventive resin restorations in a group of environmentally homogeneous children.
OBJECTIVE
Pit and fissure sealants reduce occlusal caries when proper patient selection and application techniques are followed. To increase retention rate of sealants over time, good adaptation and deep sealant penetration are important. Studies remain inconclusive, however, as to determining if the bur preparation of pits and fissures would increase the adaptation and penetration thus improving sealant retention. The aim of this study was to assess if tooth preparation prior to sealant application improves sealant retention.


METHODS
In this prospective cohort study, 43 children and adolescents from 4 Hutterites colonies were, for 3 years, bussed to the University of Manitoba pediatric dental clinic, Winnipeg, Manitoba, Canada, for comprehensive dental care including sealant placement using standard procedures. These came from a community with homogeneous social economical status, dietary habits, fluoride intake, and lifestyles. The decision of tooth preparation prior to sealant application was made ad hoc. Of 122 treated permanent posterior teeth, 54 had been treated as preventive resin restorations (PRRs, type A or B) and 68 were nonprepared sealants.


RESULTS
After 1 year, teeth prepared (type B PRRs) and restored with flowable composite resins had significantly (P<.01) lower retention rates (27% vs 63%) than did teeth with nonprepared sealants or typeA PRRs. Teeth prepared (type B PRRs) were also significantly (P<.001) more likely to have caries on follow-up examination (50% vs 11%) than were teeth with nonprepared sealants or type A PRRs.


CONCLUSIONS
These results suggest that preventive resin type B restorations restored with flowable composites are not helpful in terms of retention or caries reduction.
Lekic
Predrag Charles
PC
Pediatric Dentistry, Department of Preventive Dental Science, Faculty of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada. lekicpc@cc.umanitoba.ca
Deng
Dianna
D
Brothwell
Doug
D
D000293:Adolescent; D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D003188:Composite Resins; D001840:Dental Bonding; D003731:Dental Caries / Q000517:prevention & control*; D003793:Dental Restoration, Permanent / Q000379:methods*; D005247:Feeding Behavior; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008350:Manitoba; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D011446:Prospective Studies; D033303:Protestantism; D012923:Social Class; D012931:Social Environment; D019246:Tooth Preparation / Q000145:classification
D002327:Cariostatic Agents; D003188:Composite Resins; D010895:Pit and Fissure Sealants; C111840:flowable hybrid composite; D005459:Fluorides