title: Population- vs. risk-based applications of fissure sealants in first permanent molars: a 13-year follow-up.
abstract: OBJECTIVE
  To evaluate and compare the long-term outcome of a population-based and a risk-based strategy of applying fissure sealants in newly erupted first permanent molars.
  
  
  METHODS
  Retrospective cohort study in primary dental care.
  
  
  METHODS
  Four hundred and ninety-six subjects from two cohorts were included. In group P (n = 236), routine applications of fissure sealants were conducted while sealants were placed on the basis of subjective criteria in Group R (n = 260). Data of applications, maintenance, decay, restorations, extractions, and cumulative time of applications from six to 19 years were extracted from the dental records and bite-wing radiographs by two of the authors simultaneously. The main outcome measures were the total caries prevalence at the age of 19 years as well as the fate of each sealed and non-sealed occlusal surface.
  
  
  RESULTS
  In group P, 87.7% of all first permanent molars were sealed compared with 20.2% in group R. There was no statistically significant difference concerningthe total DFT at 19 years of age between the groups (mean 3.5 +/- 3.8 vs. 3.7 +/- 3.4). Considering the occlusal surfaces of the first permanent molars only, a statistically significant treatment effect was demonstrated in group P with an odds ratio of 4.6 (95% CI: 3.0 - 6.7; p < 0.05). The absolute risk reduction was 36.3% and the number needed to treat was 2.8. In Group R, no statistically significant treatment effect was disclosed (OR = 1.3; 95% CI: 0.9 - 1.7; risk reduction 5.5%).
  
  
  CONCLUSIONS
  This 13-year follow-up showed that population-based applications of fissure sealants in first permanent molars shortly after eruption showed a statistically significant treatment effect on the occlusal surfaces at the age of 19 years, which was in contrast to findings from a cohort in which sealants were applied on the basis of an individual risk-based strategy. There were, however, no significant differences concerning the total caries experience between the two cohorts.
authors.affiliation: Public Dental Service, County of Halland, Sweden.
authors.forename: Monica
authors.initials: M
authors.lastname: Benteke
authors.forename: Lena
authors.initials: L
authors.lastname: Berntsson
authors.forename: Ulla
authors.initials: U
authors.lastname: Broman
authors.forename: Karin
authors.initials: K
authors.lastname: Edfeldt
authors.forename: Kerstin
authors.initials: K
authors.lastname: Sköld-Larsson
authors.forename: Svante
authors.initials: S
authors.lastname: Twetman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008963:Molar; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D013548:Sweden; D013997:Time Factors; D014078:Tooth Eruption; D016896:Treatment Outcome
chemical_list: D010895:Pit and Fissure Sealants