Randomized trial on fluorides and sealants for fissure caries prevention.
To investigate the effectiveness of topical fluorides in preventing fissure caries, we conducted a randomized controlled trial with parallel groups. In total, 501 children (1,539 molars, 3,078 sites), mean age 9.1 years, who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited. They were randomly allocated among four groups: (1) resin sealant, single placement; (2) 5% NaF varnish, semi-annual application; (3) 38% silver diamine fluoride (SDF) solution, annual application; and (4) placebo control. Follow-up examinations were conducted every 6 months by a masked examiner. After 24 months, 485 children (97%) were examined. Proportions of pit/fissure sites with dentin caries in the sealant, NaF, SDF, and control groups were 1.6%, 2.4%, 2.2%, and 4.6%, respectively. A multi-level logistic regression analysis accounting for the effects of data clustering and confounding factors showed that fissures in any of the three treatment groups had significantly lower risks of carious cavity development into dentin than did controls (p < 0.05). We concluded that placement of resin sealant, semi-annual application of NaF varnish, and annual application of SDF solution are all effective in preventing pit and fissure caries in permanent molars (ClinicalTrials.gov number CT01446107).
Faculty of Dentistry, University of Hong Kong, 3/F, Prince Philip Dental Hospital, Hong Kong SAR.
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Lin
D000134:Acid Etching, Dental / Q000379:methods; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002648:Child; D003188:Composite Resins / Q000627:therapeutic use; D003731:Dental Caries / Q000473:pathology / Q000517:prevention & control*; D003750:Dental Fissures / Q000473:pathology / Q000517:prevention & control; D003804:Dentin / Q000187:drug effects / Q000473:pathology; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008963:Molar / Q000187:drug effects / Q000473:pathology; D010756:Phosphoric Acids / Q000737:chemistry; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D010919:Placebos; D000644:Quaternary Ammonium Compounds / Q000627:therapeutic use; D018030:Silver Compounds; D012969:Sodium Fluoride / Q000627:therapeutic use; D016896:Treatment Outcome
D002327:Cariostatic Agents; C500418:Clinpro Sealant; D003188:Composite Resins; D005460:Fluorides, Topical; D010756:Phosphoric Acids; D010895:Pit and Fissure Sealants; D010919:Placebos; D000644:Quaternary Ammonium Compounds; D018030:Silver Compounds; C023807:sodium fluoride topical preparation; D012969:Sodium Fluoride; C024633:silver diamine fluoride; C030242:phosphoric acid