title: Comparison between visual clinical examination and the replica method for assessments of sealant retention over a 2-year period.
abstract: To compare the levels of agreement and the survival rates of sealant retention for different sealing materials over a 2-year period assessed using the visual clinical examination and replica methods, sealant retention data were obtained by visual clinical examination and from replicas of the same sealed tooth at baseline and at 0.5-, 1- and 2-year evaluation points in 407 children and were compared for agreement using kappa coefficients. Survival curves of retained sealants on occlusal surfaces were created using modified categorisation (fully retained sealants and those having all pits and fissures partly covered with the sealant material versus completely lost sealants that included pit and fissure systems that had ≥1 pit re-exposed) according to the Kaplan-Meier method. The kappa coefficient for the agreement between both assessment methods over the three evaluation time points combined was 0.38 (95% confidence interval (CI): 0.35-0.41). More sealant retention was observed from replicas than through visual clinical examination. Cumulative survival curves at the three evaluation times were not statistically significantly higher when assessed from replicas (P=0.47). Using the replica method, more retained sealant material was observed than through visual clinical examination during the 2-year period. This finding did not result in a difference in the survival rates of sealants assessed by the two assessment methods. When replicas cast in die stone are used for assessing sealant retention, the level of reliability of the data is higher than that of data obtained through the commonly used visual clinical examination, particularly if such assessments are conducted over time.
authors.affiliation: State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Preventive Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: Private Practitioner, Guangzhou, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Ye
authors.affiliation: State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Ming-Wen
authors.initials: MW
authors.lastname: Fan
authors.affiliation: Department of Preventive and Restorative Dentistry, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Marie-Charlotte
authors.initials: MC
authors.lastname: Huysmans
authors.affiliation: Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Jo E
authors.initials: JE
authors.lastname: Frencken
mesh_terms: D003752:Dental Health Services; D006801:Humans; D010808:Physical Examination; D010895:Pit and Fissure Sealants
chemical_list: D010895:Pit and Fissure Sealants