Effect of Fluoridated Sealants on Adjacent Tooth Surfaces: A 30-mo Randomized Clinical Trial.
A double-blind randomized clinical trial was performed in 6- to 7-yr-old schoolchildren to evaluate, in a 30-mo period, whether the caries increment on the distal surface of the second primary molars adjacent to permanent first molars sealed with fluoride release compounds would be lower with respect to those adjacent to permanent first molars sealed with a nonfluoridated sealant. In sum, 2,776 subjects were enrolled and randomly divided into 3 groups receiving sealants on sound first molars: high-viscosity glass ionomer cement (GIC group); resin-based sealant with fluoride (fluoride-RB group); and a resin-based sealant without fluoride (RB group). Caries (D1 - D3 level) was recorded on the distal surface of the second primary molar, considered the unit of analysis including only sound surfaces at the baseline. At baseline, no differences in caries prevalence were recorded in the 3 groups regarding the considered surfaces. At follow-up, the prevalence of an affected unit of analysis was statistically lower (p = .03) in the GIC and fluoride-RB groups (p = .04). In the GIC group, fewer new caries were observed in the unit of analysis respect to the other 2 groups. Incidence rate ratios (IRRs) were 0.70 (95% confidence interval: 0.50, 0.86; p < .01) for GIC vs. RB and 0.79 (95% confidence interval: 0.67, 0.89; p = .005) for fluoride-RB vs. RB [Corrected]. Caries incidence was significantly associated with low socioeconomic status (IRR = 1.18; 95% confidence interval: 1.10, 1.42; p = .05). Dental sealant high-viscosity GIC and fluoride-RB demonstrated protection against dental caries, and there was evidence that these materials afforded additional protection for the tooth nearest to the sealed tooth (clinical trial registration NCT01588210).
WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, San Paolo Hospital, Milan, Italy.
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Cagetti
Department of Surgery, Microsurgery, and Medical Science, School of Dentistry, University of Sassari, Italy.
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Carta
WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, San Paolo Hospital, Milan, Italy Department of Chemistry, University of Sassari, Italy.
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Cocco
Department of Surgery, Microsurgery, and Medical Science, School of Dentistry, University of Sassari, Italy.
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Sale
Department of Surgery, Microsurgery, and Medical Science, School of Dentistry, University of Sassari, Italy.
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Congiu
Department of Surgery, Microsurgery, and Medical Science, School of Dentistry, University of Sassari, Italy.
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Mura
WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, San Paolo Hospital, Milan, Italy.
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Strohmenger
Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden.
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Lingström
WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, San Paolo Hospital, Milan, Italy Department of Surgery, Microsurgery, and Medical Science, School of Dentistry, University of Sassari, Italy gcampus@uniss.it.
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Campus
D002327:Cariostatic Agents / Q000627:therapeutic use*; D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D005459:Fluorides / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008297:Male; D008963:Molar / Q000187:drug effects*; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D019279:Resin Cements / Q000737:chemistry; D012923:Social Class; D014094:Tooth, Deciduous / Q000187:drug effects*; D014783:Viscosity
D002327:Cariostatic Agents; D005899:Glass Ionomer Cements; D010895:Pit and Fissure Sealants; D019279:Resin Cements; D005459:Fluorides
community dentistry; dental caries; fluorides; pit and fissure sealants; primary prevention; primary teeth