title: Caries-preventive Effect of Supervised Toothbrushing and Sealants.
abstract: To investigate the effectiveness of 3 caries-preventive measures on high- and low-caries risk occlusal surfaces of first permanent molars over 3 y. This cluster-randomized controlled clinical trial covered 242 schoolchildren, 6 to 7 y old, from low socioeconomic areas. At baseline, caries risk was assessed at the tooth surface level, through a combination of ICDAS II (International Caries Detection and Assessment System) and fissure depth codes. High-caries risk occlusal surfaces were treated according to daily supervised toothbrushing (STB) at school and 2 sealants: composite resin (CR) and atraumatic restorative treatment-high-viscosity glass-ionomer cement (ART-GIC). Low-caries risk occlusal surfaces received STB or no intervention. Evaluations were performed after 0.5, 1, 2, and 3 y. A cavitated dentine carious lesion was considered a failure. Data were analyzed according to the proportional hazard rate regression model with frailty correction, Wald test, analysis of variance, and t test, according to the jackknife procedure for calculating standard errors. The cumulative survival rates of cavitated dentine carious lesion-free, high-caries risk occlusal surfaces were 95.6%, 91.4%, and 90.2% for STB, CR, and ART-GIC, respectively, over 3 y, which were not statistically significantly different. For low-caries risk occlusal surfaces, no statistically significant difference was observed between the cumulative survival rate of the STB group (94.8%) and the no-intervention group (92.1%) over 3 y. There was neither a difference among STB, CR, and ART-GIC on school premises in preventing cavitated dentine carious lesions in high-caries risk occlusal surfaces of first permanent molars nor a difference between STB and no intervention for low-caries risk occlusal surfaces of first permanent molars over 3 y.
authors.affiliation: Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil leandrohilgert@gmail.com leandrohilgert@unb.br.
authors.forename: L A
authors.initials: LA
authors.lastname: Hilgert
authors.affiliation: Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil.
authors.forename: S C
authors.initials: SC
authors.lastname: Leal
authors.affiliation: Department of Oral Global Health, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Mulder
authors.affiliation: Department of Oral Rehabilitation, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: N H J
authors.initials: NH
authors.lastname: Creugers
authors.affiliation: Department of Oral Global Health, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Frencken
mesh_terms: D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D006801:Humans; D010895:Pit and Fissure Sealants; D014099:Toothbrushing
chemical_list: D010895:Pit and Fissure Sealants
keywords: ART sealants; atraumatic restorative treatment; caries prevention; dental caries; glass-ionomer cements; resin composite