title: Impact of the intermediary layer on sealant retention: a randomized 24-month clinical trial.
abstract: OBJECTIVE
  The aims of this study were to assess long-term impact of tooth eruption stages (ES) on sealant retention on occlusal surfaces previously coated with intermediary bonding layer and to determine caries prevention.
  
  
  METHODS
  Sixty-five school children were selected (aged 6-10 years), with four non-carious permanent first molar in different ES (OP (operculum present), ME (marginal edge), CE (completely erupted)). Split-mouth and single-blind study design was used. The teeth (260) were randomly selected according to treatment (sealant/technique): F (Fluroshield), H (Helioseal Clear Chroma), SF (Single Bond + F), EH (Excite + H). Sealant retention, marginal integrity, discoloration, and caries prevention were assessed after 6, 12, 18, and 24 months by calibrated examiner (Spearman = 0.91) using visual inspection. Data were submitted to the Cox proportional hazard model (survival analysis) and Likelihood ratio χ2test (correlation), p ≤ 0.05.
  
  
  RESULTS
  At baseline, ES was 20 % in OP, 54 % in ME, and 26 % in CE. There was no significant difference on sealant retention between the treatments (p = 0.2774). However, significant differences were found regarding the ES on sealant retention (p = 0.0041). The CE stage showed the highest retention survival rate during the 24 months. The overall sealant prevention average was found to be about 99.4 % and showed no difference between the groups.
  
  
  CONCLUSIONS
  Eruption stages affect sealant retention irregardless of the intermediate layer and type of sealant. However, there was caries prevention on tooth occlusal surfaces after 24 months, regardless of treatment.
  
  
  CONCLUSIONS
  Sealing is recommended to prevent occlusal caries of newly erupted teeth in high-caries-risk patients. However, its application is critical on moisture limited control surfaces independently of sealer material and technique.
authors.affiliation: Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil.
authors.forename: Kelly Maria Silva
authors.initials: KMS
authors.lastname: Moreira
authors.affiliation: Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil.|São Leopoldo Mandic Institute and Dental Research Center, Campinas, São Paulo, Brazil.
authors.forename: Kamila Rosamilia
authors.initials: KR
authors.lastname: Kantovitz
authors.affiliation: Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil.
authors.forename: Juliana Pedrini Dias
authors.initials: JPD
authors.lastname: Aguiar
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil.
authors.forename: Ana Flávia Sanches
authors.initials: AFS
authors.lastname: Borges
authors.affiliation: Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil.
authors.forename: Fernanda Miori
authors.initials: FM
authors.lastname: Pascon
authors.affiliation: Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-900, Brazil. rmpuppin@fop.unicamp.br.
authors.forename: Regina Maria
authors.initials: RM
authors.lastname: Puppin-Rontani
mesh_terms: D002648:Child; D001840:Dental Bonding / Q000379:methods*; D003731:Dental Caries / Q000517:prevention & control*; D003738:Dental Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008963:Molar; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D016037:Single-Blind Method; D014078:Tooth Eruption
chemical_list: D003738:Dental Cements; D010895:Pit and Fissure Sealants
keywords: Adhesive system; Clinical trial; Intermediary layer; Pit and fissure sealants; Retention; Tooth eruption