title: Effectiveness of pit and fissure sealants bonded with different adhesive systems: a prospective randomized controlled trial.
abstract: OBJECTIVE
  To evaluate and compare the clinical retention of a resin-based fissure sealant placed with an intermediate layer of etch-and-rinse (ER) or self-etch (SE) adhesives.
  
  
  METHODS
  Two hundred twenty-eight sealants were placed in 57 children with previously unsealed, caries-free permanent first molars, employing a split-mouth design. The teeth were randomized into four groups (n = 57 teeth/groups) according to the adhesive system placed under the tested sealant (Delton FS+; Dentsply). Group 1 (control): no bonding agent (conventional acid-etch sealant); group 2: prior enamel etch + ER adhesive (XP Bond; Dentsply); group 3: SE adhesive (Clearfil SE Bond; Kuraray) without prior etching; and group 4: prior enamel etch + SE adhesive (Clearfil SE Bond). Clinical assessments were performed according to modified USPHS criteria at 1, 3, 6, 12, 18, and 24 months. The data were analyzed statistically using Fisher's Exact test, the Kaplan-Meier analysis, and the Log-rank test.
  
  
  RESULTS
  At 24 months, sealants bonded with XP Bond and Clearfil SE Bond with prior enamel etching showed similar retention rates (p > 0.05), and these rates were significantly better than the rates of the conventional sealant and Clearfil-SE groups (p < 0.05). There was no significant difference between the retention rates of the latter two groups (p > 0.05). The cumulative survival rates on palatal/buccal surfaces showed similar outcomes as with occlusal surfaces: XP Bond (94%), Clearfil SE Bond + acid-etch (94%), conventional sealant (52%), and Clearfil SE Bond only (37%).
  
  
  CONCLUSIONS
  Application of the tested ER adhesive and the SE adhesive with enamel etching significantly improved the clinical retention of Delton-FS over the 24-month period.
  
  
  CONCLUSIONS
  The use of a resin-based fissure sealant placed with ER or SE adhesive with prior acid-etching yielded better retention than the conventional sealant over the 24-month period.
authors.affiliation: Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, 06100, Sihhiye/Ankara, Turkey. erbasgizem@yahoo.com.
authors.forename: Gizem
authors.identifier: http://orcid.org/0000-0002-8916-5949
authors.initials: G
authors.lastname: Erbas Unverdi
authors.affiliation: Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, 06100, Sihhiye/Ankara, Turkey.
authors.forename: Stephan Atilla
authors.initials: SA
authors.lastname: Atac
authors.affiliation: Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, 06100, Sihhiye/Ankara, Turkey.
authors.forename: Zafer Cavit
authors.initials: ZC
authors.lastname: Cehreli
mesh_terms: D000134:Acid Etching, Dental; D017438:Bisphenol A-Glycidyl Methacrylate / Q000737:chemistry; D002648:Child; D001840:Dental Bonding / Q000379:methods*; D017220:Dentin-Bonding Agents / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D010895:Pit and Fissure Sealants / Q000737:chemistry*; D011446:Prospective Studies; D019279:Resin Cements / Q000737:chemistry; D016037:Single-Blind Method; D013499:Surface Properties; D016896:Treatment Outcome
chemical_list: C438313:Clearfil SE Bond; D017220:Dentin-Bonding Agents; D010895:Pit and Fissure Sealants; D019279:Resin Cements; C532387:XP-Bond; D017438:Bisphenol A-Glycidyl Methacrylate
keywords: Adhesive systems; Clinical study; Fissure sealant; Intermediate bonding layer; Retention