Retention and effectiveness of dental sealant after 15 years

Article Abstract:

The pits and fissures found on the surface of the permanent molars are the sites of many dental cavities. Researchers have for many years have sought a way to reinforce the enamel in these areas to prevent cavities. The effectiveness and retention of pit and fissure sealant, which has now been in use for over 15 years, were studied. A group of 33 patients who had their first four permanent molars sealed in 1976 were randomly chosen for the study. They came in for follow-up examinations at five, 10, and 15 years from the time they originally received the sealant. At the 15-year follow-up, 24 of the 33 patients were examined to determine how much, if any, of the original sealant had been retained on the teeth and what condition the teeth were in. A group of subjects who had not received the sealant and who were matched to the study subjects were also examined, for control purposes. For the 15-year follow-up, there were 16 matched pairs of study and control subjects. Complete sealant retention was observed on 27.6 percent of surfaces and there was partial retention on 35.4 percent of surfaces of the 24 study subjects. In these 24 subjects, 74 percent of the tooth surfaces were sound. For the 16 matched pairs, 68.8 percent of the tooth surfaces of subjects that received sealant were sound, while the rest had cavities or fillings. In the matched pair control subjects, only 17.2 percent of the tooth surfaces were sound and 82.8 percent had cavities or fillings. When whole teeth rather than surfaces were considered, 25 of the 64 molars in the sealed group had cavities or fillings and 60 of 64 teeth in the control group had cavities or fillings. These results suggest that a single application of sealant on the surfaces of the permanent molars can greatly reduce the incidence of cavities. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Managing occlusal surfaces of young permanent molars

Article Abstract:

The patterns of cavities in children have changed over the past few decades. Both the overall incidence of cavities and the incidence of smooth-surface cavities have declined as a result of fluoride. The incidence of cavities in the pits and fissures of the permanent molars has not shown similar decreases. Traditionally, molars with cavities were filled, while molars not showing cavities were left alone and watched until cavities appeared. New treatment options and preventive measures make this type of treatment outdated. Little has changed in the diagnosis of molar cavities, but treatment choices vary with diagnosis. For molars that are sound, no treatment is necessary if the pits and fissures are smooth and broad and other molars are also sound. If the pits are deep or other molars have required fillings, using a sealant on sound molars is the proper treatment. Sealants are substances applied to the surface of the molars that further protect the molars from cavity formation. If the molar is questionable, a sealant or a preventive resin restoration (PRR) is the proper treatment. Sealants have been shown to prevent further decay, despite fears of 'sealing over' cavities. PRR involves minor removal of questionable areas and then filling and sealing the tooth to prevent further damage. If cavities are diagnosed, a number of options are available beyond traditional amalgam filling. PRR may be used if the cavities are small and discrete. Alternative materials to amalgam are also available. A number of conservative treatments are now available to the dentist for treating permanent molars. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Molars

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Using a resin-modified glass ionomer as an occlusal sealant: a one-year clinical study

Article Abstract:

A resin-modified glass ionomer (RMGI) does not appear to protect teeth from cavities any better than a light-cured resin sealant. Resin sealants and glass-ionomer cements have both been used to seal cracks in teeth to prevent cavities. Researchers compared a RMGI with a resin sealant in 50 children by treating one side of the mouth with resin sealant and the other side with a RMGI sealant. After one year, there was no significant difference in the incidence of cavities but the RMGI sealant wore significantly faster than the resin sealant.

Cover Story, Sealants, Sealing compounds

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