Long-term study shows effectiveness of fissure sealing

By Sarah Guy

Sealing pits and fissures with a resin-based material can arrest the progression of noncavitated dentinal occlusal caries, show results of a 36-month clinical trial.

"Resin-based sealants have relatively good adherence to tooth structure and have increased resistance to wear, and thus act as mechanical obstacles to the formation of biofilm on the occlusal surface," say the researchers.

Previous studies have indicated similar findings at 12 months' follow up, they add, but this duration may be too short to provide clinicians with sufficient evidence to seal teeth presenting with such caries.

The longer length of the current trial should "be of major impact" and thereby provide stronger clinical evidence to use the method, write Boniek Borges (Federal University of Rio Grande do Norte, Brazil) and colleagues in the International Dental Journal.

The team randomly assigned 60 molar teeth, from 35 individuals aged between 10 and 22 years, to either a control group in which individuals received instructions on oral hygiene (n=30), or to an experiment/intervention group that received the instructions and were treated with an opaque pit-and-fissure sealant (n=30).

At the 12-month follow-up appointment, participants underwent clinical examination including X-rays. Borges and co-investigators report a significant difference in caries' progression between the control and intervention groups at this time point, with 96.1% versus 11.5% of the groups affected, respectively.

By 12 months, only three teeth in the intervention group had either partial (n=2) or full loss of sealant.

At the 24- and 36-month appointments the authors saw no further sealant loss or caries progression, but by then the control group had all experienced caries progression that required restorative treatment, and were thus excluded from further analysis.

"This leads to the assumption that the blocking of the nutritional supply to infected dentine may be the most plausible explanation for the lack of caries progression observed in [this study]," write Borges et al.

The team suggests regular professional follow up when sealing caries in patients because bacterial growth and progression can occur when the sealant bond is disrupted and the infected dentine resumes its nutritional supply, as observed in the control group in this study.

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