Effectiveness of Fissure Sealant Retention and Caries Prevention with and without Primer and Bond

Abstract

Objective: This study evaluated the effectiveness of sealant retention and caries prevention with and without primer and bond below the fissure sealant among Kuwaiti schoolchildren. Subjects and Methods: This clinical trial used fissure sealant that was applied to four sound first permanent molars on 78 children. All the teeth were cleaned with pumice and rubber cups, isolated with rubber dams, and etched for 20 s. In a split-mouth study design, for the test teeth (n = 156), primer and bond (3M Scotchbond Multi-Purpose Plus System primer and bond) were applied below the sealant, and for the control teeth (n = 156), only sealant (Delton Plus) was applied. The number of tooth surfaces included was 480. Due to loss to follow-up, only 60 children were evaluated at 5 years for sealant retention and caries. The evaluation criteria were: completely retained sealant, complete or partial sealant retention, and caries. Results: In teeth sealed with primer and bond, 47 (19.6%) tooth surfaces had completely retained sealant, 60 (9.2%) teeth had partially retained sealant, while in 51 (21.3%) caries was prevented and 120 (50%) tooth surfaces were carious or filled. In teeth sealed without primer and bond, 25% (60 tooth surfaces) had completely retained sealant, 6% (14 teeth surfaces) had partially retained sealant, 26% (54 teeth surfaces) showed caries prevention, and 49.6% (119 tooth surfaces) were carious or filled. There was no difference between teeth sealed with primer and bond (120 teeth) and teeth sealed without primer and bond (120 teeth) in completely retained sealant (p = 0.15), complete or partial sealant retention (p = 0.6), caries prevented (p = 0.37), and caries (p = 0.93). Conclusion: Caries prevention was not enhanced in teeth sealed with primer and bond sealant compared with those sealed with sealant alone.

Evaluation of pit‐and‐fissure sealants placed with four different bonding protocols: a randomized clinical trial

“…Use of bonding agent, however, consistently increased percentage of sealant retention. Feigal et al 5 and Sakkas et al reported statistically significant increase in retention of sealants placed using adhesives at 5‐year and 36‐month follow‐up, respectively; however, few studies in literature indicate that use of bonding agent as an intermediate layer may not be beneficial although a tendency for improved retention was noted, similar to the results of our study. The difference in results of the studies may be attributed to the variation in the type of bonding agent and sealant used, sample size, age group and duration of the study.…”

Dental hypomineralization treatment: A systematic review

“…Lygidakis et al reported that fissure sealants applied using an adhesive system had a higher retention rate than those that were applied without it. However, results regarding the use of an adhesive prior to fissure sealant application are conflicting . In 2015 a meta‐analysis carried out by Botton et al concluded that the nonuse of an adhesive resulted in a higher retention rate of fissure sealants in teeth without hypomineralization.…”

“…However, results regarding the use of an adhesive prior to fissure sealant application are conflicting. [83][84][85][86] In 2015 a meta-analysis carried out by Botton et al 87 concluded that the nonuse of an adhesive resulted in a higher retention rate of fissure sealants in teeth without hypomineralization. As so, further studies are needed in order to confirm the results reported by Lygidakis et al 44 Fragelli et al 41 evaluated the success of glass ionomer restorations in teeth affected with MIH, reporting a success rate of 78.8% at Comparison between groups is statistically significant at P < 0.001. c Comparison with baseline is statistically significant at P < 0.05.…”

A concise review of dental sealants in caries management

“…However, this difference disappeared at 6-month and 12-month follow-ups (121). Some other studies did not find an enhancement in the retention rate of dental sealant with the addition of dental adhesives (122,123). Literature shows strong evidence on the operative factors affecting the longevity of dental sealant.…”