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Clinical Evaluation of a Fissure Sealant vs Flowable Composite in Occlusal Caries Prevention
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The split-mouth randomized controlled trial compared a fissure sealant and a flowable composite material in terms of survival retention and caries prevention in permanent molars for 36 months after placement. A total of 34 patients with 220 sealants placed in 117 upper molars and 103 lower molars were included. There were no statistically significant differences between material retention (survival) at any time point from 6 to 36 months. Survival ranged from approximately 96% at 6 months to approximately 80% at 36 months for both materials. The fissure sealant behaved a bit more favorably in the mandibular molars compared with the flowable composite, which behaved better in the maxillary molars, suggesting that location and gravity may play a role in material retention.
- The use of either a fissure sealant or a flowable composite is proven to provide good overall protection against occlusal caries. Clinicians should choose an appropriate material based on the application process and tooth location.
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersOBJECTIVES
The purpose of the present clinical evaluation was to investigate the effect of a fissure sealant and a flowable composite at fissures of permanent molars in terms of retention and caries-incidence rates over a 36-month period.
METHODS
Thirty-four patients, ages varied from 16 to 22 years, diagnosed with at least 2 non-cavitated pit-and-fissure caries in the first and second molars were involved in the study. A total of 220 sealants, were placed in 117 upper molars and 103 lower molars. Teeth were sealed with either a flowable resin composite (Tetric Evo Flow) or a sealant material (Helioseal F)(n=110). Each restoration was evaluated in terms of retention and caries incidence at 6, 12, 24 and 36 months according to their location as well. Data were analyzed using Mann-Whitney U, Friedman and 1-way ANOVA tests at p < 0.05.
RESULTS
Tetric Evo Flow showed total retention with 95.5%, 93.8%, 88.5% and 80.2% at 6, 12, 24 and 36-month follow-ups respectively, while Helioseal F had retention rates of 95.5%, 94.8%, 85.4% and 80.2% respectively. After 36-months, there were 6 subjects totally lost in Helioseal F group, whereas 7 of the Tetric Evo Flow sunjects were totally lost. Caries development was firstly detected at 12-month evaluation for both of the materials however, no significant differences were observed among materials in retention rates or caries incidence after 36-month follow-ups (p>0.05).
SIGNIFICANCE
Using the flowable composite found as effective as the fissure sealant after 36-months regarding retention and caries incidence rates.
Additional Info
Disclosure statements are available on the authors' profiles:
COMPARATIVE EVALUATION OF A FISSURE SEALANT AND A FLOWABLE COMPOSITE: A 36-MONTH SPLIT-MOUTH, RANDOMIZED CLINICAL STUDY
J Dent 2022 Jun 17;[EPub Ahead of Print], G Ozan, HS Sancakli, U Erdemir, BC Yaman, SO Yildiz, E YildizFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This spilt-mouth randomized clinical study compared the retention rate and caries incidence of a resin sealant and a flowable composite material for permanent molars at 6, 12, and 36 months. The study was conducted at Istanbul University and included 34 patients between the ages of 16 and 22 years who had at least two permanent molars with International Caries Detection and Assessment System (ICDAS) scores of 0, 1, or 2 caries lesions. A sample size of 110 was used for each of the materials, Helioseal F (resin sealant) and Tetric Evo Flow (flowable composite). The retention rate of resin sealants and flowable composite was high (approximately 80%) at 36 months. There was no difference in the rate of caries incidence between the two materials at 6 months (ICDAS 0, 100%) and 36 months (ICDAS 0, 92.7%; ICDAS 2, 7.3%).
The use of sealants is strongly recommended as a preventive and therapeutic measure for primary and permanent teeth. The present study is well-designed, with reasonable sample size. Based on these results, either material can predictably be used for sealing pits and fissures. While the authors did not use a bonding agent with the resin sealant, studies show that they enhance retention. Furthermore, the use of rubberdam or isovac instead of cotton rolls could have provided better isolation and clinical outcomes.