Comparison of Fissure Sealant Chair Time and Patients’ Preference Using Three Different Isolation Techniques

Abstract

This randomized clinical trial aimed to evaluate the patient’s preference and chair time needed during pit and fissure sealant placement under three isolation techniques (Isolite system, rubber dam isolation, and cotton roll isolation). Participants, aged 6–15 years and requiring four sealants on the first or second permanent molars, attending the pediatric dental clinics at King Saud University in Saudi Arabia were enrolled according to the inclusion criteria. Each participant received sealants on three random first or second permanent molars using three isolation techniques. The time required for sealant placement was recorded for each technique. Following sealant placement, an interview-based questionnaire was administered to the participants to evaluate their preference regarding the isolation techniques. Forty-eight children (23 male and 25 female) with a mean age of 8.58 ± 1.93 years participated in this study. The mean chair times were 248.14, 255.89, and 243.29 s for the Isolite system, rubber dam isolation, and cotton roll isolation, respectively. Approximately 79% of participants considered cotton roll isolation to be the most comfortable, whereas approximately 71% were significantly less likely to use rubber dam isolation again. In conclusion, there were no significant differences in sealant placement time among the three isolation techniques. However, cotton roll isolation was the technique that was most preferred by the participants.

Evaluation of fissure sealant retention rates using Isolite in comparison with rubber dam and cotton roll isolation techniques: A randomized clinical trial

“…A previously published clinical trial assessed the patient preferences and differences in the time taken to place PFS under IS, RDI, and CRI. 10 A nonsignificant difference was found for placement time; the participants, however, significantly preferred CRI. The same patients were followed up in this study for PFS retention, and several factors were tested to measure their impact on sealant retention, dental arch (maxilla or mandible), type of tooth, and follow-up time.…”

“…The sample size was calculated based on the previous investigation. 10 The participants in this study are followups from a previous clinical trial, in which their preference for isolation techniques and timing of fissure sealant placement were evaluated. Further details are provided in Appendix S1.…”

“…6 Among the several techniques available to isolate teeth receiving PFS, rubber dam isolation (RDI) is the most commonly recommended technique 7 ; several disadvantages, however, such as the need for local/topical anesthesia and many children disliking it are associated with its use. [8][9][10] Another widely used most common technique for PFS placement among paediatric dentists is cotton roll isolation (CRI) 11 ; clinicians may, however, also face difficulties with this technique. Cotton rolls may stimulate the gag reflex if placed on the lateral portion of the tongue and are considered time-consuming when maxillary and mandibular teeth are sealed simultaneously.…”

“…Cotton rolls may stimulate the gag reflex if placed on the lateral portion of the tongue and are considered time-consuming when maxillary and mandibular teeth are sealed simultaneously. 12 Recently, a new isolation technique named the Isolite system (IS) 13 has been investigated in the field of paediatric dentistry, 9,10,12,14 which possesses five main characteristics: facilitating access to upper and lower quadrants simultaneously, applying continuous suction, retracting soft tissue, acting as a bite block, and providing intraoral LED illumination.…”

“…Moisture control is “the ability to regulate the fluid environment within the oral cavity and around the individual teeth being operated on. Fluids include water, saliva, gingival exudate, and blood.” 6 Among the several techniques available to isolate teeth receiving PFS, rubber dam isolation (RDI) is the most commonly recommended technique 7 ; several disadvantages, however, such as the need for local/topical anesthesia and many children disliking it are associated with its use 8–10 . Another widely used most common technique for PFS placement among paediatric dentists is cotton roll isolation (CRI) 11 ; clinicians may, however, also face difficulties with this technique.…”