Efficacy of sealing the mesial surfaces of first permanent molars with respect to the status of the distal surfaces of the second primary molars in children at high caries-risk

Abstract

These results suggest that sealing sound surfaces and non-cavitated caries in the proximal mesial surfaces of permanent molar teeth effectively prevents or reduces the progression of caries adjacent to lesions on the distal surfaces of the second primary molars.

Preventive and Therapeutic Proximal Sealing: A 3.5-Year Randomized Controlled Clinical Trial Follow-Up

“…However, earlier studies have shown promising results when a sealing treatment of early, non-cavitated enamel lesions on proximal posterior surfaces was used in children [Gomez et al, 2005] and young adults [Martignon et al, 2012] for controlling caries progression. Similarly, the same positive results were reported in our first report on this study population 12-14 months following sealing therapy [Gomez et al, 2014]. However, it must be noted that in the therapeutic sealing group, the progression rate of the initial lesions covered with a sealant was very close to being significantly different from that of the paired untreated control surfaces ( p = 0.06).…”

“…It is interesting to note that the efficacy (ARR; treated vs. paired control) of the preventive sealing increased from 17.1% at the 12-14-month follow-up of this study population [Gomez et al, 2014] to 40.0% after 3.5 years in this group. This result suggests that the preventive sealing applied on a mesial permanent molar abutting a second molar surface with active caries is a very efficacious clinical preventive strategy that can be applied to avoid the development of caries in children at high caries risk.…”

“…Therefore, the most desirable intervention is to completely prevent the development of caries lesion and/or arrest the progression on the mesial surface of the first permanent molars. The evaluation of the sealed first permanent molars of the present study population after 12-14 months showed caries progression in 3% compared with 41% in unsealed caries control surfaces [Gomez et al, 2014]. However, long-term clinical studies are needed to confirm this outcome.…”

“…The details of the sealing procedure have been described previously [Gomez et al, 2007[Gomez et al, , 2014. Orthodontic separators were used around the proximal contact area, and a 0.8-1.0 mm interproximal space was achieved within 4-6 days.…”

“…Using a split-mouth design, the other 6m surface in the pair served as control. Results: After 3.5 years, standardized follow-up radiographs enamel lesions on proximal posterior surfaces in both children [Gomez et al, 2005[Gomez et al, , 2014 and young adults [Martignon et al, 2012].Dental caries present on the distal surface of the second primary molar significantly increases the risk of development of caries lesions on the mesial surface of the first permanent molar compared with that in first permanent molars with a sound, neighboring second primary molar [Mejàre et al, 2001;Vanderas et al, 2004;Leroy et al, 2005;Skeie et al, 2006]. Therefore, the most desirable intervention is to completely prevent the development of caries lesion and/or arrest the progression on the mesial surface of the first permanent molars.…”