Randomized Trial on Fluorides and Sealants for Fissure Caries Prevention

Abstract

To investigate the effectiveness of topical fluorides in preventing fissure caries, we conducted a randomized controlled trial with parallel groups. In total, 501 children (1,539 molars, 3,078 sites), mean age 9.1 years, who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited. They were randomly allocated among four groups: (1) resin sealant, single placement; (2) 5% NaF varnish, semi-annual application; (3) 38% silver diamine fluoride (SDF) solution, annual application; and (4) placebo control. Follow-up examinations were conducted every 6 months by a masked examiner. After 24 months, 485 children (97%) were examined. Proportions of pit/fissure sites with dentin caries in the sealant, NaF, SDF, and control groups were 1.6%, 2.4%, 2.2%, and 4.6%, respectively. A multi-level logistic regression analysis accounting for the effects of data clustering and confounding factors showed that fissures in any of the three treatment groups had significantly lower risks of carious cavity development into dentin than did controls (p < 0.05). We concluded that placement of resin sealant, semi-annual application of NaF varnish, and annual application of SDF solution are all effective in preventing pit and fissure caries in permanent molars (ClinicalTrials.gov number CT01446107).

Seal or Varnish? A randomised controlled trial to determine the relative cost and effectiveness of pit and fissure sealant and fluoride varnish in preventing dental decay

“…61,[66][67][68] In their 2016 review of these studies, Ahovuo-Saloranta et al 16 said that it was not possible to reach conclusions about whether to apply FS or FV to the occlusal surfaces of permanent molars to best effect. The clinical outcomes from the current trial suggest that there is no significant difference in the clinical outcome, irrespective of whether FS or FV is used.…”

Retention and caries-preventive effect of glass ionomer and resin-based sealants: An 18-month-randomized clinical trial

“…In the present study, no significant difference in the cumulative survival of free-pit and fissure caries was found between Fuji Triage and Clinpro sealants. Similarly, a field study found no significant difference in the cumulative survival of pit and fissure caries between glass-ionomer and resin-based sealants after two years 30) . Another study reported no significant difference in caries incidence between glass-ionomer and resin-based sealants 33) .…”

“…Possibility effect of topical fluoride on the effectiveness of sealants in fissure caries prevention might exist. In addition, both sealant recharge fluoride from the topical fluoride which may increase the caries-preventive effect of both the sealants 29,30) . However, in the current study, no difference in caries-preventive effect between the two sealants was observed as the topical fluoride application was applied to all children and balanced by the same type and concentration.…”

Performance of Preventive Methods Applied to the Occlusal Surface of Primary Teeth: A Randomized Clinical Study

“…According to researchers, this product forms a chemical seal with obliteration of dentinal tubules, and the resulting materials -calcium fluoride, silver phosphate and silver proteinate -covering both organic and inorganic parts [29][30][31]. In a 24-month study addressing decay on 1491 molars, it was found the resin sealant Clinpro ® achieved better results in comparison to silver diamine fluoride at a concentration of 38% [32]. A similar result was found in the present investigation when comparing the number of carious lesions in teeth sealed with the resin sealant Alpha Seal ® or Vitremer ® to those sealed with silver diamine fluoride.…”