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European Archives of Paediatric... Feb 2022To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the...
PURPOSE
To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?'
METHODS
An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers.
RESULTS
Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed.
CONCLUSION
The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.
Topics: Adolescent; Child; Composite Resins; Dental Enamel Hypoplasia; Humans; Incisor; Molar; Pit and Fissure Sealants
PubMed: 34110615
DOI: 10.1007/s40368-021-00635-0 -
Journal of Dentistry Aug 2023To evaluate predictors for caries incidence on first permanent molars and to assess the accuracy and efficiency of these predictors for the indication of pit and fissure...
OBJECTIVES
To evaluate predictors for caries incidence on first permanent molars and to assess the accuracy and efficiency of these predictors for the indication of pit and fissure sealants.
METHODS
This 7-y cohort study started in 2010 with a sample of 639 children (1-5 years) from Southern Brazil. Dental caries was assessed using the ICDAS. Maternal education, family income, parental perception on child oral health and severe dental caries experience were collected at baseline and used to test the prediction of dental caries. Predictive values, accuracy and efficiency were estimated for each possible predictor.
RESULTS
449 children were re-assessed at follow-up (70.3% retention rate). The baseline characteristics showed similar risks for dental caries incidence in first permanent molars. Low family income and poor parental perception of child oral health were moderately accurate in correctly identifying sound children who would not need to receive pit and fissure sealant. However, all the adopted criteria have lower accuracy incorrectly identifying children who later developed dental caries in first permanent molars.
CONCLUSIONS
Distal and intermediate factors were relatively accurate in determining caries risk incidence on children's first permanent molars. The criteria adopted were more accurate in identifying sound children than those who need to receive pit and fissure sealant.
CLINICAL RELEVANCE
Our findings reinforce the idea that investing in strategies that take into account common risk factors still represents the best option for dental caries prevention. However, adopting only these parameters is not enough to indicate pit and fissure sealants.
Topics: Humans; Child; Pit and Fissure Sealants; Dental Caries; Prospective Studies; Cohort Studies; Molar
PubMed: 37230242
DOI: 10.1016/j.jdent.2023.104557 -
Evidence-based Dentistry Jun 2023This study was a randomised controlled trial (RCT) designed to evaluate the effectiveness of music therapy and aromatherapy on reducing dental anxiety and fear in... (Randomized Controlled Trial)
Randomized Controlled Trial
DESIGN
This study was a randomised controlled trial (RCT) designed to evaluate the effectiveness of music therapy and aromatherapy on reducing dental anxiety and fear in children during a fissure sealant treatment.
CASE SELECTION
Participants were selected from three primary schools from the Phitsanulok Province in Thailand. These children were randomly allocated to a (1) Control group (n = 33), (2) Music Therapy Experimental Group (n = 33), (3) Aromatherapy Group (n = 33) and (4) Combination Experimental Group (n = 33). Measures included dental anxiety and fear scores as well as vital signs (blood pressure, heart rate and oxygen saturation level) pre- and post-fissure sealant treatment.
DATA ANALYSIS
Descriptive statistics were used for categorical data. Mean and standard deviations were calculated for continuous data. For the four arms, Chi-squared tests and one-way ANOVA were used to compare base line characteristics of the participants. Paired t-tests were used to compare changes within groups in dental anxiety and fear and vital signs pre- and post-treatment.
RESULTS
Overall, 128 participants took part in were in the final analysis (32, 33, 31 and 32 in groups 1-4, respectively). In the music therapy group and aromatherapy group, there was a decrease in dental anxiety and fear, blood pressure and increase in oxygen saturation level (p = 0.05). In the combination group, there was a decrease in dental anxiety and fear, heart rate, blood pressure and increase in oxygen saturation level (p = 0.05). A statistically significant interaction effect was found between combination therapy on dental anxiety and fear (F = 22.22; P < 0.001) and oxygen saturation level (F = 17.40; P < 0.001).
CONCLUSIONS
The authors conclude that the findings of this RCT suggest that the use of music therapy and aromatherapy reduces dental anxiety and fear in children, and is more effective when used in combination.
Topics: Child; Humans; Music Therapy; Aromatherapy; Dental Anxiety; Pit and Fissure Sealants; Heart Rate
PubMed: 37161071
DOI: 10.1038/s41432-023-00881-9 -
Pediatric Dentistry Oct 2018This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in...
This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits-and-fissures of occlusal surfaces. This is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the U.S. market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions. The guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of non-cavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others. These recommendations are designed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents. Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients. The authors recommend that clinicians re-orient their efforts toward increasing the use of sealants on the occlusal surfaces of primary and permanent molars in children and adolescents.
Topics: Adolescent; Child; Dental Caries; Fluorides, Topical; Humans; Molar; Pediatric Dentistry; Pit and Fissure Sealants
PubMed: 32074886
DOI: No ID Found -
Archives of Oral Biology Mar 2023To develop clinically applicable methods to characterize occlusal topography and assess possible associations between morphology and caries incidence and development.
OBJECTIVE
To develop clinically applicable methods to characterize occlusal topography and assess possible associations between morphology and caries incidence and development.
DESIGN
In this retrospective clinical study, we evaluated caries presence and severity pre- and post-orthodontic treatment for first molars of 147 patients (384 teeth). These teeth were previously scanned using a clinical intraoral scanner, and the obtained digital elevation models were used to 1) analyze the 3D occlusal surface parameters (n = 384) and 2) quantitatively characterize the mandibular molars' (n = 166) fissure patterns using three novel methods. Pearson correlation coefficients were calculated to evaluate the associations among the measurements, and presence/severity of caries pre- and post-treatment were assessed using generalized linear mixed-effects models.
RESULTS
Robust quantitative fissure characterizations were developed, and reliable occlusal surface parameters were obtained. In the studied population, none of the parametric measurements (Slope: p = 0.62 for presence, p = 0.96 for severity; Relief Index (RFI): p = 0.36, p = 0.84; Orientation Patch Count rotated (OPCr): p = 0.48, p = 0.13; Dirichlet Normal Energy (DNE): p = 0.91, p = 0.15) or the fissure morphological measurements (Mesial Angle: p = 0.43; Distal Angle: p = 0.86; Average Angle: p = 0.52; Area Difference: p = 0.83; Percent Fissure: p = 0.68) were found to be significantly associated with caries status or severity.
CONCLUSION
Despite the lack of correlation in the limited studied sample, the tools developed to characterize occlusal surface topography and fissure morphology have the potential to be used in more comprehensive clinical evaluations.
Topics: Humans; Retrospective Studies; Pit and Fissure Sealants; Dental Caries; Molar; Incidence
PubMed: 36657276
DOI: 10.1016/j.archoralbio.2023.105623 -
The Journal of Clinical Pediatric... Sep 2023The aim was to systematically evaluate the cost-effectiveness of pit and fissure sealants (PFSs) compared with that of fluoride varnishes (FVs) in dental caries...
The aim was to systematically evaluate the cost-effectiveness of pit and fissure sealants (PFSs) compared with that of fluoride varnishes (FVs) in dental caries prevention. We searched four electronic databases including the Cochrane Oral Health Group's Trials Register (till 03 June 2022), Web of Science (from 1945 to 03 June 2022), PubMed (from 1996 to 03 June 2022), and EMBASE Ovid (from 1980 to 03 June 2022) to identify the cost and effectiveness of PFSs and FVs in decreasing dental caries incidence. Two researchers independently screened search results, extracted data from the included studies, and conducted the risk of bias assessments. The main characteristics of the included studies were extracted and analyzed. The initial search produced 874 articles. After removing duplicates and full-text review, 19 studies were included. In this study: nine studies were on PFSs comparison with control; five on PFSs comparison with FVs; and five on FVs comparison with control. Regarding the type of economic evaluation (EE), 13 studies conducted cost-effectiveness analysis, five conducted cost-utility analyses, and one conducted both cost-effectiveness analysis and cost-utility analyses. The cost-effectiveness evaluation of PFSs and FVs in the available studies was limited. The prevalence of dental caries, payers' willingness to pay, length of follow-ups, delivery settings, retention rate of PFS, and application intervals of FV can affect the economic evaluation of these two methods for dental caries prevention. Therefore, more studies in the future are need to draw clear conclusions about which method is more cost-effective for the two preventive interventions in future.
Topics: Humans; Cost-Benefit Analysis; Fluorides, Topical; Pit and Fissure Sealants; Dental Caries; Cost-Effectiveness Analysis
PubMed: 37732430
DOI: 10.22514/jocpd.2023.048 -
Journal of Dental Research Apr 2015For shallow or moderately deep pit-and-fissure lesions, various treatment options are available: (1) noninvasive treatments (e.g., fluoride application, antibacterial... (Meta-Analysis)
Meta-Analysis Review
For shallow or moderately deep pit-and-fissure lesions, various treatment options are available: (1) noninvasive treatments (e.g., fluoride application, antibacterial treatments, oral hygiene advice) avoid any dental hard tissue removal; (2) microinvasive treatments (e.g., sealing) remove only a few micrometers of hard tissues by etching; and minimally invasive methods (e.g., "preventive" resin/sealant restoration) remove carious dentin but avoid sacrificing sound tissues. We aimed at systematically reviewing and comparing these strategies for treating pit-and-fissure lesions in permanent teeth using network meta-analysis. Randomized or nonrandomized clinical trials investigating shallow or moderately deep primary caries lesions in fissured or pitted surfaces were included. We compared the risk of requiring invasive treatments or any retreatments in noninvasive, microinvasive, and minimally invasive treated lesions; untreated lesions were used as controls. Five electronic databases were systematically screened up to September 2013 and cross-referencing performed. Pairwise and network meta-analyses were performed and odds ratios and 95% confidence intervals (CI) calculated. Certainty of estimates was evaluated via GRADE criteria. From a total of 2,214 identified records, 14 studies representing 1,440 patients with 3,551 treated lesions were included. Pairwise meta-analysis found microinvasive and minimally invasive treated lesions to require less invasive retreatments than control lesions (odds ratios [95% confidence intervals]: 0.13 [0.07 to 0.26], 0.13 [0.03 to 0.50], respectively), whereas the estimate for noninvasively treated lesions remained nonsignificant (0.64 [0.39 to 1.06]). These findings were reflected in the strategy ranking stemming from network meta-analysis (first, minimally invasive; second, microinvasive; third, noninvasive). However, microinvasive treatment required significantly more total retreatments (including resealing) than minimally or noninvasive treatments. Due to limited study quality, the evidence was graded as low or very low. Clinical treatment decisions should consider the long-term sequelae and costs stemming from different therapies as well as their subjective impact on the patient. Available treatment options seem suitable for treating shallow or moderately deep pit-and-fissure lesions in permanent teeth; further conclusions are not possible.
Topics: Cariostatic Agents; Dental Atraumatic Restorative Treatment; Dental Enamel; Dental Fissures; Humans; Pit and Fissure Sealants; Risk Factors; Treatment Outcome
PubMed: 25710951
DOI: 10.1177/0022034515571184 -
Pediatric Dentistry Sep 2017This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in...
BACKGROUND
This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits-and-fissures of occlusal surfaces.
TYPES OF STUDIES REVIEWED
This is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the U.S. market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions.
RESULTS
The guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of non-cavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others. Conclusions and practical implications: These recommendations are designed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents. Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients. The authors recommend that clinicians re-orient their efforts toward increasing the use of sealants on the occlusal surfaces of primary and permanent molars in children and adolescents.
Topics: Adolescent; Child; Dental Care for Children; Dental Caries; Dentition, Permanent; Humans; Molar; Pit and Fissure Sealants; Tooth, Deciduous
PubMed: 29179354
DOI: No ID Found -
Dental Clinics of North America Apr 2018We focus on scalable public health interventions that prevent and delay the development of caries and enhance resistance to dental caries lesions. These interventions... (Review)
Review
We focus on scalable public health interventions that prevent and delay the development of caries and enhance resistance to dental caries lesions. These interventions should occur throughout the life cycle, and need to be age appropriate. Mitigating disease transmission and enhancing resistance are achieved through use of various fluorides, sugar substitutes, mechanical barriers such as pit-and-fissure sealants, and antimicrobials. A key aspect is counseling and other behavioral interventions that are designed to promote use of disease transmission-inhibiting and tooth resistance-enhancing agents. Advocacy for public water fluoridation and sugar taxes is an appropriate dental public health activity.
Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Child; Child, Preschool; Dental Caries; Fluoridation; Fluorides; Humans; Pit and Fissure Sealants; Toothpastes
PubMed: 29478454
DOI: 10.1016/j.cden.2017.11.003