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Materials (Basel, Switzerland) Sep 2023The scope of this paper is to compare different dental sealants and flow materials indicated for sealing pits and fissures considering their chemical formula. The... (Review)
Review
The scope of this paper is to compare different dental sealants and flow materials indicated for sealing pits and fissures considering their chemical formula. The narrative review aims to address the following questions: What is the essence of different dental sealants' activity, how does their chemical formula affect their mechanisms of caries prevention, and what makes a dental sealant efficient mean of caries prevention? Another vital issue is whether the sealants that contain fluoride, or any other additions, have potentially increased antimicrobial properties. An electronic search of the PubMed, Cochrane, Web of Science, and Scopus databases was performed. The following keywords were used: (dental sealants) AND (chemical composition). Additionally, information about composition and indications for clinical use provided by manufacturers were utilized. All of the considered materials are indicated for use both in permanent and primary dentition for sealing fissures, pits, and . The selection of suitable material should be made individually and adjusted to conditions of the sealing procedure and patient's needs. Cariostatic mechanisms increasing sealants' effectiveness such as fluoride release are desired in modern dentistry appreciating preventive approach. The review aims are to find crucial elements of sealants' composition which affect their cariostatic mechanisms.
PubMed: 37834590
DOI: 10.3390/ma16196453 -
Contemporary Clinical Dentistry 2019Pit and fissure sealants (PFSs) are the most effective preventive materials in dentistry. Secondary caries around the sealed pits and fissures at the material-tooth...
CONTEXT
Pit and fissure sealants (PFSs) are the most effective preventive materials in dentistry. Secondary caries around the sealed pits and fissures at the material-tooth interface and the wear of the material remains the common problems. To address these problems, efforts have been made by incorporating zinc oxide (ZnO) and calcium fluoride (CaF) nanoparticles (NPs) into the sealants to develop caries-inhibiting and stress-bearing sealants.
AIM
Evaluation of antibacterial and mechanical properties of PFS containing ZnO and CaF NPs.
SETTINGS AND DESIGN
This was an study.
MATERIALS AND METHODS
A total of 196 fissure sealant samples were divided into six test groups and a control group. The test group samples were prepared by incorporating two concentrations (0.5 wt% and 1 wt%) of ZnO and CaF NPs into the sealants. The antibacterial activity was evaluated by direct contact test; compressive and flexural strengths were evaluated by a universal testing machine.
STATISTICAL ANALYSIS USED
Statistical analysis was done by one-way ANOVA and Tukey test.
RESULTS
Sealants containing 1 wt% ZnO and CaF NPs and their mixture exhibited significantly higher antibacterial activity against and when compared to control group ( < 0.001). Samples with ZnO NPs exhibited similar mechanical properties as conventional sealant (control group); however, the samples with CaF NPs showed inferior mechanical properties ( < 0.05).
CONCLUSION
The observations of the study infer that sealants containing 1 wt% ZnO and CaF NPs and their mixture exhibited superior antibacterial activity. The mechanical properties of samples containing ZnO and mixture of ZnO and CaF particles remained comparable to the conventional sealants.
PubMed: 32308323
DOI: 10.4103/ccd.ccd_805_18 -
International Journal of Clinical... 2010Antibacterial properties of fluoride releasing glass Ionomer cements (GICs) and pit and fissure sealants on Streptococcus mutans. (Review)
Review
TITLE
Antibacterial properties of fluoride releasing glass Ionomer cements (GICs) and pit and fissure sealants on Streptococcus mutans.
BACKGROUND
Occlusal pit and fissures are the most susceptible sites for dental caries. The clinical effectiveness of GICs and fissure sealants in preventing caries is well-documented, but there is some concern about bacteria left beneath sealants.
OBJECTIVE
(1) Study the antibacterial activity of GICs and pit and fissure sealants. (2) Compare between these materials.
METHODOLOGY
GICs (Fuji IX GP and Ketac molar) and pit and fissure sealants (Teethmate-F1 and Helioseal-F ). The strains was grown in the Brain Heart Infusion broth and was incubated anaerobically for 18 hours at 37°C and subcultured in MSB agar.Four wells measuring 5 mm diameter was prepared on each agar plate and the prepared materials was placed and further incubated anaerobically for 48 hours at 37°C. The zone of inhibition was measured.
RESULTS
All the materials tested showed antibacterial properties to varying levels except; among pit and fissure sealants it is Teethmate-F which showed more antibacterial property.
CONCLUSION
Teethmate-F1 sealant showed more antibacterial property compared to Fuji IX and Ketac molar. Helioseal-F did not show any antibacterial property.
PubMed: 27507918
DOI: 10.5005/jp-journals-10005-1060 -
Journal of Dental Research Feb 2018
Topics: Biofilms; Biomimetic Materials; Cariostatic Agents; Clinical Trials as Topic; Congresses as Topic; Dental Caries; Dental Research; Fluorides, Topical; Forecasting; Humans; Pit and Fissure Sealants; Tooth Remineralization
PubMed: 29355470
DOI: 10.1177/0022034517746371 -
Caries Research 2016The management of occlusal caries still remains a major challenge for researchers as well as for general practitioners. The present paper reviews and discusses the most... (Review)
Review
The management of occlusal caries still remains a major challenge for researchers as well as for general practitioners. The present paper reviews and discusses the most up-to-date knowledge and evidence of the biological principles guiding diagnosis, risk assessment, and management of the caries process on occlusal surfaces. In addition, it considers the whole spectrum of the caries process on occlusal surfaces, ranging from the molecular ecology of occlusal biofilms to the management of deep occlusal caries lesions. Studies using molecular methods with focus on biofilms in relation to occlusal caries should explore the relationship between the function and the structural composition of these biofilms to understand the role of occlusal biofilms in caries development. State-of-the-art measures to evaluate risk for occlusal caries lesion activity, caries incidence, and progression should include the assessment of the occlusal biofilm and the stage of tooth eruption. Careful clinical examination of non-cavitated lesions, including assessment of the lesion activity status, remains the major tool to determine the immediate treatment need and to follow on the non-operative treatment outcome. Even medium occlusal caries lesions in the permanent dentition may be treated by non-invasive fissure sealing. By extending the criteria for non-invasive treatments, traditional restoration of occlusal surfaces can be postponed or even avoided, and the dental health in children and adolescents can be improved. Selective removal (incomplete) to soft dentin in deep carious lesions has greater success rates than stepwise excavation. Selective (complete) removal to firm dentin has a lower success rate due to increased pulp exposure.
Topics: Biofilms; Dental Caries; Dental Occlusion; Dental Plaque; Dental Pulp; Dentition, Permanent; Denture, Partial, Removable; Disease Progression; Humans; Incidence; Pit and Fissure Sealants; Risk Factors; Tooth Eruption
PubMed: 27658123
DOI: 10.1159/000448662 -
The Cochrane Database of Systematic... Aug 2014Poor or inequitable access to oral health care is commonly reported in high-, middle- and low-income countries. Although the severity of these problems varies, a lack of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Poor or inequitable access to oral health care is commonly reported in high-, middle- and low-income countries. Although the severity of these problems varies, a lack of supply of dentists and their uneven distribution are important factors. Delegating care to dental auxiliaries could ease this problem, extend services to where they are unavailable and liberate time for dentists to do more complex work. Before such an approach can be advocated, it is important to know the relative effectiveness of dental auxiliaries and dentists.
OBJECTIVES
To assess the effectiveness, costs and cost effectiveness of dental auxiliaries in providing care traditionally provided by dentists.
SEARCH METHODS
We searched the following electronic databases from their inception dates up to November 2013: the Cochrane Effective Practice and Organisation of Care (EPOC) Group's Specialised Register; Cochrane Oral Health Group's Specialised Register; the Cochrane Central Register of Controlled Trials (Issue 11, 2013); MEDLINE; EMBASE; CINAHL; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effectiveness; five other databases and two trial registries. We also undertook a grey literature search and searched the reference list of included studies and contacted authors of relevant papers.
SELECTION CRITERIA
We included randomised controlled trials (RCTs), non-randomised controlled clinical trials (NRCTs), interrupted time series (ITSs) and controlled before and after studies (CBAs) evaluating the effectiveness of dental auxiliaries compared with dentists in undertaking clinical tasks traditionally performed by a dentist.
DATA COLLECTION AND ANALYSIS
Three review authors independently applied eligibility criteria, extracted data and assessed the risk of bias of each included study and two review authors assessed the quality of the evidence from the included studies, according to The Cochrane Collaboration's procedures. Since meta-analysis was not possible, we gave a narrative description of the results.
MAIN RESULTS
We identified five studies (one cluster RCT, three RCTs and one NRCT), evaluating the effectiveness of dental auxiliaries compared with dentists in providing dental care traditionally provided by dentists, eligible for inclusion in this review. The included studies, which involved 13 dental auxiliaries, six dentists, and more than 1156 participants, evaluated two clinical tasks/techniques: placement of preventive resin fissure sealants and the atraumatic restorative technique (ART). Two studies were conducted in the US, and one each in Canada, Gambia and Singapore.Of the four studies evaluating effectiveness in placing preventive resin fissure sealants, three found no evidence of a difference in retention rates of those placed by dental auxiliaries and dentists over a range of follow-up periods (six to 24 months). One study found that fissure sealants placed by a dental auxiliary had lower retention rates than one placed by a dentist after 48 months (9.0% with auxiliary versus 29.1% with dentist). The same study reported that the net reduction after 48 months in the number teeth exhibiting caries (dental decay) was lower for teeth treated by the dental auxiliary than the dentist (3 with auxiliary versus 60 with dentist, P value < 0.001).One study showed no evidence of a difference in dental decay after treatment with fissure sealants between groups. The one study comparing the effectiveness of dental auxiliaries and dentists in performing ART reported no difference in survival rates of the restorations (fillings) after 12 months.All studies were at high risk of bias and the overall quality of the evidence was very low, as assessed using the GRADE approach. In addition, four of the included studies were more than 20 years old; the materials used and the techniques assessed were out of date. We found no eligible studies comparing the effectiveness of dental auxiliaries and dentists in the diagnosis of oral diseases and conditions, in delivering oral health education and other aspects of health promotion, or studies assessing participants' perspectives including the acceptability of care received. None of the included studies reported adverse effects. In addition, we found no studies comparing the costs and cost-effectiveness of dental auxiliaries and dentists, their impact on access and equity of access to care that met the pre-specified inclusion criteria.
AUTHORS' CONCLUSIONS
We only identified five studies for inclusion in this review, all of which were at high risk of bias and four were published more than 20 years ago, highlighting the paucity of high-quality evaluations of the relative effectiveness, cost-effectiveness and safety of dental auxiliaries compared with dentists in performing clinical tasks. No firm conclusions could be drawn from the present review about the relative effectiveness of dental auxiliaries and dentists.
Topics: Dental Atraumatic Restorative Treatment; Dental Auxiliaries; Dental Care; Dental Caries; Dental Restoration Failure; Dentists; Humans; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Time Factors; Treatment Outcome
PubMed: 25140869
DOI: 10.1002/14651858.CD010076.pub2 -
BMC Oral Health Oct 2023Children aged 6-9 years are vulnerable to dental caries due to age-related limitations and a lack of adequate knowledge regarding oral health and hygiene practices. This...
The combined effect of pit and fissure sealant application and oral health education on oral health status of children aged 6-9 years: a 12-month follow-up study in Northeast China.
BACKGROUND
Children aged 6-9 years are vulnerable to dental caries due to age-related limitations and a lack of adequate knowledge regarding oral health and hygiene practices. This study aimed to establish a cohort of children aged between 6 and 9 years and conducted a 12-month follow-up to examine the combined effect of pit and fissure sealant (PFS) application and oral health education on their oral health status.
METHODS
A cohort study with 12-month follow-up was conducted in Liaoning province, China. A multi-stage stratified cluster sampling approach was employed in the study. The enrolled 6- to 9-year-old children were all from the selected primary schools, who had resided in the designated area for at least 6 months. Children who were unable to cooperate with the examiner or without informed consent from their guardians were excluded. Experienced dental professionals examined the oral health status of primary school children aged 6-9 years. All children and their guardians were mandated to complete a questionnaire (qualitative data) at the beginning of the study. In the experiment group, children underwent PFS application and chairside oral health education. Clinical examinations and questionnaire surveys were repeated at the 12-month follow-up. The chi-square test and binary logistic regression were conducted to investigate the potential risk factors associated with dental caries prevalence (dependent variable). Independent variables were items from the questionnaire (such as living place, parents' education level and children' birth weight). The significant variables identified in the chi-square tests were subsequently included in the binary logistic regression analysis.
RESULTS
A total of 4,085 children aged 6-9 years were included in the study, with 1805 participants assigned to the experiment group and 2280 to the control group. At baseline, the caries rates of the experimental and control group were 77.95% and 80.35%, respectively without any statistically significant differences. However, at the 12-month follow-up, the caries rate in the experimental group (83.65%) was significantly lower than that in the control group (86.62%) (P < 0.05). The results from the binary logistic regression analysis indicated that parents with a college degree and children in the experimental group exhibited lower caries rates. Conversely, higher caries rates were associated with the consumption of sweet beverages and foods more than once a day and a lack of knowledge regarding the causes of caries (P < 0.05).
CONCLUSIONS
In Liaoning, China, children aged 6 to 9 years exhibited a high prevalence of dental caries. Several factors, including the parent's education level, the frequency of consuming sweet beverages and foods, and the children's understanding of the cause of caries, significantly affected the caries prevalence rates. The implementation of PFS application and oral health education effectively reduce the caries rate among the surveyed children.
Topics: Humans; Child; Infant; Oral Health; Dental Caries; Follow-Up Studies; Pit and Fissure Sealants; Cohort Studies; Health Education, Dental; China
PubMed: 37891599
DOI: 10.1186/s12903-023-03467-0 -
BMC Oral Health Oct 2023Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue... (Review)
Review
BACKGROUND
Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue destruction. In addition to proper oral hygiene, prophylactic sealing of fissures and cavities with a sealant is a method of preventing the development of caries. The aim of this study is to summarise the effectiveness of fissure sealing of permanent teeth with fissure sealants compared to other preventive methods or no intervention.
METHOD
An umbrella review was carried out to achieve the purpose of our study. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. Quality assessment of the included studies was performed using the AMSTAR2 tool. In addition, a manual search for recommendations/clinical practice guidelines on dental prophylaxis was performed.
RESULTS
204 publications were identified, of which 15 met the inclusion criteria. Based on the results of 3 systematic reviews, there was a statistically significant reduced odds of caries occurrence or development with prophylactic sealing of permanent teeth compared with no intervention - depending on the review and follow-up period odds ratio (OR) ranged from 0.06 [95%CI: (0.01-0.32)] to 0.28 [95%CI: (0.20-0.38)]. In the eight systematic reviews that analysed different sealants, there were no statistically significant differences between the types of materials used for prophylactic tooth sealing. For systematic reviews comparing the efficacy of fissure sealants with fluoride varnish, three reported no statistically significant difference in the efficacy of caries incidence, with only one systematic review based on 1 RCT finding a statistically significant difference in favour of fissure sealants.
CONCLUSION
Compared to the no intervention, dental sealing is an effective method for the prevention of dental caries. However, it is not possible to conclude conclusively which type of sealant and which of the available prophylactic methods is more effective in preventing caries.
Topics: Humans; Dental Caries; Dentition, Permanent; Fluorides; Pit and Fissure Sealants; Systematic Reviews as Topic
PubMed: 37891656
DOI: 10.1186/s12903-023-03499-6 -
Dental Materials Journal Sep 2017This study assessed the effect of bur or Er:YAG laser preparation on marginal and internal adaptation of conventional and extended fissure sealing (FS) with a...
This study assessed the effect of bur or Er:YAG laser preparation on marginal and internal adaptation of conventional and extended fissure sealing (FS) with a 3-component etch-and-rinse (Optibond FL; OFL) and a 1-component self-etch (Scotchbond Universal; SB) adhesive system. Scanning electron microscope analysis was performed before and after thermocycling/occlusal load and additional optical coherence tomography evaluation was carried out for internal marginal assessment. Significant differences were observed between the groups (ANOVA, p<0.05). Laser-prepared and non-etched FS suffered from marginal degradation after fatigue. When enamel was etched with HPO and independently of the adhesive system, laser technique was equally effective to bur-preparation with percentages of continuous margins ranging from 96 to 99%, being laser less invasive than bur preparation. This is clinically relevant in paediatric dentistry as minimally invasive FS can be performed with laser and adhesive systems used as fissure sealants. Nevertheless, enamel etch with phosphoric acid is still necessary.
Topics: Acid Etching, Dental; Composite Resins; Dental Bonding; Dental Cavity Preparation; Dental Enamel; Dentin-Bonding Agents; Humans
PubMed: 28835596
DOI: 10.4012/dmj.2016-025 -
Applied Health Economics and Health... Jan 2023To critically examine the methods used for full economic evaluations of preventive interventions for dental caries and periodontitis.
OBJECTIVES
To critically examine the methods used for full economic evaluations of preventive interventions for dental caries and periodontitis.
METHODS
Published literature post-2000 was searched to April 2021. Based on a developed intervention classification framework for dental caries and periodontitis, only universal, selective or indicated interventions were included in this review. The Drummond 10-point checklist was used for quality appraisal.
RESULTS
Of 3,007 unique records screened for relevance, 73 studies were reviewed. Most model-based studies (61/73) used cost-effectiveness analysis (49%) or cost-benefit analysis (28%). Trial-based studies (16/73) commonly used cost-effectiveness analysis (59%). Four studies used both economic evaluation methods. Sixty-four papers (88%) were on dental caries, eight papers (11%) focused on periodontitis, and one paper (1%) included both oral diseases; 72% of model-based and 82% of trial-based studies were of good quality. The most frequently investigated dental caries preventive interventions were water fluoridation (universal intervention; cost-saving or cost-effective), fissure sealant and fluoride varnish (selective and indicated interventions; cost-effectiveness outcomes were inconsistent). Supportive periodontal therapy with oral health education (indicated intervention; cost-effective) was the most frequently evaluated preventive intervention for periodontitis. Thirty percent of studies with a time horizon > 1 year did not apply an appropriate discount rate and 26% did not comprehensively discuss other important considerations beyond the technical analysis.
CONCLUSIONS
Generic health outcome measures should be incorporated for economic evaluations on preventive interventions for dental caries and periodontitis, and an increased focus to prevent periodontitis using economic evaluation methods is needed to inform resource allocation and policy decision-making.
Topics: Humans; Cost-Benefit Analysis; Cost-Effectiveness Analysis; Dental Caries; Periodontitis; Pit and Fissure Sealants; Fluoridation; Fluorides, Topical; Oral Hygiene; Health Education
PubMed: 36089630
DOI: 10.1007/s40258-022-00758-5