A randomized clinical trail of fissure sealant retention : self etch adhensive versus total etch adhensive
Date of Award
Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)
Community Health Sciences
ABSTRACT INTRODUCTION: Pit and fissures are naturally occurring surface defects of teeth of varying depth and morphology. About 90 percent of carious lesions are found in the pits and fissures of the permanent posterior teeth (molars and premolars). Pit and fissure sealant has been considered as a highly effective caries preventive dental treatment. The principal feature required for achieving success in caries prevention is adequate retention. Pit and fissure sealants have conventionally been placed with and without use of bonding agent or adhesive. There are limited studies on comparison of Total etch (TB) and Self etch (SE) adhesive for placement of sealants. Our study was based on comparison of effect of seventh generation Self etch bonding agent versus fifth generation Total etch adhesives in fissure sealant retention. METHODS: This study was a randomized clinical trial; split mouth design was used for treatment allocation. Subjects were enrolled from patients visiting the dental section at Aga Khan University Hospital. Subjects were eligible if they were in the age range of 6-25 years with indication for sealant placement and had at least one pair of permanent first or second molar. The total sample size required was 84 pairs for this study. The sample size was inflated by 20% to compensate for attrition. The treatment allocation was done by simple randomization, where treatment was allocated to tooth on right side and alternate was allotted to left side tooth. The SE arm was treated with SE adhesive (Adper Easy One 3M ESPE) before sealant placement according to manufacturer's guidelines. The TE adhesive arm (Adper Single Bond 2 3M ESPE) was treated by acid etching and drying followed by adhesive application and subsequent application of TE adhesive and cured, this was followed by sealant application. The patients were followed up after 3 months and were clinically examined for assessment of sealant retention. The sealant retention was assessed by independent assessor blinded to treatment allocation. RESULTS: 37 subjects with 101 pair of teeth were recruited in the study, 33 subjects (89.2%) and 91 pairs of molar (90%) were reevaluated clinically for sealant retention. Mean age of the study participants was 15.73(S.D 6.18) years of age. The average number of intervention pair included per subject was 3 pairs of teeth. The most common indication for sealant placement in the subjects was presence of deep occlusal fissure (59.5%). There was no significant difference in the distribution of caries in right and left of teeth included in study. There was significant difference between proportion of teeth with partial or complete absence of sealants in SE compared to TE (p-value<0.001). Sealant retention in TE was 56% compared to 28% in SE based sealants. CONCLUSION: Higher proportions of Total etch adhesive based sealants were found to be retained in the occlusal fissures than the SE based sealants. Therefore, the use of TE based sealants is recommended.
Aman, N. (2009). A randomized clinical trail of fissure sealant retention : self etch adhensive versus total etch adhensive (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.