European Archives of Paediatric Dentistry

, Volume 10, Issue 4, pp 211–217 | Cite as

Fissure sealant retention and caries development after resealing on first permanent molars of children with low moderate and high caries risk

  • C. J. OulisEmail author
  • E. D. Berdouses


AIM: This was to evaluate the retention of fissure sealants (FS) and their effectiveness after resealing on caries reduction applied to first permanent molars, in a sample of children stratified according to their caries risk status in a private practice setting. METHODS: The sample was 1,274 FS applied on first permanent molars (FPM) of 380 children (6 to 8 years old). Follow-up and monitoring for resealing was 3 years after FS placement, having at least one recall visit per year. Caries risk was based on baseline dmft index: low (dmft=0), moderate (dmft=1–4), high (dmft >4), with almost half of the teeth belonging to the high-risk group. All sealed teeth were evaluated and recorded for FS failure and resealing in case of partial/total loss, as well as caries development. Survival analysis using the Cox Proportional Hazards regression model was used for data evaluation. RESULTS: Of the 1,274 sealed surfaces, 927 (72.8%) needed no intervention 185 (14.5%) needed only resealing and 162 (12.7%) developed caries during the study. Of 162 carious surfaces, 107/675 (15.9 %) were from the high caries risk children, compared with 17/144 (11.8 %) and 38/455 (8.3 %) from the moderate and low caries risk group respectively. The highest number of failures, 4.9% and resealing were found at first recall, declining to 1.4% at the end of the study. Development of caries followed a steady rate of 6–8% per year. Cox proportional hazards model indicated, regardless if resealing or caries development was considered a failure or resealing was a success and caries development a failure, only the high dmft index appeared in both cases to significantly increase the chance (158% and 173% respectively) of FS failure and caries development compared with moderate and low dmft index. Other variables when inserted into the hazard model, such as age, sex and number of visits, either did not show a significant effect or only marginally affected FS retention, without modifying the association between caries risk and sealant failure. CONCLUSIONS: Children of a high baseline caries risk status showed lower FS retention rates and higher occlusal caries prevalence following FS loss compared with those of moderate and low risk status. Resealing does not seem to dramatically change the final outcome of the higher risk group to develop more caries, necessitating other more effective measures to increase the retention of FS on these highly vulnerable areas.

Key words

sealant retention resealing caries risk children 


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  1. Ahovuo-Saloranta A, Hiiri A, Nordblad A, Mäkelä M, Worthington HV. Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev 2008;Oct 8 (4):CD001830.Google Scholar
  2. Bader JD, Shugars DA. The evidence supporting alternative management strategies for early occlusal caries and suspected occlusal dentinal caries. J Evid Based Dent Pract 2006;Mar 6(1):91–100.PubMedCrossRefGoogle Scholar
  3. Beauchamp J, Caufield P, Crall J, et al. Evidence-based clinical recommendations for the use of pit-and-fissure sealants A report of the American Dental Association Council on Scientific Affairs. Dent Clin North Am. 2009;Jan, 53(1):131–47.PubMedCrossRefGoogle Scholar
  4. Bravo M, Osorio E, Garcia-Aullo I, Llodra JC, Baca P. The influence of dft index on sealant success: A 48-month survival analysis. J Dent Res 1996;75(2):768–774.PubMedCrossRefGoogle Scholar
  5. Carvalho JC, Ekstrand KR, Thylstrup A. Dental Plaque and Caries on occlusal Surfaces of First Permanent Molars in Relation to Stage of Eruption. J Dent Res 1989;May 68(5):773–779.PubMedCrossRefGoogle Scholar
  6. Cox, D.R., D. Oakes. Analysis of Survival Data. London, Chapman & Hall, 1984.Google Scholar
  7. Dennison JB, Straffon LH, More FG. Evaluating tooth eruption on sealant efficacy. J Am Dent Assoc. 1990;Nov 121(5):610–614.PubMedGoogle Scholar
  8. Feigal R.J. Sealants and preventive restorations: Review of effectiveness and clinical suggestions for improvement. Pediatr. Dent 1998;20:85–92.PubMedGoogle Scholar
  9. Hamilton JC, Dennison JB, Stoffers KW, Welch KB. A clinical evaluation of air-abrasion treatment of questionable carious lesions. A 12-month report. J Am Dent Assoc. 2001;132(6):762–769.PubMedGoogle Scholar
  10. Handelman SL, Leverett DH, Espeland M, Curzon JA. Retention of sealants over carious and sound tooth surfaces. Community Dent Oral Epidemiol 1987;15:1–5.PubMedCrossRefGoogle Scholar
  11. Heller KE, Reed SG, Bruner FW, Eklund SA, Burt BA. Longitudinal evaluation of sealing molars with and without incipient dental caries in a public health program. J Public Health Dent 1995;55:148–153.PubMedCrossRefGoogle Scholar
  12. Heyduck C, Meller C, Schwahn C, Splieth CH. Effectiveness of sealants in adolescents with high and low caries experience. Caries Res. 2006;40(5):375–381.PubMedCrossRefGoogle Scholar
  13. Houpt M, Shey Z. The effectiveness of a fissure sealant after six years. Ped Dent 1983;5:104–106.Google Scholar
  14. Irinoda Y, Matsumura Y, Kito H, et al. Effect of selants viscosity on the penetration of resininto ecthed human enamel. Oper Dent. 2000 Jul–Aug;25(4):274–282PubMedGoogle Scholar
  15. Leake JL, Martinello BP. A four-year evaluation of a fissure sealant in a public health setting. J Can Dent Assoc 1976;42:409–415.Google Scholar
  16. Leskinen K, Ekman A, Oulis C, et al. Comparison of the effectiveness of fissure sealants in Finland, Sweden, and Greece. Acta Odontol Scand 2008;Apr 66(2):65–72.PubMedCrossRefGoogle Scholar
  17. Llodra JC, Bravo M, Delgado Rodriguez M, Baca P, Galvez M. Factors influencing the effectiveness of sealants-meta-analysis. Community Dent Oral Epidemiol 1993;2:261–268.CrossRefGoogle Scholar
  18. Makhija SK, Childers NK, Lauten J, et al. Evaluation of initial caries score and caries incidence in a public health sealant program: a retrospective study. Pediatr Dent 2006;Sep–Oct 28(5):420–424.PubMedGoogle Scholar
  19. Mejare I, Lingström P, Petersson LG, Holm A, Twetman S. Caries-preventive effect of fissure sealants: a systematic review. Acta Odontol Scand 2003;61:321–330.PubMedCrossRefGoogle Scholar
  20. Poulsen S, Holus AK. The relation between dental caries in the primary and permanent dentition of the same individual. J Public Health Dent 1980; 40:17–25.PubMedCrossRefGoogle Scholar
  21. Raadal M., Espelid I. Caries prevalence in primary teeth as a predictor of early fissure caries in permanent first molars. Community Dent Oral Epidemiol 1992;20:30–34.PubMedCrossRefGoogle Scholar
  22. Ripa LW. Sealants revisited: an update of the effectiveness of pit-and-fissure sealants. Caries Res 1993; 27(Supp):77–82.PubMedCrossRefGoogle Scholar
  23. Romcke RG, Lewis DW, Maze BD, Vickerson RA. Retention and maintenance of fissure sealants over 10 years. J Can Dent Assoc 1990; 56:235–237.PubMedGoogle Scholar
  24. Simecek JW, Diefenderfer KE, Ahlf RL, Ragain JC. Dental sealant longevity in a cohort of young US naval personnel. J Amer Dent Assoc 2005;136:171–178.Google Scholar
  25. Thylstrup A, Poulsen S. Retention and effectiveness of a chemically polymerized pit and fissure sealant after 2 years. Scand J Dent Res 1978; 86:21–24.PubMedGoogle Scholar
  26. Tickle M, Yeung CA, Milsom KM, Blinkhorn AS. The prescription and outcomes of fissure sealants applied to a group of high caries risk children by general dental practitioners working in the North West of England. Community Dent Health 2007;Sep 24(3):135–139.PubMedGoogle Scholar
  27. Weintraub JA, Stearns SC, Burt BA, Beldran E, Eklund SA. A retrospective analysis of the cost-effectiveness of dental sealants in a children’s health center. Soc Sci Med 1993;36:1483–1493.PubMedCrossRefGoogle Scholar
  28. Weintraub JA, Stearns SC, Rozier RG, Huang CC. Treatment outcomes and costs of dental sealants among children enrolled in Medicaid. Am J Public Health 2001;91(11):97–101.CrossRefGoogle Scholar
  29. Welbury R, Raadal M, Lygidakis NA. EAPD guidelines for the use of pit and fissure sealants. Eur J Paediatr Dent 2004;Sep 5(3):179–184.PubMedGoogle Scholar

Copyright information

© Adis International 2009

Authors and Affiliations

  1. 1.Dept. of Paediatric Dentistry, Dental SchoolUniversity of AthensHalandri, AthensGreece

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