Friday, March 6, 2009

Clinical Evaluation of Sealants and Preventive Resin Restorations in a Group of Environmentally Homogenous Children

Author(s): Lekic et al.
Journal: Journal of Dentistry for Children
Volume (number): 73:1
Month, Year: 2006
Major topic / Purpose of Study: To assess if tooth preparation prior to sealant application improves sealant retention
Methods and Materials:
43 children and adolescents (ages 6 to 18 years) from 4 Hutterite colonies were transported by bus to the University of Manitoba pediatric dental clinic in Winnipeg, Manitoba. These patients came from communities considered homogenous in terms of economic status, dietary habits, fluoride intake, and lifestyle.
Sealants were placed on permanent molars during a 4 year time period (8/98 to 4/01); it was decided during the initial appt. whether or not to prep teeth.
Preparations were done with a 1/2 or 1/4 round bur. Tooth surfaces were cleaned with pumice slurry. Rubber dam isolation was used for all teeth. After acid etching for 20 seconds and rinsing for 30 seconds, non-prepped teeth were sealed with BIS-GMA.
PRRs were categorized into three types: (A) minimal fissure prep (1/4 to 1/2 round burs), (B) caries removal with 1 or 2 round bur.
Types (A) and (B) PRRs were sealed with flowable composite using bonding agent first.
122 total teeth were treated; 54 were PRR and 68 were nonprepared sealants
Teeth were all evaluated at least 6 months after initial sealant placement
Results:
1 year after placement PRR’s type B PRRs had significantly lower retention rates (27%) compared with type A or nonprepared teeth (63%). Type B restorations were also more likely to have caries on follow-up examination (50% vs 11%).
Conclusions:
Type B preventative resin restorations are not helpful in terms of retention or caries reduction
Assessment of article: Fair article. Would have been nice to assess all teeth at the same time intervals as well as compare different sealant techniques in the same mouth.

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