This in-vitro study aimed to evaluate and compare the marginal leakage and penetration ability of a moisture-tolerant (Embrace WetBondTM) and a conventional (ClinproTM) resin-based sealants under three different enamel surface preparations (acid etched, acid etched and saliva contaminated and bur preparation and acid etched). One hundred and twenty extracted caries free human premolars teeth were cleaned and randomly divided into six groups of equal numbers, according to the type of sealants used and surface preparations. All the sealed teeth were subjected to thermocycling and immersed in a methylene blue dye. Each tooth was then embedded into acrylic resin before it was sectioned into four sections per tooth. Marginal leakage and unfilled surface area (indicating penetration depth of resin) were then measured using an optical 3D measurement device (Alicona Infinite Focus®). Both sealants exhibited comparable proportion of marginal leakage on acid etched only surfaces. Moisture-tolerant sealant showed the least proportion of marginal leakage on bur prepared and etched surfaces. Presence of saliva has detrimental effect on adhesion of both sealants. Nevertheless, depth of penetration of sealant into the fissures is comparable with both sealant types irrespective of the surface preparations.
Pit and Fissure Sealants ; Dental Caries ; Dental Materials

OBJECTIVES: To assess the effect of glazing materials with different sealants on sealant surface roughness and surface hardness. METHODS: Ultraseal XT(TM) sealant (group 1) and 3M Concise(TM) sealant (group 2) were applied on the buccal surfaces of 26 bicuspid teeth per group. The buccal surface of each tooth was then divided into two half surfaces for 52 halves per group. BisCover LV(TM) glaze was applied to one of the two buccal half surfaces of randomly selected 13 teeth per group. For the other remaining 13 teeth per group, we applied Fortify(TM) glaze to one of the two half surfaces. The remaining 26 buccal half surfaces per group covered with sealant only, did not receive any glaze. The surface roughness and hardness of each sample was measured, and the average value of the three measurements from the individual sample was calculated. The sample surfaces were also observed by scanning an electron microscopy. RESULTS: Two-way ANOVA with surface roughness and hardness as the individual dependent variables identified a statistically significant interaction between the sealants and glazing materials. BisCover LV lowered Ultraseal XT surface roughness and application of surface glazing materials on 3M Concise promoted the hardness. Micro-cracks were identified on the surface in no glaze compared to being less in any glaze. CONCLUSIONS: Surface glaze material could improve the surface roughness and hardness of the selected pit and fissure sealant material. Such a sealant-reinforcing procedure, involving surface glazing, may be clinically useful.
Acrylates ; Bicuspid ; Electrons ; Hardness ; Pit and Fissure Sealants ; Resin Cements ; Tooth

To compare the levels of agreement and the survival rates of sealant retention for different sealing materials over a 2-year period assessed using the visual clinical examination and replica methods, sealant retention data were obtained by visual clinical examination and from replicas of the same sealed tooth at baseline and at 0.5-, 1- and 2-year evaluation points in 407 children and were compared for agreement using kappa coefficients. Survival curves of retained sealants on occlusal surfaces were created using modified categorisation (fully retained sealants and those having all pits and fissures partly covered with the sealant material versus completely lost sealants that included pit and fissure systems that had ≥1 pit re-exposed) according to the Kaplan-Meier method. The kappa coefficient for the agreement between both assessment methods over the three evaluation time points combined was 0.38 (95% confidence interval (CI): 0.35-0.41). More sealant retention was observed from replicas than through visual clinical examination. Cumulative survival curves at the three evaluation times were not statistically significantly higher when assessed from replicas (P=0.47). Using the replica method, more retained sealant material was observed than through visual clinical examination during the 2-year period. This finding did not result in a difference in the survival rates of sealants assessed by the two assessment methods. When replicas cast in die stone are used for assessing sealant retention, the level of reliability of the data is higher than that of data obtained through the commonly used visual clinical examination, particularly if such assessments are conducted over time.
Dental Health Services ; Humans ; Physical Examination ; Pit and Fissure Sealants

The aim of this study was to evaluate the effect of etching time and bonding agents on bond strength of sealant applied to the occlusal surface of primary molars.Forty non-carious exfoliated human primary molars were included in the study. The teeth were randomly divided into 4 groups for measurement. For group I, no acid etching treatment was used. For group II, III, and IV, acid etching gels were applied on the occlusal surface for 15, 30, and 60 seconds, respectively. Each group was divided into 2 subgroups; one group was treated with bonding agents on the enamel while the other was not. Microtensile bond strength was evaluated using a universal testing machine.There were no statistically significant differences in bond strength with varying duration of etching among groups. The results revealed that the use of bonding agents prior to application of fissure sealant increased the bond strength(p < 0.05).It could be concluded that etching time greater than 15 seconds does not significantly enhance the bond strength, but the use of bonding agents as an intermediate layer between the primary molar and fissure sealant would be beneficial in increasing the bond strength.
Dental Enamel ; Gels ; Humans ; Molar ; Pit and Fissure Sealants ; Tooth

OBJECTIVE: This work aimed to compare the effect of retention and preventive caries of the pit and fissure sealant on primary teeth by using glass ionomer cements (GIC) with or without acid etching technique. METHODS: In this clinical trail, 100 children aged 3-4 years old with a split-mouth design were equally divided into two groups (the left second upper and lower mandibular primary molars were present in group A, and the right second upper and lower mandibular primary molars were present in group B; each group had 200 molars). All participants were placed in pit and fissure sealant with Ketac® Molar Easymix and seated with atraumatic restorative treatmen press-finger technique in the two groups. Group A was subjected to acid etching (40 s, 35% H₃PO₄), while group B were not subjected to acid etching. GIC preservation rate, caries rate, and decayed teeth (dt) index were observed after 12 months. RESULTS: After a 12-month follow-up period, the completely lost, partially losing, and losing rates of GIC in 86 children (172 second primary molars) were 83.14%, 9.88%, 6.98% in group A and 62.79%, 20.35%, and 16.86% in group B, respectively. The differences between the two groups were insignificant (P<0.05). The caries rates of groups A and B were 8.14% and 16.86%, and their dt indices were 0.08±0.31 and 1.17±0.46, respectively, thereby indicating significant difference between the two groups (P<0.05). CONCLUSIONS Using acid etching technology, the retention rate of the pit and fissure sealant increased, while its losing rate decreased. The retention effect of the GIC was improved, and the dental caries prevention effect was enhanced. Sealant processing was a self-curing procedure that sets without the external energy. Hence, this procedure is suitable for the preventive caries of primary teeth in children.
Child, Preschool ; Dental Caries ; Glass Ionomer Cements ; Humans ; Pit and Fissure Sealants ; Tooth, Deciduous ; Treatment Outcome

OBJECTIVE: To evaluate the clinical effect of fluoride releasing flowable resin used in treatment of early enamel caries of children compared with conventional sealant. METHODS: Seventy-six patients, including fifty-two couples of permanent first molars and thirty couples of premolars were selected for this trial. Both sides of all the molars and premolars were diagnosed as early enamel caries based on International Caries Detection and Assessment System (ICDAS) dental caries diagnostic criteria. Using the contralateral control, the teeth were randomly divided into two groups. Molars/premolars in the experimental group were sealed with a fluoride releasing flowable resin; the contralateral molars/premolars were sealed with a conventional fissure sealant as a control group. The retention rate and progress of caries were evaluated at the end of 3, 6, 12 and 24 months. RESULTS: There was no fissure sealant loss or caries progression in both groups 3 and 6 months after sealing the premolars by fluoride releasing flowable resin or conventional fissure sealants. At the end of 12 and 24 months, only one case of fissure sealant loss was observed in conventional fissure sealant group. There was no statistical significance between the two premolar groups. In the first molar group, fluoride releasing flowable resin showed 100%, 98.08%, 90.38% and 88.46% complete retention at the end of 3, 6, 12 and 24 months, respectively. The conventional fissure sealant retention rates were 96.15%, 92.31%, 76.92% and 73.08% at the corresponding time points. The data at the end of 24 months showed that fluoride releasing flowable resin had significantly higher retention rate than the conventional fissure sealant group (P<0.05). The incidence of caries progression at the end of 6, 12 and 24 months were 1.92%, 5.77% and 7.69%, respectively, in the fluoride releasing flowable resin group. In the conventional fissure sealant group, the incidence was 5.77%, 19.23% and 25.00%, respectively. At the end of 12 and 24 months, more significant decrease of caries progress incidence was observed in the fluoride releasing flowable resin group than in the control group, and there was statistical difference between the two groups (P<0.05). CONCLUSION Compared with conventional fissure sealant, using fluoride releasing flowable resin as a fissure sealant in children enamel caries of permanent molars can improve the sealant preservation rate and effectively prevent enamel caries progress.
Child ; Dental Caries/prevention & control* ; Dental Enamel ; Fluorides ; Humans ; Molar ; Pit and Fissure Sealants

OBJECTIVES: In 2002, the Ministry of Health and Welfare initiated a national sealant program (NSP) in public health centers in order to promote oral health among children in rural areas as well as among children with low socio-economic status in urban areas. However, this program was terminated in 2009 and substituted with the national insurance coverage of sealants (NICS). The aim of this study is to evaluate the impact of the change from NSP to NICS on regional inequality. METHODS: Based on data obtained from the 2010 and 2012 Korea National Oral Health surveys conducted, we analyzed the average number of permanent teeth with sealants (mean sealant) on the first molars and the prevalence of active dental caries in permanent teeth (D rate), segregated by region, in 8-year-old children. Analyses were performed using SPSS 21.0 (SPSS Inc., Chicago, IL, USA) after taking into consideration the complex design of the samples. RESULTS: The D rate of rural children was higher than that of those in metropolitan and city areas. Compared to the 2010 data on the mean sealants on the first molars, a 14.4% and 48.1% increase was observed in the mean sealants in children in the metropolis and in cities in 2012, respectively. However, this number decreased by 7.5% only in the rural areas. CONCLUSIONS: Accessibility to dental services was limited in the rural areas as compared than in other areas; this result is based on the fact that the D rate in rural areas was higher than that in other areas. The NSP has decreased this regional inequality with regard to the accessibility to dental services. However, it was suggested that the mean sealant on the first molars was reversed due to a change from NSP to NICS.
Child ; Dental Caries ; Humans ; Insurance Coverage* ; Korea ; Molar ; Oral Health ; Pit and Fissure Sealants ; Prevalence ; Public Health ; Socioeconomic Factors ; Tooth

OBJECTIVES: The aim of this study was to examine the characteristics of the high caries risk group among 12-year-old children in Korea. METHODS: Information on oral health status and interview data were collected from 6,253 children (3,309 male and 2,944 female children) aged 12 years who participated in the Korea National Oral Health Survey in 2010. The subjects were sorted according to the decayed missing filled tooth (DMFT) data. The highest one-third was selected as the significant caries (SiC) group (N=2,184), and the others were classified as the middle group (N=4,466) and the caries-free group (N=7,067). This study also used demographic variables such as gender and area of residence. The variables for the oral health behavior were the number of dental sealants on the first molar, self-perceived oral health, average frequency of tooth brushing per day, and the mean frequency of daily snack consumption. The variables for the oral health status were the mean number of DMFTs and the SiC index. The associations between the high caries risk group and the demographic and social variables, oral health status, and oral health-related consciousness and behavior were evaluated by logistic regression analysis. RESULTS: A significant proportion of the high caries risk group participants had no dental sealant on the first molar (46.4%) and lived in rural areas (38.1%, P<0.05). The determinants of the high-risk group were whether the first molar was sealed ('0', OR=52.67) and the self-perceived oral health ('fair', OR=1.43, 'poor', OR=2.09). CONCLUSIONS: The characteristics of the high caries risk group among 12-year-old Korean children were the absence of dental sealant on the first molar, poor self-perceived oral health, gender, and region.
Aged ; Child ; Consciousness ; Female ; Humans ; Korea ; Logistic Models ; Male ; Molar ; Oral Health ; Pit and Fissure Sealants ; Snacks ; Tooth

OBJECTIVES: The purposes of this study were to review changes in the amount of pit and fissure sealant (PFS) provided after the inclusion of PFS in treatments covered by the National Health Insurance (NHI) and to assess differences in the supplied amount between geographical areas where accessibility to dental care differs. METHODS: The years for comparison were selected based on data availability and the time of inclusion of PFS into NHI coverage. The selected pre-inclusion year was 2008, and the post-inclusion year was 2012. Data regarding the amount of PFS supplied were collected from the oral health program, NHI, and Medical care. To dichotomize areas by high and low dental care accessibility, we standardized the population size, number of dental institutions, and number of dentists in each group. RESULTS: We considered metropolitan areas and Gyeonggi Province as high dental care accessibility areas, while other provinces were considered as low dental care accessibility areas. Regardless of the transforming constant, the amount of PFS supplied increased in high dental care accessibility areas and decreased in low dental care accessibility areas after inclusion of PFS in NHI. CONCLUSIONS: To increase the amount of PFS provided in low dental care accessibility areas, promotion of PFS should be strengthened and support from oral health programs should be increased. Additionally, waiving out-of-pocket money for PFS in NHI should be considered to remove barriers of supply.
Dental Care ; Dentists ; Gyeonggi-do ; Humans ; Korea ; National Health Programs* ; Oral Health ; Pit and Fissure Sealants* ; Population Density

OBJECTIVES: The aim of this study was to evaluate the caries preventive effects of oral health programs composed of pit and fissure sealant and community water fluoridation in Hapcheon-Up, Hapcheon-Gun, the Republic of Korea. METHODS: Dental surveys were conducted on 6 to 14 year old children at Hapcheon-Up, Hapcheon-Gun in 2000 and 2009, respectively. The number of the subjects was 1,957 and 1,535 children in 2000 and 2009, respectively. The percentage of samples among total population aged 6 to 14 years in 2000 and 2009 was 90.6% and 92.3%, respectively. The obtained data from these surveys were analyzed with the PASW statistical package version 18.0 (SPSS Inc., Chicago, IL, USA). The 2009 dental health data including the prevalence of dental caries and fissure sealants on children's permanent teeth was compared to the 2000 dental health data, and assessed using chi-square test and independent-sample t-test. RESULTS: DMF rate of 12-year olds was 76.9% in 2000, and it significantly decreased to 42.5% in 2009. DMFT index of 12-year olds was 3.03 in 2000, and it significantly decreased to 1.07 in 2009. The prevalence rate of sealed permanent teeth among the 12-year olds was 15.4% in 2000, and it significantly increased to 97.2% in 2009. The caries reduction rate from pit and fissure sealant added by community water fluoridation program was calculated as 44.7% in 12-year olds by the difference of DMFT index between 2000 and 2009 year. Logistic regression analysis revealed that both programs were associated with an increasing likelihood of experiencing no dental caries (OR=4.00, 95% CI; 3.23-4.95). CONCLUSIONS: These results suggest that the oral health program composed of pit and fissure sealant and community water fluoridation in Hapcheon was very effective in caries prevention. The program should be expanded to other area to prevent dental caries among children.
Aged ; Chicago ; Child ; Dental Caries ; DMF Index ; Fluoridation ; Humans ; Logistic Models ; Oral Health ; Pit and Fissure Sealants ; Prevalence ; Tooth