The effectiveness of a bonding agent in fissure sealant retention and caries prevention
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Background:In the Kuwait School Oral Health Program, fissure sealants are used as a preventive measure against caries along with fluoride rinsing, tablets or gel in the different governorates. Even though Kuwait has implemented these preventive programs since 1985, caries in Kuwaiti school children remains high. Some literature supports the use of a bonding agent underneath a sealant to enhance sealant retention and thus prevent caries and some did not support the use of bonding agent. Therefore, to increase sealant retention and prevent caries it was decided to perform a clinical trial using primer and bond underneath fissure sealant. Aim: To evaluate among Kuwaiti school children the effectiveness of a bonding agent in fissure sealant retention and caries prevention. Methods: In a split mouth study design, fissure sealant (Delton Plus) was applied to four sound first permanent molars on 78 children. All teeth were cleaned with pumice and rubber cups, isolated with rubber dam, and etched for 20 seconds. For the test teeth, two teeth were sealed with primer and bond (3M Scotch bond Multi-purpose Plus System primer and bond) and for the control teeth, two teeth were sealed without primer and bond, one in each arch. Sixty children were available for evaluation at five-years. Sealants were evaluated for retention and caries. The evaluation criteria were: completely retained sealant, partially retained sealant, completely lost sealant, caries, and restoration. Results: At the year five examination, the gender distribution was 86.6% female and 13.3% male. The mean age at evaluation was 12.7[plus or minus]0.63 years. Overall, 22.3% of the sealants were completely retained sealant, 7.5% were partially lost sealant, 45.4% were completely lost, and 24.8% were restored. In teeth sealed with primer and bond, 19.6% of the sealants were completely retained, 9.2% were partially lost, 49.1% were completely lost, 22% were restored, and 28% were carious. In teeth sealed without primer and bond, 25% of the sealants were completely retained, 5.8% were partially lost, 41.6% were completely lost, 27.5% were restored, and 22% were carious. There were no differences seen between teeth sealed with Primer and bond, and teeth sealed without primer and bond in completely retained sealant (p=0.1 5), partially lost sealant (p=0. 16), completely lost sealant (p=0.27), restoration (p=0.16) and caries (p=0.14). In the conditional multivariate logistic regression model after controlling for gender, age at application, arch, and surface, there were no differences between teeth sealed with primer and bond and teeth sealed without primer and bond in all the outcome variables (completely retained sealant (p=0.51), complete or partially retained (p=0.79), caries free teeth (p=0.65) and caries (p=0.52). Conclusion: If the proper technique is used in sealant application, after five years the use of a primer and bond under a sealant did not enhance sealant retention or prevent caries compared to use of sealant alone in Kuwaiti school children.
PLEASE NOTE: This work is protected by copyright. Downloading is restricted to the BU community: please click Download and log in with a valid BU account to access. If you are the author of this work and would like to make it publicly available, please contact email@example.com.Thesis (MSD) --Boston University, Henry M. Goldman School of Dental Medicine, 2009 (Department of Health Policy and Health Services Research).Includes bibliographic references: leaves 51-53.
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