Dhar Vineet, Chen Haiyan
Department of Pediatric Dentistry, Dental School, University of Maryland, Baltimore, MD, USA.
Pediatr Dent. 2012 Jan-Feb;34(1):46-50.
The purpose of this study was to compare the two year clinical performance of two fissure sealants, placed with and without tooth preparation.
A total of 25 children, between 6-10 years of age, had sealants placed and evaluated for two years at six monthly intervals. All the four first permanent molars of each patient were used in split mouth design and subjected to two different sealants with and without tooth preparation. Teeth were evaluated for defects, retention and development of caries.
Among the teeth subjected to preparation, 60% of those sealed with glass ionomers and 32% of those sealed with resin sealants showed total loss of sealants at the end of two years. Among the teeth sealed with no preparation, 100% of those sealed with glass ionomers and 80% of those sealed with resin showed total loss. Resin based sealants offered better long term retention compared to glass ionomer-based fissure sealants. Tooth preparation improved the retention of sealants irrespective of the material used. Highest retention was seen in resin sealants with tooth preparation, and lowest retention was seen in glass ionomer-based sealants without preparation. There was a significant increase in caries in teeth sealed after preparation with either material. Teeth sealed with resin sealants exhibited significantly higher caries development compared to teeth sealed with glass ionomers.
In the current study, resin-based sealants were found to be superior to glass ionomer-based sealants, and tooth preparation improved retention. Loss of sealants seemed to predispose tooth to development of caries, especially in cases where teeth preparation was done.
本研究旨在比较两种窝沟封闭剂在有或无牙齿预备情况下放置两年后的临床性能。
共有25名6至10岁的儿童接受了窝沟封闭，并每六个月进行一次为期两年的评估。每位患者的四颗第一恒磨牙均采用双侧对照设计，分别使用两种不同的窝沟封闭剂，一种有牙齿预备，另一种无牙齿预备。对牙齿的缺损、封闭剂保留情况和龋齿发展情况进行评估。
在进行了预备的牙齿中，使用玻璃离子水门汀封闭的牙齿有60%在两年后封闭剂完全脱落，使用树脂封闭剂的牙齿有32%出现这种情况。在未进行预备的牙齿中，使用玻璃离子水门汀封闭的牙齿100%封闭剂完全脱落，使用树脂封闭剂的牙齿有80%出现这种情况。与玻璃离子类窝沟封闭剂相比，树脂类封闭剂具有更好的长期保留率。无论使用何种材料，牙齿预备都能提高封闭剂的保留率。树脂封闭剂在进行牙齿预备后保留率最高，玻璃离子类封闭剂在未进行预备时保留率最低。使用任何一种材料进行预备后封闭的牙齿龋齿发生率均显著增加。与使用玻璃离子水门汀封闭的牙齿相比，使用树脂封闭剂封闭的牙齿龋齿发展更为显著。
在本研究中，发现树脂类封闭剂优于玻璃离子类封闭剂，牙齿预备可提高封闭剂的保留率。封闭剂脱落似乎会使牙齿更容易发生龋齿，尤其是在进行了牙齿预备的情况下。
