Clinical evaluation of a medium-filled flowable restorative material as a pit and fissure sealant.

This clinical study evaluated the retention rate and caries protection of a medium-filled (46% volume) flowable restorative material (CuRay-Match, OMNII Oral Pharmaceuticals, West Palm Beach, FL 33409, USA) compared to an unfilled sealant (Delton, Dentsply Caulk, Milford, DE 19963, USA). Using a half-mouth design, sealants were applied on randomly assigned caries-free first and/or second permanent molars of 32 children ranging in age from 6-11 years. A total of 118 teeth were etched, dried and sealed. Teeth were evaluated at one, six and 18-month intervals. After one month, 52 teeth sealed with unfilled sealant were intact compared with 46 sealed with a medium-filled resin, and after six months, 36 teeth sealed with an unfilled sealant were intact compared with 27 that were sealed with a medium-filled resin. After 18 months, 29 teeth were still fully sealed with an unfilled sealant, whereas 18 were sealed with a medium-filled resin. The difference between the two groups was not statistically significant. Regarding caries development, four teeth sealed with a medium-filled material and five teeth sealed with an unfilled sealant were decayed after 18 months. These results indicate that a medium-filled flowable restorative material did not perform better in retention rate and caries increment when compared to an unfilled conventional sealant. However, the effect of the additional techniques, such as the use of bonding agent and fissurotomy on retention rates should be evaluated in further studies.

Assessing the effect of fluoride varnish on early enamel carious lesions in the primary dentition.

BACKGROUND: The aim of this study was to evaluate the effect of fluoride varnish on enamel caries progression in the primary dentition. METHODS: One hundred forty-two children in Head Start schools (3 to 5 years old) were randomized into the varnish and control groups. Children in the varnish group received fluoride varnish (Duraphat, Colgate-Palmolive Co.) at baseline and after four months, and children in the control group received no professional fluoride applications. Two calibrated examiners performed the examinations at baseline and at nine months. RESULTS: At nine months, the authors found that in the control group, 37.8 percent of active enamel lesions on occlusal, buccal and lingual surfaces became inactive, 3.6 percent progressed and 36.9 percent did not change. In the varnish group, 81.2 percent became inactive, 2.4 percent progressed and 8.2 percent did not change. The difference between the groups was statistically significant (P < .0001). The mean decayed surfaces, or ds, value in the varnish group was significantly lower after nine months than it was at baseline (P < .0001). When enamel lesions were included in the data analysis (along with dentinal lesions), the decayed with initial enamel lesions, missing and filled surfaces, or dEmfs, values; decayed with initial enamel lesions, missing and filled teeth, or dEmft, values; and decayed surfaces with initial enamel lesions, or dEs, values were significantly lower in the varnish group after nine months than they were at baseline (P < .0001). CONCLUSIONS: These results suggest that fluoride varnish applications may be an effective measure in reversing active pit-and-fissure enamel lesions in the primary dentition. CLINICAL IMPLICATIONS: Fluoride varnishes are safe, easy to apply and well-accepted by patients. This study shows that fluoride varnish may offer an efficient, nonsurgical alternative for the treatment of decay in children.