Abstract
Aim The hypothesis was tested that dentine carious lesion progression is higher in sealed micro-cavitated pits and fissures than in sealed pits and fissures having no or enamel carious lesions at baseline over a period of four years.
Results Epidemiological survey identified no enamel carious lesions (code 0), enamel carious lesions (code 1), and micro-cavitated dentine carious lesions (code 2), in pits/fissures of occlusal surfaces of first permanent molars at baseline. Using block randomisation, 405 children (mean age of eight years) were allocated to high-viscosity glass-ionomer, atraumatic restorative treatment method (HVGIC/ART), thermo-cured HVGIC/ART, glass-carbomer, and resin composite groups, receiving 1,344 sealants. Evaluation was performed after six months and annually. Carious lesion progression for baseline code 0 (n = 784) and code 1 (n = 481) was determined by scoring code 2, and that for baseline code 2 (n = 79) by scoring code 3 or 4 (frank cavitation). Tests were performed using a proportional hazard model with frailty correction.
Discussion and conclusion There was neither an effect for sealant group nor between baseline codes 0 and 1. A total of 19 baseline code 0, and 20 code 1 developed a cavitated dentine carious lesion; while 5% of the sealed over micro-cavitated dentine carious lesions developed frank cavitation. The progression of carious lesions in the group baseline code (0 + 1) was not statistically significantly different from the group of baseline code 2 (p = 0.29). Progression of micro-cavities sealed over with HVGIC according to the ART method, a glass-carbomer or a resin composite over a period of four years is low. Dentine lesions with a small orifice (Ø <0.5 mm) in pits/fissures of occlusal surfaces in permanent molars have a high chance of surviving four years if they are sealed over.
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Author contributions , Acknowledgements and Declaration of conflict of interests
Author contributions
W. W. Zhang contributed to conception and interpretation and drafted the manuscript; J. Mulder contributed to data analysis and drafted the manuscript; J.E. Frencken contributed to conception, data analysis and interpretation, and drafted the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work.
Acknowledgements
We thank Dr Ye Lu, Dr Li Jiqi and Dr Hu Xuan, the dental assistants, final-year students and evaluators for their pleasant and valuable contribution to the implementation and evaluation phases of the main trial. We appreciate the donation of dental materials from 3MESPE, China and Glass-Carbomer N.V., The Netherlands. The main trial was financed by grants from the Ministry of Science and Technology, China (2007BA128B00), the Netherlands Academy of Science (08CDP011) and the Radboud University Nijmegen (RL000045), The Netherlands.
Declaration of conflict of interests
The authors declare no potential conflict of interests with respect to the authorship and/or publication of this article. We thank Mrs. S. van Tonder for editing the manuscript.
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Zhang, W., Mulder, J. & Frencken, J. Is preventing micro-cavities in dentine from progressing with a sealant successful?. Br Dent J 226, 590–594 (2019). https://doi.org/10.1038/s41415-019-0195-9
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DOI: https://doi.org/10.1038/s41415-019-0195-9
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