Longitudinal evaluation of sealing molars with and without incipient dental caries in a public health program.

OBJECTIVES: This study undertook a retrospective evaluation of the effect of sealants on the caries experience of initially sound and incipient permanent first molar pit and fissure surfaces. METHODS: Records of children with complete five-year records were obtained from a school-based dental sealant program in a fluoridated community. Sealants were placed on 677 tooth surfaces in 96 children; 120 tooth surfaces in 17 children who received baseline examinations were not sealed because of lack of caregiver consent. Tooth surfaces were initially diagnosed as being sound or having incipient lesions, and evaluated for caries status after five years. RESULTS: For initially incipient surfaces the five-year decay rate was 10.8 percent (41 of 380 surfaces) for sealed surfaces and 51.8 percent (29 of 56 surfaces) for nonsealed surfaces with an odds ratio of 8.88 (95% CI = 4.56, 17.35). Initially sound surfaces had a decay rate of 8.1 percent (24 of 297 surfaces) for sealed surfaces and 12.5 percent (8 of 64 surfaces) for nonsealed surfaces with an odds ratio of 1.63 (95% CI = 0.63, 4.08). The two odds ratios were significantly different. CONCLUSIONS: Initially sound tooth surfaces were unlikely to become decayed in five years, and did not benefit greatly from the application of sealants. Within the limitations of this study, there were clear efficiencies in sealing incipient, but not sound, surfaces. The targeting of teeth with incipient caries for sealants is therefore recommended.

Twenty-four-month clinical trial of visible-light-activated cavity liner in young permanent teeth.

A clinical study of young permanent teeth for twenty-four months evaluated the use of a new product, VLC-Dycal, as a cavity liner. VLC-Dycal is a light-activated calcium hydroxide cavity liner. After twenty-four months, VLC-Dycal had a 91 percent success rate used as a liner with young permanent teeth. From the fifty-four teeth evaluated at twenty-four months, only five were failures. Failure occurred more frequently with DPC. Of the five teeth that became devital over the twenty-four months, three were DPC. The success rate for DPC was 70 percent. IPC had a success rate of 85 percent. None of the CCR procedures failed in the study. Because of the improved physical properties, VLC-Dycal was evaluated in a clinical trial for biological properties and proved to be a useful cavity liner for young permanent teeth.