Retention of pit and fissure sealants placed in a dental school pedodontic clinic: a retrospective study.

The purpose of this study was to determine the combined retention rates of two Bis-GMA sealants ("Delton" and "Nuva-Seal") in a pedodontic clinic. Included in this study were 176 patients whose mean age was eleven years and five months. For all teeth examined, the relationship between the percentage of teeth with "sealant all present" and longevity is almost linear from the plotted value at six months (85%) to that at thirty-three months (67%). corresponds to an initial failure rate of 15% followed by a failure rate of about 4% at each six-month recall exam. Retention rates have also been reported for all permanent eeth, maxillary versus mandibular permanent eeth, and premolars versus molars. The high retention rates support the use of sealants as a means of preventing pit and fissure caries in children. Although there have been numerous studies ’22 that have reported on occlusal sealant retention, this study was conducted to assess the value of sealants in a pedodontic clinic where a large number of operators and assistants with varying degrees of knowledge and technical skills would use the material. The vast majority of previous studies have used a small number (mean -3) of professionals who were highly trained in the sealant application technique, involving up to 4,462 teeth in one study~ and in excess of 3,780 in another. 3 The specialization of these operators may very well have resulted in superior sealant retention rates. While clinical results obtained by trained and experienced personnel under optimal conditions are of interest, it is also important to know how well sealants are retained when applied under average practice conditions. While the conditions of this study are not typical of conditions in private practice, these results may be more representative than those research studies that had a large number of sealants placed by a few experienced clinicians. This paper reports the results of a sealant retention study that routinely used rubber dam whenever the teeth to be sealed were erupted sufficiently to allow its placement. Of the 20 "Nuva-Seal" and "Delton" studies reviewed, only one4 used. rubber dam routinely. Although Poulsen and Peltoniemi5 found no significant difference in retention when sealants were placed on primary teeth with isolation by cotton rolls on one side of the mouth versus rubber dam on the other, one would expect improved retention if rubber dam were routinely used for sealant application. Another purpose of this study is to explore the advantages and disadvantages of a retrospective sealant retention study using a dental school pedodontic population. Some potential advantages are low cost, data collection over a short period of time, and data that is representative of sealants placed throughout the year, rather than at one time. Although two studies ~.7 were based on the placement of sealants by students in dental school pedodontic clinics, this is the first retrospective sealant retention study. Methods and Materi~ls Patients receiving treatment in the Department of Pedodontics at the College of Dentistry of The University of Iowa were the subjects eligible for this study. Their dental charts were checked for previous sealant application; patients who had sealants placed five or more months earlier were included. Data was collected over a five-month period during the summer and fall of 1979. From a very large pedodontic clinic population, 176 patients whose mean age was eleven years and five months were included in this study. Two brands of sealants were used; "Delton,"aan autopolymerized sealant and "Nuva-Seal, ’’b an ultraviolet light polymerized sealant. For the first six months only "Nuva-Seal" was available; this was followed by the introduction of "Delton," which soon became the only brand used. ~Johnson and Johnson; East Windsor, NJ. bThe L. D. Caulk Company; Milford, DW. 22 RETROSPECTIVE SEALANT RETENTION: Anson, Full, and Wei