Composite/sealant restoration: 6 1/2-year results.

This study was performed to examine the success of a conservative cavity preparation using the principle of "sealing for prevention" rather than "extension for prevention." A total of 332 restorations were placed in 243 permanent molars in 114 children aged 6-14 with a mean age of 8 years. After 80 months, 104 restorations were examined for sealant retention, marginal staining, anatomic wear, marginal adaptation of the composite if the sealant was lost, and dental caries. Twenty restorations sustained partial loss and 16 complete loss of the sealant. Marginal staining was not evident, but 5 restorations showed evidence of wear and 11 marginal caries. These findings indicate that conservative cavity preparation with sealing for prevention is a successful restoration which conserves valuable tooth structure. In classical restorative dentistry technique, whenever the occlusal surface of a molar is prepared, the preparation usually is extended to include all pits and fissures whether or not these areas are carious (Gilmore 1979). Although these extensions of the preparation are performed to prevent caries, sound tooth structure is removed and a weakened tooth results. The first permanent molar in the adult mouth frequently sustains cusp fracture following placement of a restoration, necessitating extensive restorative or endodontic treatment. This problem might be caused inadvertently when conscientious practitioners use extension for prevention with young patients. Consequently, it would be beneficial to preserve sound tooth structure and employ fissure sealants for prevention. The composite/sealant restoration has been investigated with excellent results (Simonsen and Stallard 1977; Azhdori et al. 1979; Simonsen 1980; Mertz-Fairhurst et al. 1983) and recently it has been advocated for widespread use by general practitioners (Anusavice 1988). This article reports the 6 1/2Figs 1-8 (opposite) reprinted with permission from Quintessennce International 16:489-92,1985. year results of a study which examined the success of a conservative occlusal restoration in which fissure sealant was used rather than cavity extension into pits and fissures for prevention of caries.