Fissure sealant retention: a comparison of three sealant types under field conditions

Two two-year double-blind clinical trials were undertaken involving the newly-erupted first permanent molars of 133 children aged 5-6 years at the outset. In one study of 76 subjects, half the teeth were sealed with the filled sealants Prismashield or Estiseal. In the other study of 58 children, half were again sealed with Prismashield, and the others with the unfilled Concise white sealant, by a community dental service hygienist, as part of her routine dental duties. Subjects were examined under blind conditions at 6 monthly intervals and, by 24 months in the first study, 71 per cent of Prismashield sites were intact and caries-free, compared with only 53 per cent of Estiseal-treated tooth units (P less than 0.001). In the second study comparing Prismashield and Concise, by two years, 81 per cent of Prismashield resins were complete, compared with 88 per cent of the nonfilled Concise material. There were, however, no differences noted with respect to buccal and palatal site retention for either study. It can be concluded that Estiseal is a poorer material than Prismashield, certainly in relation to its bulk retention properties. Nonetheless it is possible that, along with other tooth-coloured/transparent resins, small fragments may not be as readily detectable as is the case with the unfilled Concise white sealant. However, as the abrasion resistance of unfilled materials is poorer than that of filled resins, the similar buccal/palatal site retention for Prismashield and Concise was also unexpected. Nevertheless this study illustrates again the value of sealant placement in the erupting first permanent molars of 5-6-year-old children, at a time when these teeth are most susceptible to carious attack.