Tserakhava, T.N. Clinical effectiveness of fissure sealing of the first permanent molars using material HELIOSEAL / T.N. Tserakhava, N.D. Cherniauskaya // Zbornik radova : 9. Medunarodni kongress stomatologa Vojvodine, 19 i 20. maj 2018, Novi Sad. Novi Sad : Drustvo lekara Vojvodine Srpskog lekarskog drustva, Stomatoloska sekcija, 2018 (Petrovaradin : Maxima graf). S.36-40 CLINICAL EFFECTIVENESS OF FISSURE SEALING OF THE FIRST PERMANENT MOLARS USING MATERIAL HELIOSEAL Tserakhava TN, Cherniauskaya N.D. Department of Pediatric Dentistry, Belarusian State Medical University, Minsk, Belarus Introduction. Despite the high achievements in the development of dentistry, dental caries continues to be one of the most common diseases among preschool and primary school children [1]. Although the chewing surface accounts for only 12.5% of the total tooth surface area, it is most susceptible to caries. Almost 80% of caries lesions develop on occlusion surfaces [2,3]. Among all permanent teeth the first molars are more often affected by caries which is associated with the peculiarities of the structure of the chewing surfaces of this group of teeth and the low level of their mineralization along with insufficient oral hygiene [2,4,5,6]. Caries of pits and fissures has a latent flow and therefore it is difficult to diagnose it especially at the initial stages. Usually the lesion is detected already at the stage of the carious cavity and treated by preparation and sealing. The methods for diagnosing the initial stages of the carious process in the fissure of the chewing teeth are based on visual and instrumental research and are not sufficiently informative. In addition to the visual instrumental dental examination in the last decade a new International Caries Detection and Assessment System (ICDAS II) has been applied to assess the condition of hard tooth tissues, allowing timely detection and
registration of a significant proportion of caries lesions in the early stages of development [7]. Several classifications of caries have been integrated into one universal system using a 6-digit scale to indicate lesions from initial manifestations of carious cavities. The main areas of prevention of caries of pits and fissures are caused by risk factors for its occurrence, clinical flow and diagnostic features. Currently, in the prevention of occlusal caries special technologies called " sealing of pits and fissures" are used. Materials with different chemical bases can be used as a fissure sealant. The main factors that determine the clinical effectiveness of sealants are their retention ability and the degree of preservation in fissures. The aim of the study was to assess the effectiveness of sealing of fissures of the first permanent molars using Helioseal material (Ivoclar Vivadent). Materials and methods. We performed non-invasive fissure sealing of the 152 first permanent molars in 51 children aged 6-7 years, whose parents agreed to participate in the preventive program. Sealing was performed in teeth that did not have caries of enamel and dentin and estimated from 0 to 2 points on the ICDAS II index using Helioseal (Ivoclar Vivadent) material, which is an unfilled composite light curing sealant. The comparison group consisted of children (21 people) whose parents did not agree to carry out preventive measures. Fissure sealing was performed using a non-invasive method in which the occlusal surfaces were cleaned with a rotating brush and a fluoride-free polishing paste, rinsed thoroughly with water, and dried with an air pistol. To isolate the teeth from saliva, cotton swabs and a saliva ejector were used. On the occlusal surface of the teeth, 37% orthophosphoric acid was applied for 30 seconds, washed for 20 seconds with water and dried. The sealant was applied to fissures, distributed using a dental probe, photopolymerized. The retention of the sealant, the presence or
absence of air bubbles and marginal fit were assessed. With the help of occlusal paper, the presence or absence of overage of material was evaluated and in the absence of drawbacks the procedure was terminated with the application of 5% fluoride varnish. The clinical effectiveness of sealing the fissures of the first permanent molars using Helioseal was evaluated according to the Ryge criteria recommended by the American Dental Association (ADA) in twelve months period [8]. The following clinical parameters were taken into account: safety of the sealant, presence of air bubbles, marginal fit, surface roughness of the sealant and color change along the edge of the sealant. Statistical processing of digital material was carried out using nonparametric methods in Excel, Statystica 10.0. Results of the study. We established that in 125 teeth (82.23%) the sealant was preserved completely, the total safety of the sealant was registered statistically significantly more often (χ2 = 5.6 p <0.05) in the tooth 36 (90.24%). It should be noted that in the teeth of the upper jaw the total safety of the sealant was observed significantly less frequently (χ2 = 4.9 p <0.05) than in the teeth of the lower jaw, 54 (75.00%) and 71 (88.75%), respectively. Table - Results of sealing with Helioseal after 1 year Safety of Upper jaw Lower jaw sealant n % n % total safety 54 75,0 71 88,8 partial safety 12 16,7 5 6,2 total loss 6 8,3 4 5,0 total 72 100 80 100
Partial safety of sealants was observed in 17 (11.18%) teeth: in 12 teeth (16.67%) of the maxilla and in 5 teeth (6.25%) of the lower jaw. Complete loss of sealants was recorded in 10 (6.50%) teeth, of which 6 (8.33%) teeth on the upper jaw and 4 (5.00%) teeth on the lower jaw. However, the differences in the total loss of sealants on the teeth of the upper and lower jaws were statistically insignificant (χ2 = 0.7, p> 0.05). Partial and total loss of sealant was statistically significantly more frequent (χ2 = 4.9, p <0.05) in the teeth of the upper jaw than in the teeth of the lower jaw, which is apparently related to the physical properties of the material (thixotropy) and the position of the patient during the manipulation. It should be noted that carious lesions were not diagnosed in the teeth with partial or complete loss of sealant, both on the upper and lower jaw, while in 5 children from the comparison group in 9 teeth we diagnosed with caries of dentine. Differences in tooth decay in caries in children of both groups are statistically highly significant (χ2 = 25, p <0.001). The conclusion. Thus the results of the study indicate a high caries prophylactic effectiveness of Helioseal composite material when sealing the fissures of the first permanent molars. Literature 1. Terekhova TN, Melnikova EI Dynamics of the dental status of the children of the Republic of Belarus // Modern dentistry. - 2016-2. - P.52-53. 2. Heinrich-Weltzien R., Kühnisch J., Senkel H., Stösser L. Welchen Beitrag leistet die Fissurenversiegelung zur Zahngesundheit? / R. Heinrich-Weltzien, J. Kühnisch, H. Senkel, L. Stösser// Oralprophylaxe. - 1998. Vol. 20. - P. 146-154. 3. Lobovkina LA Prophylaxis in therapeutic dentistry is profitable. Lobovkina, A.M. Romanov // New in Dentistry. - 2007. - 6. - P. 46-49.
4. Feigal RJ. The use of pit and fissure sealants / R.J. Feigal, K.J. Donly // Pediatr. Dent. - 2006. - Vol. 28, 2. - P. 143-150. 5. B.K. Leontiev, K.V. Zhorov // Stomatology for all. - 2006. - No. 3. - P. 34-36. 6. Hoszek А. Chlorhexidine-containing glass ionomer cement. A clinical investigation on the fissure caries inhibitory effect in first permanent molars / A. Hoszek et al. // Swed. Dent. J. - 2005. - Vol. 29, 3. - P. 89-96. 7. Braga M. M, Oliveira L. B, Bonini G. A., Bönecker M., Mendes F. M. Feasibility of the International caries Detection and Assessment System (ICDAS- II) in epidemiological surveys and comparability with standard World Health Organization criteria / M. M Braga, L. B Oliveira, G. A. Bonini, M. Bönecker // Caries Research. 2009-43. - P. 245-249. 8. Ryge, G. Clinical criteria //Int. Dent. J. 1980. Vol. 30