The Effectiveness of a Self-etch Fissure Sealant in an Outreach Setting- Preliminary Results

Objectives: The efficacy and cost-effectiveness of fissure sealants in the prevention of caries is well-established. Placement in outreach settings has been poorly reported, and can be challenging due to moisture control and equipment availability. It has been suggested that self-etch sealant materials may partially address these limitations, and may be more suitable for applying in outreach settings. The aim of this randomised controlled trial was to compare the retention of a self-etch sealant material versus “conventional” resin- based sealant, conducted in an outreach setting in Mfuleni Township, South Africa.
Methods: 238 children, aged 6-9 years participated in a school sealant program. 100 randomly selected children had conventional sealants applied on their molar teeth, in a mobile dental unit. The other 138 children had the self-etch sealant placed in a classroom (without using air syringe or suction). A blinded assessment was carried out after 6 months by three calibrated examiners, to assess sealant retention. Subsequent follow-up assessments will continue for 5 years. This study was approved by the UWC Ethical Committee.
Results: Preliminary data of the 6 month assessment were available for 72 children (35 boys, 37 girls), and included clinical assessments of 224 sealants on first permanent molar teeth. The self-etch sealant material appeared to show lower retention rate than the conventional sealant material. 60% of the children presented full retention versus 75% among the children whose teeth were sealed by the conventional technique. These differences were not statistically significant.
Conclusions: The self-etch material placed in a community outreach setting performed satisfactorily when compared to conventional sealants. Ongoing reassessments will be carried at 6 monthly intervals. Placement of fissure sealant in outreach setting remains a challenge for dental teams.