Clinical Evaluation of a Nanofilled Fissure Sealant Placed with Different Adhesive Systems: 24-month Results

Objective: This clinical study compared the retention rates of a nanofilled occlusal Assure sealant placed with the use of an etch-and-rinse or a self-etch adhesive over 24 months. Methods: Two-hundred and forty-four sealants were placed on the permanent premolars and molars of 16 subjects who had no restorations or sealants present on the fissures and no detectable caries. The sealants were placed with either SoloBond M two-step etch-and-rinse adhesive or FuturaBond NR one-step self-etch adhesive by four previously calibrated dentists, using a table of random numbers. After completion of the adhesive application, a nanofilled sealant, Grandio Seal, was applied and light-cured. Clinical evaluations were done at baseline and at 1-, 3-, 6-, 12-, 18- and 24-month recalls. Two other calibrated examiners, who were unaware of which adhesive had been used, independently evaluated the sealants. Evaluation of the sealants on every follow-up visit involved visual examination with the aid of a dental explorer and an intra-oral mirror. Each sealant was evaluated with the following criteria: 1= completely retained; 2= partial loss; 3= total loss. The Pearson Chi-square test was used to evaluate differences in the retention rates among the sealants used with different adhesives for each evaluation period. Results: For the 12-month recalls, complete retention rates of 89.3% for the SoloBond M group and 20.5% for the FuturaBond NR group were observed. Sixteen of the 244 restorations were unavailable after 12 months. At 24 months, a total loss of 9 sealants in the SoloBond M group and 84 in the FuturaBond NR group were observed, resulting in retention rates of 81.6% and 15.8%, respectively. There were statistically significant differences in retention rates between the SoloBond M and FuturaBond NR groups in all periods of evaluation (p<0.05). No statistically significant difference between the retention rates for premolars and molars was found at each evaluation period (p>0.05). There was no new caries formation throughout the 24-month recall period. Conclusion: Fissure sealants placed with etch-and-rinse adhesive showed better retention rates than those placed with self-etch adhesive.