Evaluation Of Commonly Treated Maxillary Teeth With Preventive Resin Sealant Among Children With Primary Dentition
Anu Iswarya Jaisankar1, Vignesh Ravindran2*
1 Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai- 77, India.
2 Senior Lecturer, Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences [SIMATS], Saveetha University, Chennai- 77, India.
*Corresponding Author
Vignesh Ravindran,
Senior Lecturer, Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences [SIMATS], Saveetha
University, Chennai- 77, India.
Tel: +91-9789934476
E-mail: vigneshr.sdc@saveetha.com
Received: September 13, 2021; Accepted: September 20, 2021; Published: September 21, 2021
Citation:Anu Iswarya Jaisanka, Vignesh Ravindran. Evaluation Of Commonly Treated Maxillary Teeth With Preventive Resin Sealant Among Children With Primary Dentition. Int J Dentistry Oral Sci. 2021;8(9):4475-4479. doi: dx.doi.org/10.19070/2377-8075-21000910
Copyright: Vignesh Ravindran©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Application of Pit and fissure sealants is an integral part of comprehensive caries management approach. Their role in the field of caries prophylaxis is undisputed. A Pit and fissure sealant is a clear or an opaque plastic material which when applied to the deep pit and fissure of the posterior teeth can prevent caries. The current study aims at estimating the frequency of commonly treated maxillary primary teeth with pit and fissure sealants in a dental hospital setting and also in the provision of a detailed statistical report on the same. The study was performed in the Outpatient department of saveetha dental college, under a university setting. It was a retrospective study. Data required for the study was procured by reviewing patient records dating between June 2019 and March 2021.The collected data was sorted and analysed and the results were interpreted in the form of graphs. Our results show that the majority of the preventive resin sealant procedures that is 50.51% are done on male children and children of three years of age were the frequently treated (28.06%). Primary first and second maxillary molars were more commonly treated in both male and female children, which was not statistically significant (p-value = 0.315). From our results we conclude that Primary second molars are the most commonly treated teeth with the majority of the treatment procedures done on male children and children of 3 years age.
2.Introduction
3.Materials and Methods
3.Results
4.Discussion
5.Conclusion
5.References
Keywords
Maxillary Teeth; Primary Dentition; Fissure Sealant.
Introduction
The human tooth is a carefully designed structure. Teeth are very
important for humans as they are an essential component of the
oral cavity that helps us in Mastication, Speech and also in the
maintenance of the contour of the face. Humans have two sets
of dentition. The primary and the permanent dentition. The First
tooth develops between 6 to 10 months of the age of the child
and by 25 to 33 months the child has its complete set of Primary
dentition. A good care of the primary dentition is very important
as they are more susceptible to dental caries. Early Childhood
Caries is still one of the major issues worldwide. It refers to one
or more numbers of decayed, missing or filled teeth in the primary
dentition. Dental caries in a continuous process if not intervened
that eventually leads to the loss of teeth. Primary teeth have
relatively faster progression of caries due to their relatively less
thicker enamel and dentin layers and larger pulp chambers and
the early loss of primary teeth have got its own ill effects. Studies
show that Maxillary teeth are more commonly affected with
11.5% frequency percentage. Primary teeth serve as the guide to
the permanent teeth. It is generally accepted that the premature
loss of deciduous teeth is associated with the malocclusion of
permanent dentition. The premature loss of primary teeth may
reduce the arch length required for the succeeding tooth, and
hence predisposes crowding, rotation, and impaction of the permanent
teeth [1]. The dental pain from the cavitated lesions can
lead to decreased chewing and feeding habits that can lead to
malnourishment of the child. Moreover, the dental abscess and
infection can cause permanent damage to the permanent teeth [1,
2]. Studies show that A child with early childhood caries has 90%
chances of developing caries in the permanent teeth [3]. Also
early loss of teeth can adversely affect the speech and pronunciation of the child. Therefore a proper maintenance of caries free
primary teeth is really very important. Of all the different types
of carious lesions, pit and fissure caries account to 90% of dental
caries in permanent teeth and 44% of caries in primary teeth [4].
Pits and Fissures are the grooves present in the occlusal surface
of the posterior teeth. Comprehensive studies reveal that the potential
of the dental cavities is directly related to the depth of
the fissures and pits. This is due to their morphological complexity
which leads to increased plaque accumulation making dental
hygiene process difficult. On that note, Pit and fissure sealants
are really very important. A Pit and fissure sealant is a clear or an
opaque plastic material which when applied to the deep pit and
fissure of the posterior teeth can prevent caries. The sealant acts
as a mechanical barrier that prevents the accumulation of bacterial
microorganisms and also the food debris [5].
E.I Cueto in 1966 developed the first sealant material with methyl
cyanoacrylate however the material was unstable and was susceptible
to easy bacterial breakdown. It was in 1970 Bunocore made
further advances to the existing sealants by developing a sealant
that was made of Bisphenol - A - Glycidyl Methacrylate. The
material was found to be both resistant to bacterial breakdown
and also bonded well to the enamel layer of the tooth. Then J.D
Mclean and A.D Wilson in 1974 introduced the Glass ionomer cement
sealants. Now there are different types of sealants available
in the market. Based on the method of polymerisation, whether
they contain fluoride or not, based on the type of resin used: filled
or unfilled, there are different types of dental sealants. There are
four different generations of Resin based sealants known. First
generation sealants are cured with ultraviolet, second generation
sealants are chemically cured, the third generation sealants are
light cured whereas the fourth generation sealants release fluoride.
The other type is the Glass ionomer cement based sealants
[6]. Both Resin based and Glass ionomer cement based sealants
are good in their own way. Resin based sealants are durable, highly
adaptable and are used in areas of teeth where adequate moisture
control is a matter of concern [7]. The important advantage of
Glass ionomer based sealants is their fluoride releasing property.
They not only act as a physical barrier but also helps in remineralising
the lost tooth structure, thereby restoring the strength
and function of the lost tooth structure [8]. The placement of
sealant is a quite easier process and does not consume much time.
A phosphoric acid tooth etchant is applied to the tooth structure
that increases the surface area of the tooth structure [9]. Then the
sealants are placed exactly halfway through the inclination of the
cuspal ridges.
Saliva contamination is the major problem in the placement of
the sealants. Therefore a good moisture control and isolation
technique is important. Though dental materials wear over a period
of time, Dental sealants can stay in the teeth for 5 to 10
years. However Frequent dentist visits are important in ensuring
the same. In terms of Retention properties, Resin based sealants
are considered superior. Dental sealants are recommended to all
patients who are at the risk of developing caries [10]. They are
also recommended to people who take high carbohydrate food
and also in cases of enamel defects such as Amelogenesis imperfecta.
Application of Pit and fissure sealants is an integral part
of comprehensive caries management approach. Their role in the
field of caries prophylaxis is undisputed. Our team has extensive
knowledge and research experience that has translate into high
quality publications [11-23, 24-30]. The current study aims at estimating
the frequency of commonly treated maxillary primary
teeth with pit and fissure sealants in a dental hospital setting and
also in the provision of a detailed statistical report on the same.
Materials and Methods
The study was performed in the Outpatient department of a private
dental college, under a university setting. It was a retrospective
study. The Ethical approval was obtained from the Institutional
ethical committee. Informed consent was obtained from
the parents or guardian regarding usage of the clinical data for
research purposes. Data required for the study was procured by
reviewing 5,00,000 patient records dating between June 2019 and
March 2021.
Inclusion criteria of this study was the pediatric population within
the age group of 2 to 6 years who had treatment with preventive
resin sealant in their maxillary arch within the time period extending
from June 2019 to February 2021. The patients who had
preventive resin sealant treatment in their mandibular arch as well
as patients of other age groups having mixed dentition or only
permanent dentition were excluded in the study.
Digital entry of clinical examination, intraoral photographs of the
oral cavity and the treatment procedure were assessed. The data
collected (digital entry and intraoral photographs) was verified by
an external additional reviewer. The sampling bias was minimised
by a simple random sampling method. A third examiner reviewed
the case records of the collected data to confirm the validity of
the data with post operative photographs. If any error in data entry
or patient details or clinical data were noticed, that case sheet
was excluded from the study.
The data collected were tabulated in MS Excel and was then analysed
in SPSS software version 22 (IBM Corp, Texas, LA). The
independent variable was age and the dependent variable was silver
diamine fluoride application and gender. Descriptive statistics
were used and comparison between groups were done by using
Chi square tests.
Results
Of Reviewing patients records dating between June 2019 and
March 2021, we have retrieved data for about 392 Preventive resin
sealant procedures done on the Maxillary teeth of Primary dentition.
Our results show that the majority of the preventive resin
sealant procedures that is 50.51% are done on male children while
49.91% procedures are performed on female children (figure 1).
Our results also show that children of three years of age were the
frequently treated ones with 28.06% treatment frequency, with
least no of procedures performed on children of two years of
age (12.24%) (figure 2). The stats also show that Left primary
maxillary second molars were the most commonly treated ones
(figure 3). Primary first and second maxillary molars were more
commonly treated in both male and female children, which was
not statistically significant (figure 4)(p-value = 0.315).
Figure 1. Represents the Gender of the children who had undergone preventive resin sealant application in their Maxillary teeth. The x axis refers to the gender while the y axis refers to the frequency percent of the same. The Red zone represents the Male children whereas the orange zone represents the female children. The frequency percentage in male children is found to be 50.51% whereas in female children it is about 49.49%.
Figure 2. Represents the age of the children treated. The x axis refers to the age while the y axis refers to the frequency percent of the same The light violet zone represents the age group of two years, the light blue zone three years, the light green zone four years, the yellow zone five years and the grey zone 6 years. 12.24% procedures were found to be performed on children of 2 years age, 28.06% on 3 years of age, 21.94% on 4 years of age, 16.33% on 5 years of age and 21.17% on 6 years of age.
Figure 3. Represents the type of teeth treated with the preventive resin sealants. The x axis refers to the type of tooth while the y axis refers to the frequency percent of the same. The Dark blue zone refers to the maxillary right first molar (54), the dark green zone refers to the maxillary right second molar (55), the blonde yellow region refers to the maxillary left first molar (64) and the purple zone to the maxillary left second molar (65). 8.67% procedures are done on 54, 39.54% on 55, 8.67% on 64 and 43.11% on 65.
Figure 4. Shows the association between the Gender of the children and the type of the teeth treated. The x axis refers to the gender while the y axis refers to the type of tooth. The Dark blue zone refers to the maxillary right first molar, the dark green zone refers to the maxillary right second molar, The beige region refers to the maxillary left first molar and the purple zone to the maxillary left second molar. Primary first and second molars were more commonly treated in both male and female children, which was not statistically significant (chi-square value 0.979 - p-value = 0.315 - not significant).
Discussion
392 dental preventive resin sealant procedures were found to be
performed during the time period of 22 months between June 2019 and March 2021. All these 392 procedures are found to be
done on the primary maxillary dentition. 50.51% of the procedures
were performed on male children while 49.49% procedures
are done on female children (Figure 1). It shows that male children
are more commonly treated than female children. But we
can see the margin of difference between both to be really very
less with 1.02%.Figure 2 shows the age of the children treated.
There are no procedures done on children of 1 year age. 12.24%
of procedures were found to be performed on children of 2 years
of age, 28.06% procedures on children of 3 years age, 21.94%
procedures on children of 4 years of age, 16.33% on children of
5 years of age and 21,17% procedures on children of 6 years old.
From this, we can say that children of 3 years age are more commonly
treated. Followed by children of 4 years age, 6 years age, 5 years age and 2 years age respectively. Figure 3 shows the frequency
of procedures done on the basis of the type of the teeth.
It shows that 8.67% procedures to be done on primary maxillary
right first molars (54) and 39.54% procedures to be performed
on primary maxillary right second molars (55). In the same way
8.67% procedures are done on primary maxillary left first molars
(64) and 43.11% procedures are performed on primary maxillary
left second molars (65). From the data, we can say that Primary
maxillary second molars are the most commonly treated teeth.
Left maxillary second molars are found to be more commonly
treated than Right maxillary second molars. Both Maxillary left
first molars are found to be equally treated.
Our research also analysed the association between the gender of
the patient and the type of teeth treated. But it is found to be insignificant
with a chi square value 0.979 which has been shown in
Figure 4. Though there is no significance between the two, we can
still analyse the type of the teeth treated separately for the different
gender. In both Male and Female children, Maxillary second
molars remains the commonly treated teeth which correlates with
our previous data, where we had seen the frequency percentage as
a whole without gender discrimination.
The role of pit and fissure sealants in preventing dental caries has
been recorded in plenty of literature. Studies show that Sealants
can reduce the incidence of dental caries by 76% on the sound
occlusal surfaces [31]. A Cochrane review had evaluated the caries
prevention effect of sealants in children which was compared
with a no sealant control group. The results show moderate quality
evidence that supports the sealant application [32]. Sealants
provide protection against 80% of caries for the first two years
of application and against 50% caries for upto 4 years, A study
shows [33]. The recent evidence-based guidelines of the American
Dental Association (ADA), in collaboration with the American
Academy of Pediatric Dentistry (AAPD), prefers the use of
sealants to fluoride varnish, though the quality of evidence is
found to be low [32, 34].
The limitations of the study are minimum external validity and
also the validity can be extended by encompassing subjects of a
wider range. This study is retrospective and doesn’t record success
of sealants treatment. This study may enable the necessity for
prophylactic management in mandibular molars of mixed dentition
particularly in male population.
Conclusion
Within the limitations of the present study, primary second molars
were the most commonly treated teeth with majority of the
treatment procedures done on male children and children of 3
years age.
Acknowledgement
The authors are thankful to the Department of Pediatric Dentistry,
Saveetha Dental College, Saveetha Institute of Medical and
Technical science, Saveetha University for providing a platform in
expressing their knowledge.
Source of Funding
The present project was funded by
• Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University and
• Muniyandi vilas hotel (Reference ID: MVH201107).
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