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This randomized controlled clinical trial aims to evaluate and compare the retention, caries prevention, microleakage, and fluoride release of three types of pit and fissure sealants-hydrophilic, nanofilled hydrophobic, and conventional hydrophobic-applied to partially erupted first permanent molars in children aged 5 to 7 years. The study uses a split-mouth design and includes both clinical and laboratory evaluations over an 18-month period. Outcomes will assess sealant effectiveness with and without the use of a bonding agent.
This is a randomized controlled clinical trial designed to evaluate and compare the effectiveness of three types of pit and fissure sealants-hydrophilic (Embrace WetBond), nanofilled hydrophobic (DENU Seal), and conventional hydrophobic (Helioseal F)-when applied to partially erupted first permanent molars in children aged 5 to 7 years. The study aims to assess the sealants' clinical retention, their ability to prevent dental caries, microleakage, sealant penetration depth, and fluoride release.
A total of 150 children will be randomly assigned to three equal groups of 50 participants each. A split-mouth design will be used: in each group, sealants will be applied with and without bonding agents on opposite sides of the upper or lower arch, allowing intra-subject comparisons. Clinical evaluations will be conducted at 3, 6, 12, and 18 months to assess sealant retention and caries incidence using the modified Color, Coverage, Caries (CCC) Sealant Evaluation System.
In addition to the clinical phase, a laboratory phase will be conducted using extracted human premolars. This phase will evaluate microleakage and sealant penetration under a stereomicroscope following dye penetration techniques. Fluoride release will be measured at specified time intervals (1, 7, 14, 21, and 28 days) using an ion-selective electrode in artificial saliva conditions maintained at 37°C.
The primary outcomes include sealant retention and caries incidence. Secondary outcomes focus on the degree of microleakage, sealant penetration, and fluoride release. The trial will help determine whether moisture-tolerant sealants offer superior clinical and preventive benefits over traditional hydrophobic materials, particularly in situations where ideal isolation is difficult, such as with partially erupted teeth in young children.
The study will be conducted at the Pediatric Dentistry Clinic, Faculty of Dentistry, Mansoura University, and is expected to generate evidence that could improve clinical decision-making in preventive pediatric dentistry.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Helioseal Fplus | Experimental | Participants in this arm will receive the Helioseal F Plus resin-based sealant, applied to occlusal surfaces of permanent molars. The sealant will be applied according to the manufacturer's |
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| 1 - Hydrophilic Sealant (Embrace WetBond) | Experimental | Participants will receive Embrace WetBond sealant, a moisture-tolerant resin sealant applied to slightly moist occlusal surfaces. The sealant is light-cured for 20 seconds |
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| Denu seal | Experimental | Participants in this arm will receive Denuseal, a fluoride-releasing sealant, applied to occlusal surfaces of permanent molars under dry conditions. The sealant will be light-cured for 20 seconds. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prevention | Other | Conventional Hydrophobic Sealant (Helioseal F - Control) will be used as a positive control; applied to partially erupted molars with and without bonding in a split-mouth design. |
| Measure | Description | Time Frame |
|---|---|---|
| Retention | retention is evaluated using CCC Index (Color, Coverage, and Caries) This scale is used to assess sealant retention and caries status during follow-up evaluations. Score Description Retention Caries Status Interpretation 0 Sealant completely retained no caries Full retention Best outcome
| 18 months |
| Caries | Caries Incidence: 3, 6, 12, 18 months, t each recall (3, 6, 12 months), evaluate each sealed tooth using the CCC score: If the sealant is completely intact and no caries is visible → score = 0 If the sealant is partially gone but no decay → score = 1 If sealant is lost but still no decay → score = 2 If sealant is lost/partial and there is decay → score = 3 | 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Microleakage | Microleakage Assessment (lab) - dye penetration . Score Description Microleakage Depth Interpretation 0 No dye penetration 0% of fissure depth Best outcome
Minimum score: 0 = no leakage Maximum score: 3 = extensive leakage Higher score = worse outcome |
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Inclusion Criteria:
Exclusion Criteria:
All
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dr. Heba Mohamed DEGHID, Master | Contact | 2001016684174 | Heba.pl70@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Dr rabaa MAHMOUD ABOU Bakr, Professor | Mansoura University - Pediatric Dentistry Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Facility of Dentistry،Mansoura University | Al Mansurah | Egypt |
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| Label | URL |
|---|---|
| This randomized controlled trial compared hydrophilic (UltraSeal XT Hydro) and hydrophobic (Helioseal-F) resin-based sealants in uncooperative childre in aged 6-9 years. Using a split-mouth design, sealants were applied to 49 pairs of molars and assessed | View source |
| In-vitro studies on pit and fissure sealants often involve measuring fluoride ion release to assess their potential anticariogenic effects. Fluoride release is typically measured using a fluoride ion-selective electrode and an ion analyzer. Different typ | View source |
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De-identified data will be shared upon request for academic use.
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2 years
Researcher
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| ID | Term |
|---|---|
| D003731 | Dental Caries |
| ID | Term |
|---|---|
| D017001 | Tooth Demineralization |
| D014076 | Tooth Diseases |
| D009057 | Stomatognathic Diseases |
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| ID | Term |
|---|---|
| D055502 | Secondary Prevention |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D011314 | Preventive Health Services |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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A total of 150 children aged 5-7 will be randomly assigned to three equal groups of 50 participants each
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| Prevention of caries | Other | Embrace WetBond sealant will be applied to partially erupted first permanent molars using a split-mouth design with and without bonding agent. |
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| Prevention therapy | Other | DENU Seal applied using a split-mouth design to evaluate bonding and non-bonding application outcomes from retention and caries prevention |
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| 3 months |
| Fluoride release | Fluoride Release - spectrophotometer (1, 7, 14, 21, 28 days) Fluoride Release Scoring System (Modified Scale for Clinical Correlation) Because fluoride release is continuous and measured in ppm or µg/cm²/day, we can categorize release levels into scores for easier interpretation. Score Fluoride Release Level Typical Range Interpretation 0 High, sustained release >2 ppm after 1 week Best outcome
| 2months |
| D015980 | Public Health Practice |
| D011634 | Public Health |
| D004778 | Environment and Public Health |