Aim: The objectives of this study were: to compare the retention of fissure sealants (sealants) placed on occlusal surfaces following the use of a self-etching priming agent and traditional acid etch; to compare the caries incidence of occlusal surfaces sealed using the two techniques; and to compare the ease of placement of sealant following the use of the two techniques, as assessed by subjects and operators.
Design: The study took the form of a randomized controlled trial conducted in UK National Health Service community dental service and dental hospital clinics. Sixty subjects were recruited to this study by seven dental professionals who placed sealants on lower permanent molar pairs. The technique used for enamel preparation prior to sealant placement on the right and left side of the lower arch was randomized. On one side of the lower arch, Xeno III was used to prepare the occlusal enamel, and on the other, phosphoric acid etch together with Prime & Bond was used. Opaque Delton was used to seal all surfaces. Subjects were blinded to the techniques used. The subjects and operators recorded their impressions of the techniques used on individual questionnaires.
Results: Forty-six (77%) of the 60 subjects were reviewed by the principal researcher after 6 months. The retention of the acid-etch group was significantly superior (P < 0.01), as was the caries preventive effect (P < 0.01). Subjects tended to report that placement of sealants was easier following enamel preparation with Xeno III (P = 0.085), and in the opinion of the operators, sealants were significantly easier to place when using Xeno III (P = 0.016).
Conclusions: In view of the findings of this investigation, best practice for the placement of sealants remains enamel preparation with acid etch and the use of an intermediate bonding layer.