Clinical Oral Investigations

, Volume 21, Issue 5, pp 1435–1443 | Cite as

Impact of the intermediary layer on sealant retention: a randomized 24-month clinical trial

  • Kelly Maria Silva Moreira
  • Kamila Rosamilia Kantovitz
  • Juliana Pedrini Dias Aguiar
  • Ana Flávia Sanches Borges
  • Fernanda Miori Pascon
  • Regina Maria Puppin-RontaniEmail author
Original Article



The aims of this study were to assess long-term impact of tooth eruption stages (ES) on sealant retention on occlusal surfaces previously coated with intermediary bonding layer and to determine caries prevention.

Materials and methods

Sixty-five school children were selected (aged 6–10 years), with four non-carious permanent first molar in different ES (OP (operculum present), ME (marginal edge), CE (completely erupted)). Split-mouth and single-blind study design was used. The teeth (260) were randomly selected according to treatment (sealant/technique): F (Fluroshield), H (Helioseal Clear Chroma), SF (Single Bond + F), EH (Excite + H). Sealant retention, marginal integrity, discoloration, and caries prevention were assessed after 6, 12, 18, and 24 months by calibrated examiner (Spearman = 0.91) using visual inspection. Data were submitted to the Cox proportional hazard model (survival analysis) and Likelihood ratio χ 2 test (correlation), p ≤ 0.05.


At baseline, ES was 20 % in OP, 54 % in ME, and 26 % in CE. There was no significant difference on sealant retention between the treatments (p = 0.2774). However, significant differences were found regarding the ES on sealant retention (p = 0.0041). The CE stage showed the highest retention survival rate during the 24 months. The overall sealant prevention average was found to be about 99.4 % and showed no difference between the groups.


Eruption stages affect sealant retention irregardless of the intermediate layer and type of sealant. However, there was caries prevention on tooth occlusal surfaces after 24 months, regardless of treatment.

Clinical relevance

Sealing is recommended to prevent occlusal caries of newly erupted teeth in high-caries-risk patients. However, its application is critical on moisture limited control surfaces independently of sealer material and technique.


Clinical trial Pit and fissure sealants Tooth eruption Retention Adhesive system Intermediary layer 



The authors are grateful to the Department of Pediatric Dentistry, State University of Campinas, Piracicaba Dental School. Specifically, our thanks extend to Mr. Norm Schiff for his cooperation and assistance in text editing and the Writing Area/General Coordination of the State University of Campinas-UNICAMP. This research was supported by CAPES–Coordination for the Improvement of Higher Education Personnel.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


This was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) in Piracicaba, São Paulo.

Ethical approval

This article does contain any studies with human participants performed by any of the authors. This clinical trial study was conducted after approval from the Ethics Committee of Piracicaba Dental School, State University of Campinas (protocol number 143/2003).

Informed consent

For this type of study, formal consent is required. Thus, informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Kelly Maria Silva Moreira
    • 1
  • Kamila Rosamilia Kantovitz
    • 1
    • 2
  • Juliana Pedrini Dias Aguiar
    • 1
  • Ana Flávia Sanches Borges
    • 3
  • Fernanda Miori Pascon
    • 1
  • Regina Maria Puppin-Rontani
    • 1
    Email author
  1. 1.Department of Pediatric Dentistry, Piracicaba Dental SchoolState University of CampinasSão PauloBrazil
  2. 2.São Leopoldo Mandic Institute and Dental Research CenterCampinasBrazil
  3. 3.Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of DentistryUniversity of São PauloBauruBrazil

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