European Archives of Paediatric Dentistry

, Volume 15, Issue 2, pp 65–73 | Cite as

Efficacy of sealing the mesial surfaces of first permanent molars with respect to the status of the distal surfaces of the second primary molars in children at high caries-risk

  • S. S. GomezEmail author
  • C. -G. Emilson
  • G. C. Corvalan
  • M. D. Quiroz
  • M. P. H. Moran
Original Scientific Article



This study aimed at evaluating the efficacy of sealants at preventing caries development or arresting the progression of non-cavitated mesial carious lesions in first permanent molars (6m) with respect to the status of the distal surfaces of the second primary molars (05d).


The study population comprised 121, 8- to 10-year-old schoolchildren in a high-caries community in Valparaiso, Chile. They were examined clinically and radiographically and screened for caries-related risk factors using the risk-assessment software program Cariogram. The children were divided into three groups: Group A, with no caries lesions on adjacent surfaces of 05d–6m, served as a control group. Group B, with caries on 05d, received a preventive sealant on the caries-free 6m after temporary separation, and Group C, with carious 05d, received a therapeutic sealant on a 6m with initial lesions. Standardised follow-up radiographs were taken in 110 children after 12–14 months.


In group A, with no treatment, the mean percentage of sound surfaces that developed caries lesions was 3.8 %. In group B, the mean percentage of sound 6m surfaces that developed caries lesions was 4.9 % for sealed and 22.0 % for unsealed surfaces (p < 0.05). In group C, the progression of therapeutically sealed carious lesions on 6m was 3.0 % compared with 41.2 % for unsealed carious control surfaces (p < 0.05).


These results suggest that sealing sound surfaces and non-cavitated caries in the proximal mesial surfaces of permanent molar teeth effectively prevents or reduces the progression of caries adjacent to lesions on the distal surfaces of the second primary molars.


Approximal sealing Dental caries First permanent molars Risk assessment 



This study was supported by a grant from the University of Valparaiso, Chile (Project DIPUV 30/2007). The chair-side salivary sampling kits were kindly supplied by Orion Diagnostica. The authors would like to express their gratitude to the Central Odontologica de la Primera Zona Naval, Chilean Navy as well as the Centro de Referencia Odontopediatrica Simon Bolivar de Viña del Mar for their clinical assistance.

Conflict of interest

The authors declare no conflict of interest.


  1. Alkilzy M, Berndt C, Meller C, Schidlowski M, Splieth C. Sealing of proximal surfaces with polyurethane tape: a two-year clinical and radiographic feasibility study. J Adhes Dent. 2009;11:91–4.PubMedGoogle Scholar
  2. Bratthall D, Hänsel Petersson G, Stjernswärd JR. Cariogram manual. Cariogram. Internet version 2.01. Accessed 2 Apr 2004. Spanish version.
  3. Bratthall D, Hänsel Petersson G. Cariogram—a multifactorial risk assessment model for a multifactorial disease. Community Dent Oral Epidemiol. 2005;33:256–64.PubMedCrossRefGoogle Scholar
  4. Campus G, Cagetti MG, Sale S, Carta G, Lingström P. Cariogram validity in schoolchildren: a two-year follow-up study. Caries Res. 2012;46:16–22.PubMedCrossRefGoogle Scholar
  5. Ericson D, Kidd E, McComb D, Mjör I, Noack MJ. Minimally invasive dentistry—concepts and techniques in cariology. Oral Health Prev Dent. 2003;1:59–72.PubMedGoogle Scholar
  6. Gomez SS, Basili CP, Emilson CG. A 2-year clinical evaluation of sealed noncavitated approximal posterior carious lesions in adolescents. Clin Oral Investig. 2005;9:239–43.PubMedCrossRefGoogle Scholar
  7. Gomez SS, Onetto JE, Uribe SA, Emilson CG. Therapeutic seal of approximal incipient noncavitated carious lesions: technique and case reports. Quintessence Int. 2007;38:e99–105.PubMedGoogle Scholar
  8. Gomez S, Uribe S, Onetto JE, Emilson CG. SEM analysis of sealant penetration in posterior approximal enamel carious lesions in vivo. J Adhes Dent. 2008;10:151–6.PubMedGoogle Scholar
  9. Griffin SO, Oong E, Kohn W, Vidakovic B, Gooch BF, CDC Dental Sealant Systematic Review Work Group, Bader J, Clarkson J, Fontana MR, Meyer DM, Rozier RG, Weintraub JA, Zero DT. The effectiveness of sealants in managing caries lesions. J Dent Res. 2008;87:169–74.PubMedCrossRefGoogle Scholar
  10. Hänsel Petersson G, Isberg PE, Twetman S. Caries risk assessment in school children using a reduced Cariogram model without saliva tests. BMC Oral Health. 2010;10:5.CrossRefGoogle Scholar
  11. Hänsel Petersson G, Twetman S, Bratthall D. Evaluation of a computer program for caries risk assessment in school children. Caries Res. 2002;36:327–40.CrossRefGoogle Scholar
  12. Holgerson PL, Twetman S, Stecksén-Blicks C. Validation of an age-modified caries risk assessment program (Cariogram) in preschool children. Acta Odontol Scand. 2009;67:106–12.PubMedCrossRefGoogle Scholar
  13. Hugoson A, Koch G, Nydell Helkimo A, Lundin SA. Caries prevalence and distribution in individuals aged 3–20 years in Jönköping, Sweden, over a 30-year period. Int J Paediatr Dent. 2008;18:18–26.PubMedGoogle Scholar
  14. Jensen OE, Handelman SL. Effect of an autopolymerizing sealant on viability of microflora in occlusal dental caries. Scand J Dent Res. 1980;88:382–8.PubMedGoogle Scholar
  15. Marthaler TM. Changes in dental caries 1953–2003. Caries Res. 2004;38:173–81.PubMedCrossRefGoogle Scholar
  16. Martignon S, Ekstrand KR, Ellwood R. Efficacy of sealing proximal early active lesions: an 18-month clinical study evaluated by conventional and subtraction radiography. Caries Res. 2006;40:382–8.PubMedCrossRefGoogle Scholar
  17. Martignon S, Tellez M, Santamaría RM, Gomez J, Ekstrand KR. Sealing distal proximal caries lesions in first primary molars: efficacy after 2.5 years. Caries Res. 2010;44:562–70.PubMedCrossRefGoogle Scholar
  18. Mejàre I, Källestål C, Stenlund H, Johansson H. Caries development from 11 to 22 years of age: a prospective radiographic study. Prevalence and distribution. Caries Res. 1998;32:10–6.PubMedCrossRefGoogle Scholar
  19. Mejàre I, Källestål C, Stenlund H. Incidence and progression of approximal caries from 11 to 22 years of age in Sweden: a prospective radiographic study. Caries Res. 1999;33:93–100.PubMedCrossRefGoogle Scholar
  20. Mejàre I, Kidd EAM. Radiography for caries diagnosis. In: Fejerskov O, Kidd E, editors. Dental caries: the disease and clinical management. 2nd ed. Oxford: Blackwell Munksgaard Ltda; 2008. p. 72.Google Scholar
  21. Mejàre I, Stenlund H, Julihn A, Larsson I, Permert L. Influence of approximal caries in primary molars on caries rate for the mesial surface of the first permanent molar in Swedish children from 6 to 12 years of age. Caries Res. 2001;35:178–85.PubMedCrossRefGoogle Scholar
  22. Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odont Scand. 1964;22:121–35.PubMedCrossRefGoogle Scholar
  23. Skeie MS, Raadal M, Strand GV, Espelid I. The relationship between caries in the primary dentition at 5 years of age and permanent dentition at 10 years of age—a longitudinal study. Int J Paed Dent. 2006;16:152–60.CrossRefGoogle Scholar
  24. Splieth CH, Ekstrand KR, Alkilzy M, et al. Sealants in dentistry: outcomes of the ORCA Saturday afternoon symposium 2007. Caries Res. 2010;44:3–13.PubMedCrossRefGoogle Scholar
  25. Stecksén-Blicks C, Holgerson PL, Twetman S. Caries risk profiles in two-year-old children from northern Sweden. Oral Health Prev Dent. 2007;5:215–21.PubMedGoogle Scholar
  26. Thenisch NL, Bachmann LM, Imfeld T, Leisebach Minder T, Steurer J. Are mutans streptococci detected in preschool children a reliable predictive factor for dental caries risk? A systematic review. Caries Res. 2006;40:366–74.PubMedCrossRefGoogle Scholar
  27. van Amerongen JP, van Amerongen WE, Watson TF, et al. Restoring the tooth: “the seal is the deal”. In: Fejerskov O, Kidd E, editors. Dental caries: the disease and clinical management. 2nd ed. Oxford: Blackwell Munksgaard Ltda; 2008. p. 398.Google Scholar
  28. Vanderas AP, Kavvadia K, Papagiannoulis L. Development of caries in permanent first molars adjacent to primary second molars with interproximal caries: four-year prospective radiographic study. Pediatr Dent. 2004;26:362–8.PubMedGoogle Scholar
  29. World Health Organisation. Oral health surveys—basic methods. 4th ed. Geneva: World Health Organisation; 1997.Google Scholar
  30. Zero DT, Fontana M, Martínez-Mier EA, et al. The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States. J Am Dent Assoc. 2009;140(Suppl 1):25S–34S.PubMedCrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2013

Authors and Affiliations

  • S. S. Gomez
    • 1
    Email author
  • C. -G. Emilson
    • 2
  • G. C. Corvalan
    • 1
  • M. D. Quiroz
    • 1
  • M. P. H. Moran
    • 1
  1. 1.Department of Preventive Dentistry, Facultad de OdontologíaUniversidad de ValparaísoValparaisoChile
  2. 2.Department of Cariology, Institute of OdontologySahlgrenska Academy at the University of GothenburgGöteborgSweden

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