Biomedical subjects
Publications and source records attributed to J T Cline.
Forty-three bicuspids which replaced successfully pulpotomized vital or non-vital primary molars, and twenty bicuspids, which erupted following unsuccessful pulpotomies requiring extraction of the preceding teeth, were examined for defects of position and enamel. In comparison with contralateral control teeth, test teeth in both groups showed an increased prevalence of rotation and enamel surface defects.
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A clinical trial of 4047 single applications of Nuva Seal placed on the occlusal surfaces of primary molars, permanent first and second molars and premolars by 250 dental students showed that the sealants were not well retained. The sealant was fully retained on 86% of all permanent posterior teeth at 3 months, on 76% at 6 months, 58% at 12 months, 52% at 24 months and 41% at 36 months. At 4 years, complete sealant coverage was shown by 14% of primary molars, 25% of permanent molars and 68% of premolars. Permanent mandibular molars and premolars were superior to permanent maxillary molars and premolars in fully retaining sealants. Following sealant failure, i.e. providing partial coverage or missing, permanent maxillary molars and premolars were more prone to occlusal caries than permanent mandibular molars and premolars. At 4 years, caries was diagnosed in 40% of applications to permanent molars and in 9% of applications to premolars. Twelve instances of caries under apparently intact sealants were seen.
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A clinical trial has investigated the occlusal caries experience of permanent molars and premolars, following the apparent loss of occlusal sealants applied by dental students, in comparison with that of unsealed teeth erupted for time periods similar to the sealant evaluation periods. Complete retention at one, two and three years was relatively poor. Throughout the study, premolars were superior to molars in fully retaining sealants. Regardless of the clinical condition of the sealant, a statistically significant reduction in occlusal caries-experience of sealed teeth was seen in comparison with control teeth. This relative reduction was highest at one year: 72 percent for molars and 83 percent for premolars, dropping at three years to 23 percent for molars and 64 percent for premolars. At one year, molar sealant failures showed a statistically significant, relative reduction of 41 percent in occlusal caries-experience over control teeth, suggesting as ongoing caries-inhibitory effect. Thereafter, the history of a failed sealant neither enhanced nor reduced the occlusal caries susceptibility of molars, and premolars over that of control teeth.