Determination of the success rate of Fissure sealant therapy and its related factors in children referred to Tabriz University of Medical Sciences Faculty of Dentistry

Abstract

Introduction Several methods have been proposed for preventing caries in children and adolescents, one of which is the application of sealants to the pits and fissures on the occlusal surfaces of permanent molar teeth. Several factors influence the success rate of sealant treatment. Most studies have focused on clinical factors affecting the success of sealant treatment, often aiming to compare and confirm the advantages of various materials used as sealants, as well as the conditions for preparing the teeth. However, there have been few studies on the role of factors that may indirectly affect the outcomes of sealant treatments. The present study aimed to determine the success rate of sealant treatment and its related factors in children referred to the Faculty of Dentistry, Tabriz University of Medical Sciences. Materials and Methods: The present study was a cross-sectional analytical study targeting children who had received pit and fissure sealant treatment. Children who had received sealant treatment at Tabriz Dental School were invited to participate in the study. By reviewing the archive file of patients referred to the faculty, 65 children aged 7 to 13 years were identified who had been referred to the pediatric department of Tabriz Dental School for sealant treatment within the past one to two years. All of them were invited to participate in the study, and ultimately, 57 of them agreed to take part in the study. In order to measure the outcome variable, the success rate of sealant treatment was examined and evaluated using a dental probe and oral mirror on the dental unit under sufficient light. The treatment's success in this study was defined as the complete presence of sealant material with no underlying secondary decay; failure was defined as the presence of secondary decay under sealant or either a complete or incomplete absence of sealant material. To collect data for independent variables including demographic factors (age and gender) and socio-economic factors (parents' job and place of residence), a general data collection questionnaire was used, for the variables of parents' education level, child nutrition, frequency of brushing and use of fluoride toothpaste, the WHO questionnaire was used. and to record the history of previous caries, previous records of patients in the pediatric ward of the faculty was used. To investigate the relationship between independent variables and the success rate of sealant treatment as an outcome variable, first, univariate analysis was performed using logistic regression, and the relationship of each independent variable with the outcome variable was analyzed separately. Then, considering confounding variables and for multiple regression analysis, variables with a P-value < 0.2 were candidates for multiple analysis to evaluate their simultaneous effect on the outcome variable. In the present study, a significance level of 0.05 was considered, and the analyses were performed using SPSS version 26 software. Results: The results of this study indicated that sealant treatment was successful in 56% of the participants. Multiple logistic regression analysis revealed that three factors—living district, frequency of tooth brushing, and history of tooth decay in children—were significantly associated with the success of sealant treatment. The success rate was higher among children living in affluent areas, those who brushed their teeth more frequently, and those with a history of fewer cavities. Conclusion: In this study, we examined how the number of previous dental caries, the living district, and the frequency of tooth brushing relate to the success of sealant treatment. The findings suggest that careful case selection for sealant treatment can significantly impact treatment outcomes. Specifically, for children from low socioeconomic backgrounds, those with a high number of decayed teeth, and those with poor oral hygiene, sealant treatment should be approached with caution, and follow-up should occur at shorter intervals.