Retrospektive Studie zum Überleben von Fissurenversiegelungen: Ein Vergleich zwischen Zahnärzten einer Universitätszahnklinik, Zahnärzten in der Praxis und Studenten der Zahnmedizin

Introduction: The aim of this study was to examine retrospectively various parameters that influence the survival probability of fissure sealants, as well as a comparison between the operator groups dentists in a dental clinic, dentists in a private practice and students of dentistry. Method: Using medical files, data from children and adolescents between the age of 5 and 17, who had been treated with a classical fissure sealant on the first or second permanent molar in the period from 2010 to 2012 in the department of pediatric dentistry at the dental clinic of the Philipps University of Marburg and in a nearby dental private practice (Dr. Boris Jablonski, Lollar), were surveyed. Various parameters, which could influence the success or failure of sealants, were recorded. The survival probability was analyzed using the Kaplan-Meier estimator. The log rank test was applied for group comparisons. The significance level was set to α=0.05. Teeth without changes concerning the sealants during the observation period were recorded as a “success”. Teeth with a change in terms of a new sealant, an extended fissure sealant or a filling were recorded as a “failure”. Results: Data were collected from 335 patients with a total number of 997 teeth. On average each patient had 3.0 sealants. 68 patients (191 teeth) were treated by dentists in a dental clinic, 236 patients (726 teeth) by dentists in a private practice and 31 patients (80 teeth) by students of dentistry. The mean observation period was 14.4 months (0.2-35.0 months, standard deviation: 8.6). At the end 862 (86.5%) sealants remained without any changes. The sealants of 91 (9.1%) teeth were renewed, an extended fissure sealant was performed on 14 (1.4%) teeth, 30 (3.0%) teeth received a filling. An average survival time of 29.4 months (95% confidence interval: 28.6-30.2) was determined for all pit and fissure sealants. For an age range of 5.6 to 17.9 years, the average age at the beginning of the treatment was 11.1 years. The mean dmf-t was 1.18, the DMF-T was 0.90. The examined parameters gender, age, dmf-t/DMF-T, anamnesis, tooth group, maxilla/ mandibula, type of drying, fluoridation and material did not significantly influence the survival of the sealants. A significantly higher mean survival period (p=0.0025) was exhibited for teeth that had been treated with a fissure sealant after cleaning the tooth surface (30.3 months), compared to teeth which were not cleaned or no cleaning was documented (28.4 months). The fissure sealants were examined 1 to 20 times during the observation period, on average the value was 2.9 recalls. For sealants that had been examined more than three times (32.0 months) the mean survival time was significantly higher (p<0.0001), compared to sealants that were only controlled up to three times (26.2 months). The difference in the duration of survival between the various operator groups (dentists dental clinic, dentists private practice, students) was not statistically significant (p>0.05). Conclusion: This study shows that cleaning the tooth surfaces before placement of fissure sealants and the number of recalls can significantly influence the survival rate of fissure sealants of permanent teeth. The operator (dentists dental clinic, dentists private practice, students) had no significant influence on the success of the sealants. The sealants of the dental private practice do not differ from the clinical implementation in its efficacy. And operators with low practical knowledge like students are able to achieve comparable results as experienced dentists.