EAPD guidelines for the use of pit and fissure sealants.

E-mail: r.welbury@dental.gla.ac.uk composites or compomers, and their polymerisation may be initiated chemically or by light. Several studies reported the effectiveness of second generation chemical initiated FSs. Wendt and Koch [1988] reported, under optimal dental office conditions, 80% complete retention after 8 years and combined partial and 94% complete retention after 10 years. Romcke et al. [1990], in a Canadian study after 10 years reported 41% complete retention and 8% partial retention. Eighty-five per cent of the sealed teeth were caries free after 8-10 years. Simonsen [1987] reported 57% complete retention 10 years after a single FS application and 28% after 15 years [Simonsen, 1991]. After 15 years 74% of surfaces that had been sealed were caries free. Chestnutt et al. [1994] reported on more than 7,000 FSs after 4 years where 57% of the sealed tooth surfaces remained fully sealed, with 18% scored as deficient or failed and 24% completely missing. Of the surfaces originally scored as deficient at baseline 23% were scored as carious compared with 21% of surfaces not sealed. Only 14.4% of the sound/sealed surfaces at baseline became carious. Wendt et al. [2001a] reported 95% complete or partial retention without caries in second permanent molars after 15 years and 87% complete or partial retention without caries in first permanent molars after 20 years. In a different study the same authors [Wendt et al., 2001b] reported that 74% of first permanent molars that had been sealed were caries free after 15 years. Ripa [1993] reviewed numerous studies that have been carried out comparing the retention rates between third and first and/or second generation FS. The results indicated that the performance levels for chemical initiated FS and visible light photoinitiated FS were similar within an observation period of up to 5 years. However, in three comparison studies of longer Introduction Tooth surfaces with pits and fissures are particularly vulnerable to caries development [Manton and Messer, 1995]. Ripa [1973] observed that although the occlusal surfaces represented only 12.5% of the total surfaces of the permanent dentition, they accounted for almost 50% of the caries in school children. This can be explained by the morphological complexity of these surfaces, which favours plaque accumulation to the extent that the enamel does not receive the same level of caries protection from fluoride (F) as does smooth surface enamel [Ripa, 1973; Bohannan, 1983; Ripa, 1990]. The plaque accumulation and caries susceptibility are greatest during the eruption of the molars [Carvalho et al., 1989], and caries susceptible individuals are therefore vulnerable to early initiation and fast progression of caries in these sites. Brown et al. [1996] and Kaste et al. [1996] showed that in fluoridated communities over 90% of dental caries is exclusively pit and fissure caries.

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