Evaluation of pit-and-fissure sealants placed with four different bonding protocols: a randomized clinical trial

Background: Application of adhesive after acid etching may increase the retention of pit-and-fissure sealants and improve clinical effectiveness. Aims: To clinically evaluate the retention, marginal discoloration and caries incidence of pit-and-fissure sealants applied using four bonding protocols: conventional acid etching, etch-and-rinse adhesive, multimode universal adhesive and self-etch adhesive used after acid etching. Design: In this split-mouth design study, the four adhesive protocols were randomly assigned to the four erupted, non-carious first permanent molars and involved 52 patients between 6 and 10 years of age. The sealants were evaluated at 3-, 6- and 12-month intervals. Statistical analysis was carried out using Friedman test and Kruskal–Wallis test. Results: At 12 months, the retention rate was maximum in etch-and-rinse and universal adhesive groups (77.1%) followed by self-etch adhesive (58.3%) and conventional acid etching group (45.8%). Dental caries was observed only in one tooth, and marginal discoloration was found to be the highest in conventional group and least in etch-and-rinse group. Conclusions: Use of adhesives during pit-and-fissure sealant application does not significantly enhance sealant retention nor decrease marginal discoloration. Etch-and-rinse adhesive is advantageous only at short term.