Question: What is considered the standard of care for permanent first molar eruption at age 6?

Question: What is considered the standard of care for permanent first molar eruption at age 6?

Honest question: In 2017, what is considered the standard of care (state of the art) for permanent first molar eruption at age 6? Should one be proactive and seal the grooves upon eruption? What materials should we advocate and with what clinical techniques (air abrasion or not) or should we be reactive at a 6 month recall in the future?

Panaghiotis Bazos: https://www.ncbi.nlm.nih.gov/pubmed/24783880

The state-of-the-art of ART sealants. – PubMed – NCBI
ncbi.nlm.nih.gov

John Comisi: Conclusion from the article: “The annual dentine carious lesion development in teeth with high-viscosity glass-ionomer ART sealants over the first three years is 1%. These ART sealants have a high capacity of preventing carious lesion development. Because no electricity and running water is required, ART sealants can be placed both inside and outside the dental surgery.”

Panaghiotis Bazos: Yeah, I’ve read the article…

John Comisi: I always worry about moisture contamination with RBC sealants and in my opinion, if these molars are at risk, then they should be sealed with a “bioactive” material, or at least a material that has been shown to be antimicrobial.

John Comisi: But risk assessment should be done first.

Analucia Philippi: Risk assessment is what they teach here too.

Warqa Ahmed: Con we use Activa as fissure sealantAnd what is the protocol do it Shall we make acid etching and bonding?

John Comisi: Yes you can, etch without bond, it is self adhering.

Nicolò Rebellato: Activa or embrace sealant? what would you suggest?

John Comisi: Depends on the area that I am working with and how much flow I want to have.

Liviu Steier: John, we are in agreement, bioactive materials should be considered the standard of care. Do you have evidence by clinical studies in support for your statement? Honestly worried by the claim…..

John Comisi: Jack Ferracane will be presenting a paper at IADR on this.

Liviu Steier: Highly appreciated. Nevertheless we do lack long term clinical studies and that is the only proof for similar statements. Sorry to disappoint!

John Comisi: Never a problem Liviu, your vigilance in these matters makes us stronger.

Liviu Steier: Thank you John. We need those clinical studies!!!!! It is my goal to build a base for those claims which, please do not talk me wrong, I fully support.

John Comisi: There are quite a few that have been done on Activa and more being done as we speak. Larry Clark can help with them.

Liviu Steier: This is fabulous! Can this be made available please?!

John Comisi: Larry Clark

Liviu Steier: John allow me please to draw your attention to our latest accepted paper and you will than understand the way evidence is weighted in science. Dr Ahmed Mohamed and myself worked hard on that research regarding endodontic outcome and we could conclude that there is none. How should clinicians advise their patients?

John Comisi: I need to dive into that paper.

Kamil Al-Katib: I do not prefer routine proactive sealing in all the cases. There are many article out there which shows us that a proper hygiene is more than enough. And to be honest: we know what is the standard quality in dentistry, and it is really poor. For me risk assessment is the basic, and after the operator success rate. If both are low, better to refer ūüôā

Jose Manuel Barria: Risk assesment and likelihood matrix see ICDAS.org ICCM document

ICDAS – Homepage
icdas.org

Jose Manuel Barria: https://www.ncbi.nlm.nih.gov/pubmed/27132563

There is a Positive Long-term Effect of the Nexo-method on Caries Prevention.…
ncbi.nlm.nih.gov

Larry Clark: Friends of Prevention! This is a great thread. Please allow me to share that I have just finished lecturing and training here in New Zealand with the Dental Health Boards of several regions. Activa base liner has been used for over a year as a sealant as well as a bioactive product yet to come to market. The DHB here has been sending me clinical feedback in 2016. Two days ago they informed me they have collected a lot of data as well as clinician feedback regarding observations and use from dozens of dentists and therapists. I am awaiting permission to publish this data. I will say the data will also inform on the use of Activa Restorative as well. I can say the information they will provide is exciting in many respects. Clinical experience and outcome is what we are after.

Sara Grinfeld: Viviane ColaresAlice KellyPaula ValencaTha√≠s MalheirosMirella Ara√ļjo

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