Evaluation of Pit and Fissure Dr. Huda E. Ali, Dr. Maha A. Al- Issue No.

33/2014
Sealant With and….. Mashhadaney

Evaluation of Pit and Fissure Sealant With and

Without Topical Fluoride Application

Dr. Huda E. Ali Al-Rubaye Dr. Maha A. Al- Mashhadaney

hudaelyass@yahoo.com dr_mashhadaney@yahoo.com
Al - Mustansyria University - College Of Dentistry
Department of Pediatric Dentistry and Preventive

Abstract: The majority of the detected increment in

dental caries is confined to pit and fissure surfaces of
teeth. Application of pit and fissure sealants and
topical fluorides are widely used procedures in the
prevention of decay. The purpose of this study was to
evaluate the effectiveness of pit and fissure sealant
with and without topical fluoride application in the
prevention of dental caries on the occlusal surfaces
of teeth in children. 93 healthy cooperative children
of both sexes with an average age (7-9 years) were
included in this study, accordingly, 120 permanent
first molars that were caries-free and fully erupted
divided into two groups: sealant group (sealant
applied on 60 permanent first molars) and sealant
with fluoride group (sealant plus fluoride gel applied
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Sealant With and….. Mashhadaney

topically every three months intervals for 24 months

on 60 permanent first molars). All children were
recalled for assessment of fissure sealant and the
presence or absent of dental caries at intervals of 6,
12, 18 and 24 months. The statistical analysis shows
that there was no significant differences in the
presence and absent of dental caries on the occlusal
surfaces of the teeth between sealant group and
sealant with fluoride group at baseline time and at 6,
12, 18 and 24 months intervals of recall assessment.
There was some evidence about the superiority of pit
and fissure sealant over topical fluoride application
in the prevention of occlusal decay. However, it
remained unclear to what extent there is differences
between the effectiveness of pit and fissure sealant
with and without topical fluoride application. No
recommendation for the clinical practice could be
given and the benefit of pit and fissure sealant with
and without topical fluoride application should be
considered locally and individually.
Key words: pit and fissure sealant, caries prevention, topical
fluoride, clinical trial.

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Evaluation of Pit and Fissure Dr. Huda E. Ali, Dr. Maha A. Al- Issue No. 33/2014
Sealant With and….. Mashhadaney

1. Introduction
Despite great advancement in oral health globally, the problem
of dental caries which is a chronic disease remains in many
communities around the world and continues to be a major public
health problem, particularly among socially and economically
deprived groups in developed and developing countries [1], these
dental problems result in pain, infection and lost school days and
work days each year [2,3].
Effective caries-preventive methods for use by dental
professionals in caring for their patients, by individuals or by public
health practitioners in communities and other population-based
program sites have been developed and refined since the
introduction of community water fluoridation in the 1940’s [4].
Application of pit and fissure sealants and topical fluorides are
widely used procedures in the prevention of decay. Pit and fissure
sealants are used to prevent the impaction of food and growth of
bacteria which promote decay [5]. Since the 1960s the development
of pit and fissure sealants has progressed from the first generation
(activated with ultraviolet light), through second (autopolymerized)
and third (activated by visible light), to fourth generation (contains
fluoride), and the effectiveness of dental sealants in preventing
occlusal decay have been supported by numerous studies [6,7,8],
but described significant heterogeneity and indicated the need for
further studies .
Treatment of the hard tooth surfaces in such a way that caries is
arrested or reversed is the aim of topical fluoride application, and
the American dental Association (ADA) council on Scientific
affairs commented that periodic fluoride treatment should be
considered for both children and adults who are at moderate or high
risk of developing caries [9].
Although the overall caries rate in terms of DMF-index values
has fallen in industrialized countries, the rate of caries lesions in
pits and fissures has not decreased at the same time [10]. Almost
90% of all dental caries occurs on occlusal, buccal and lingual tooth
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surfaces with pits and grooves, making these surfaces most

susceptible to decay in children and adolescents [5].
The aim of this study was to evaluate the effectiveness of pit
and fissure sealants with and without topical fluoride application in
the prevention of dental caries on occlusal surfaces of teeth in
children.

2. Materials and Methods

 Sample selection and sealant application:
This study was conducted from October 2010 to October
2012, 93 healthy cooperative children of both sexes with an average
age (7-9 years) were included in this study, they attended to private
dental clinic in Al-Yarmok city for routine oral examination and
treatment, and they had at least one fully erupted and caries-free
first permanent molar. Any child with hypoplastic permanent first
molar or other developmental anomalies was excluded from the
study. All children had satisfactory oral hygiene. Upon parental
consent, the parents and the children were informed about the
purpose and the procedure of the study. Accordingly, 120
permanent first molars that were caries-free and fully erupted
divided into two groups: sealant group (sealant applied on 60
permanent first molars) and sealant with fluoride group (sealant
plus fluoride gel applied topically every three months intervals for
24 months on 60 permanent first molars). Sealant (Delton light-
polymerized opaque fissure sealant: Johnson & Johnson Dental
products Co. USA) was applied to all caries-free, fully erupted
permanent first molars at baseline (for both groups 120 teeth), the
material was used according to manufactured instructions.
The first step in sealant placement, was cleaning the occlusal
surface of the selected teeth using a rotating brush and non-
fluoridated pumice paste to ensure the removal of all deposits and
debris from the pits and fissures. After prophylaxis, the teeth were
washed with a water spray for 20-30 seconds and re-evaluated for
residual debris or loosened pumice paste, then the area needs to be
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isolated to provide a dry working field that will enhance retention,

therefore, rubber dams was used to isolate the area, once isolated,
the teeth were dried thoroughly with compressed air. Any moisture
on the surface during the placement of the sealant will interfere
with the bonding of the material to the tooth and compromise
retention. The next step was acid etching of the teeth surfaces,
37% orthophosphoric acid was applied to the occlusal surface for
about 20-30 seconds, this will permit mechanical retention of the
sealant material, then acid etch was rinsed from surfaces and the
area thoroughly dried. Then the teeth surfaces were dried and
isolated prior to placement of the sealant material which was the
most critical aspect of the placement process [20, 28].
The fissure sealant material then was applied with the
disposable syringe provided by the manufacture and light-cured for
20–30 seconds, when polymerization was completed, the sealant
was evaluated for over filling (checking the occlusion with
articulating paper), discontinuity and retention. Irregularities
(bubbles into the fissure) were corrected immediately with adding
of a material or by adjusting high spots.
The last step of sealant application involved educating the
patient about the importance of periodic reevaluation of the sealants
[11]. In the 2nd group (sealant with fluoride), all children were seen
at 3 months intervals for 24 months with a preventive program
including regular topical fluoride application, after cotton roll
isolation, the teeth dried with compressed air and Acidulated
phosphate fluoride gel (Care 4 from Sultan chemists {ADA} Apf
23 %) was applied in properly selected flexible disposable trays and
retained for 4 minutes. Children were asked to bend their head
forward during the application period; the patients were allowed to
expectorate freely after application. They were advised not to eat,
drink, or rinse at least for 30 minutes following the application, and
the children were instructed to brush their teeth only the next
morning (Knutson technique) [13,14,15].

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Sealant With and….. Mashhadaney

 Evaluation criteria:
The clinical criteria for detecting new caries lesions included: caries
present and caries absent [16].
 Follow up examinations:
All children were recalled for assessment of fissure sealant and
the presence or absent of dental caries at intervals of 6, 12, 18 and
24 months. During routine recall examinations, it is necessary to re-
evaluate the sealed tooth surface both visually and tactually for loss
of material, exposure of voids or bubbles in the material and caries
development by using a dental mirror and explorer [14], The fissure
sealant were not reapplied if they had been lost between
examinations [17,18].

3. Results
Table (1) shows the number and percentage of caries present
and absent in the 60 teeth of the sealant group, after 24 months of
sealant application, dental caries was present on the occlusal
surface of (6) teeth (10%) and absent in 54 teeth (90%) of the total
60 teeth in the sealant group, while at baseline time caries was
absent in all the 60 teeth of the sealant group.
Figure (1) shows the percentage of caries present and absent of
the sealant group at baseline time and at 6, 12,18 and 24 months
intervals of recall assessment.
Table (2) shows that at baseline time and after 6months of
fluoride application caries was absent in all the 60 teeth of the
sealant with fluoride group, while after 24 months caries was
present on the occlusal surface of (5) teeth (8.3%) and absent in
(55) teeth (91.7%) of the total 60 teeth of the sealant with fluoride
group.
Figure (2) shows the percentage of caries present and absent in
the 60 teeth of the sealant with fluoride group at baseline time and
at 6, 12, 18 and 24months intervals of recall assessment. As shown
in figure(3) no statistically significant differences was found
between the sealant group and sealant with fluoride group at
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Sealant With and….. Mashhadaney

baseline time and at 6, 12, 18 and 24 months intervals of recall

assessment for the presence of dental caries on the occlusal surfaces
of the 120 teeth.
Figure(4) shows that there was no statistically significant
differences in the absent of dental caries on the occlusal surfaces of
the teeth between the sealant group and sealant with fluoride group
at baseline time and at 6, 12, 18 and 24 months intervals of recall
assessment.

4. Discussion
Pit and fissure sealant used to seal off minor grooves and
fissures on tooth, these grooves and fissures are potential food traps
that causes tooth decay; Sealing them makes the tooth surface
smoother and reduce tendency for food to be trapped within the
crevasses [29]. Pits and fissure sealants are indicated for children
and adolescent who are at a moderate or high risk of developing
dental caries or have incipient caries in pits and fissures. Moderate
and high risk levels for caries in children and adolescents take into
account the history of new, incipient or recurrent caries, salivary
flow, regularity of dental visits and fluoride exposure, among other
factors [19].
Sealant restorations are indicated for carious lesions that have
not advanced into the dentin in occlusal surfaces of permanent
molars, pre-molars and primary molars [20]. 95% of all carious
lesions occur on the occlusal surfaces of teeth. The occlusal
surfaces of teeth comprise 12% of the total number of tooth
surfaces, which means the pit and fissures of the occlusal surfaces
of teeth are more susceptible to decay as the smooth surfaces of the
teeth [21]. The teeth at highest risk for carious lesions are the first
and second molars, and 90% of all dental caries in school children
occurs in pits and fissures of the occlusal surface of the molars [22].
The role of topical fluoride application in the prevention of
caries initiation and progression has been well established [30, 31].
Although researches have shown that other agents such as
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Sealant With and….. Mashhadaney

fluoridated varnishes, dentifrices and mouth rinses can reduce the

prevalence of caries, but topical fluoride application plays a
promising role in caries prevention [32, 33,34].
One of the major problems when considering the success rates
of sealant restorations is the variation in techniques and materials
used. Short term studies indicate a high degree of success for
sealant restorations [23-24], this is in agreement with the present
study. However, longer term studies appear to indicate that success
is less predictable [25-26], so that the present study needed to be
extended for a longer period of time to evaluate the success rate.
For direct comparison of sealant restoration studies it is necessary
to define success as 100% retention and no caries present in the
tooth. The present study conducted over duration of (2 years)
showed a success rate ranging from (100%) caries absent at
baseline time and at 6 months intervals for both groups (sealant
group and sealant with fluoride group), to (10%) caries present at
24months intervals for the sealant group and (8.3%) caries present
at 24 months interval for the sealant with fluoride group.
In this study the effect of sealant placement alone were
compared with the effect of sealant placement with topical fluoride
application program, after 24months period, the teeth in the sealant
group and sealant with fluoride group were found to be caries-free
with rates of (90%) and (91.7%) respectively indicating a
statistically non significant differences, this result is in agreement
with results obtained by Yildiz et al, 2004 and Avinas et al, 2010
[18, 27].

5. Conclusion
There was some evidence about the superiority of pit and fissure
sealant over topical fluoride application in the prevention of
occlusal decay. However, it remained unclear to what extent there
are differences between the effectiveness of pit and fissure sealant
with and without topical fluoride application. No recommendation
for the clinical practice could be given and the benefit of pit and
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Sealant With and….. Mashhadaney

fissure sealant with and without topical fluoride application should

be considered locally and individually.

References:

[1] Petersen PE. "Challenges to improvement of oral health in

the 21st century – the approach of the WHO Global Oral
Health programmed". Inter Dental Journal 2004; 54: 329–
343.
[2] Petersen PE. "The world oral health report: continuous
improvement of oral heath in the 21th century- the
approaches of the WHO global oral health programme".
Community Dent., Oral Epidemiology 2003; 31:3-24.
[3] United States GAO, Oral health: "Dental disease is a
chronic problem among low income population", Report to
Congressional Requesters, April, 2000.
[4] U.S. Department of Health and Human Services. "Oral
health in America: a report of the Surgeon General.
Rockville, MD: U.S. Department of Health and Human
Services", National Institute of Dental and Craniofacial
Research, National Institutes of Health, 2000.
[5] Ripa LW., "Sealants revisted: an update of the
effectiveness of pit-and-fissure sealants" Caries Res1993;
27:77–82.
[6] Liodra JC, Bravo M, Delgado-Rodriguez M, Baca P, Galvez
R., "Factors influencing the effectiveness of sealants- a
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261-268.
[7] Mejare I, Lingstrom P, Petersson LG, Holm AK, Twetman
S, Kallestal C., "Caries preventive effect of fissure
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61:321-330.
[8] Ahovuo-Saloranata A, Hiiri A, Norblad A, Worthington H,
Makela M., "Pit and fissure sealants for preventing dental
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Sealant With and….. Mashhadaney

decay in the permanent teeth of children and adolescents

2004;(Cochrane Review)", Coharance Library, Issue 3.
Chichester, UK: John Wiley & Sons, Ltd.
[9] American Dental Association Council on Scientific Affairs
"Professionally applied topical fluoride: evidence-based
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2006;137:1151-1159.
[10] Marthaler TM., "Changes in dental caries 1953–2003".
Caries Res 2004;38:173-181.
[11] Donna Lesser, "RDH, BS 1-8 special supplemental issue-
Access", July 2001An Overview of Dental Sealants.
[12] World Health Organization (1997), "Oral health surveys:
basic methods", 4th ed , WHO, Geneva.
[13] Horowitz HS, Doyle J., "The effect on dental caries of
topically applied acidulated phosphate-fluoride: results
after three years", J Am Dent Assoc 1971;82:359--65.
[14] Johnston DW, Lewis DW., "Three-year randomized trial of
professionally applied topical fluoride gel comparing
annual and biannual application with/without prior
prophylaxis", Caries Res 1995; 29:331-336.
[15] Stookey GK, Beiswanger BB., "Topical fluoride therapy.
In: Harris NO, Christen AG, eds. Primary preventive
dentistry", 4th ed. Stamford, CT: Appleton & Lang,
1995:193--233.
[16] Kargul B, Tanboga I, Gulman N., "A comparative
evaluation of fissure sealant 3 years results", European
Academy of Pediatric Dentistry 2009; 10(4): 1818-1826.
[17] Dennison JB, Straffon LH, More FG., "Evaluating tooth
eruption on sealant efficacy", JADA 1990;121:610-4.
[18] Avinas J, Mary CM, Dhingras S, Gupta P., "Pit and fissure
sealant: An unused caries prevention tool", J Oral Health
Comm Dent 2010; 4(1):1-6.

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Sealant With and….. Mashhadaney

[19] Rethman, J., "Trends in preventive care: caries risk

assessment and indications for sealants", J Am Dent
Assoc, 2000; 131(suppl_1): p. 8S-12.
[20] Dental Product Spotlight, "Pit and fissure sealants". J Am
Dent Assoc, 2002; 133(9): p. 1274-1275.
[21] Bohannan H., "Caries Distribution and the case for
sealants", J Public Health Dentistry 1983;33:200-204.
[22] Harris N, Godoy-Garcia F., "Primary Preventive
Dentistry", 5th ed. Stanford, Connecticut: Appleton and
Lange, 1999.
[23] Simonsen RJ, Stallard RE., "Sealant restorations utilizing a
dilute filled composite resin: one year results",
Quintessence Int. 1977;23:307-315.
[24] Houpt M, Eidelman E, Shey EZ., "Occlusal restoration
using fissure sealant instead of ‘extension for prevention",
ASCD J Dent Child 1984;51:270-273.
[25] Houpt M, Eidelman E, Shey EZ., "Occlusal composite
restorations: 4 year results", J Am Dent Assoc
1985;110:351-353.
[26] Mertz-Fairhurst EJ, Adair SM, Sams DR, et al., "Cariostatic
and ultraconservative sealed restorations: Nine-year
results among children and adults", J Dent Child
1995;62:97-107.
[27] Yildiz E, Dorter C, Efes B, Koray F., "A comparative study
of two fissure sealants: a 2-year clinical follow up", J Oral
Rehab 2004 Oct; 31(10): 979-84.
[28] Beauchamp J, et al. "Evidence-Based Clinical
Recommendations for the use of pit and fissure sealants. A
report of the American Dental Association Council on
Scientific Affairs", J Am Dent Assoc 2008; 139(3): 257-
268.
[29] Joon M. "Pit and fissure sealant with fluoride
application", J Det Clin 2008; 10(3): 116-118.

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Sealant With and….. Mashhadaney

[30] Tanaka M, Ono H, Kadoma Y, Imai Y., "Incorporation into

human enamel of fluoride slowly released from a sealant
in vivo", J Dent Res 1987; 66: 1591-1593.
[31] Forsten L., "Short and long term fluoride release from
glass ionomer and other fluorid containing filling
materials in vitro", Scand J Dent Res 1990; 98:179-185.
[32] Marinelli CB, Donly KJ, Wefel JS, Jakobsen JR, Denehy
GE., "An in vitro comparison of three fluoride regimens on
enamel remineralization", Caries Res 1997; 31: 418-422.
[33] Hicks MJ, Flaitz CM., "Caries-like lesion formation
around fluoride-releasing sealant and glass ionomer". Am
J Dent 1992; 5: 329-334.
[34] Hicks MJ, Flaitz CM, Garcia-Godoy F., "Fluoride-
releasing sealant and caries-like enamel lesion formation
in vitro", J Clin Pediatr Dent 2000; 24: 215-219.

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Sealant With and….. Mashhadaney

Table (1)
Number and percentage of caries present and absent in sealant
group
Number Percentage %
Total 60
Baseline time:
Caries present 0 0%
Caries absent 60 100 %
6 months:
Caries present 0 0%
Caries absent 60 100 %
12 months:
Caries present 3 5%
Caries absent 57 95 %
18 months:
Caries present 5 8.3 %
Caries absent 55 91.7 %
24 months:
Caries present 6 10 %
Caries absent 54 90 %
𝛘2 = 6.37, DF = 3, P-Value = 0.095, NS: Non Significant at level P > 0.05.

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Table (2)
Number and percentage of caries present and absent in sealant
with fluoride group
Number Percentage
Total 60
Baseline time:
Caries present 0 0%
Caries absent 60 100 %
6 months:
Caries present 0 0%
Caries absent 60 100 %
12 months:
Caries present 2 3.3 %
Caries absent 58 96.7 %
18 months:
Caries present 3 5%
Caries absent 57 95 %
24 months:
Caries present 5 8.3 %
Caries absent 55 91.7 %
𝛘2 = 5.43, DF = 3, P-Value = 0.143, NS: Non significant at level P > 0.05.

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100% 100%
95.00% 91.70%
100% 90.00%
90%
80%
70%
60%
50%
%

40%
30%
20% 8.30% 10.00%
5.00%
10% 0% 0%
0%
Caries present
Caries present

Caries present

Caries present

Caries present
Caries absent

Caries absent

Caries absent

Caries absent

Caries absent
Baseline 6 12 18 24 months
time months months months

Figure (1)
Percentage of caries present and absent of sealant group

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Sealant With and….. Mashhadaney

100% 100% 96.70% 95.00% 91.70%

100%
90%
80%
70%
60%
50%
%

40%
30%
20% 8.30%
3.30% 5.00%
10% 0% 0%
0%
Caries present

Caries present

Caries present

Caries present

Caries present
Caries absent

Caries absent

Caries absent

Caries absent

Caries absent
Baseline 6 12 18 24 months
time months months months

Figure (2)
Percentage of caries present and absent of sealant with fluoride
group

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10.00%
10% 8.30% 8.30%

5.00% 5.00%
5% 3.30%
%

0% 0% 0% 0%
0%
Sealant group

Sealant group

Sealant group

Sealant group

Sealant group

Sealant+fluoride group
Sealant+fluoride group

Sealant+fluoride group

Sealant+fluoride group

Sealant+fluoride group

Baseline 6 12 18 24 months
time months months months

Figure (3)
Percentage of caries present of sealant group and sealant with
fluoride group

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100% 100% 100% 100%

100% 96.70%
95.00% 95.00%
95% 91.70% 91.70%
90.00%
%

90%

85%
Sealant group

Sealant group

Sealant group

Sealant group

Sealant group
Sealant+fluoride group

Sealant+fluoride group

Sealant+fluoride group

Sealant+fluoride group

Sealant+fluoride group
Baseline 6 12 18 24 months
time months months months

Figure (4)
Percentage of caries absent in sealant group and sealant with
fluoride group

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‫‪Evaluation of Pit and Fissure‬‬ ‫‪Dr. Huda E. Ali, Dr. Maha A. Al-‬‬ ‫‪Issue No. 33/2014‬‬
‫‪Sealant With and…..‬‬ ‫‪Mashhadaney‬‬

‫تقييم ختم التجىيف والشق مع وبدون استعمال الفلىرايد المىضعي‬

‫د‪.‬مها عبد الكريم المشهداني‬ ‫د‪.‬هدي الياس علي الربيعي‬

‫‪dr_mashhadaney@yahoo.com‬‬ ‫‪hudaelyass@yahoo.com‬‬
‫اٌجاِعح اٌّسرٕصش‪٠‬ح ‪ -‬وٍ‪١‬ح طة األسٕاْ ‪ -‬لسُ طة أسٕاْ األطفاي ‪ٚ‬اٌ‪ٛ‬لائ‪ٟ‬‬

‫المستخلص‬

‫غاٌث‪١‬ح اٌز‪٠‬ادج ف‪ ٟ‬اٌىشف عٓ ذس‪ٛ‬س األسٕاْ ‪٠‬مرصش عٍ‪ ٝ‬خرُ ذج‪٠ٛ‬ف ‪ٚ‬شك‬
‫األسٕاْ‪ٚ .‬ذسرخذَ عٍ‪ٔ ٝ‬طاق ‪ٚ‬اسع خرُ اٌرج‪٠ٛ‬ف ‪ٚ‬اٌشم‪ٛ‬ق ‪ٚ‬اٌفٍ‪ٛ‬سا‪٠‬ذ اٌّ‪ٛ‬ظع‪ٌٍٛ ٟ‬لا‪٠‬ح‬
‫ِٓ اٌرس‪ٛ‬س‪.‬‬
‫واْ اٌغشض ِٓ ٘زٖ اٌذساسح ذم‪ ُ١١‬فعاٌ‪١‬ح خرُ اٌرج‪٠ٛ‬ف ‪ٚ‬اٌشم‪ٛ‬ق ِع ‪ٚ‬تذ‪ْٚ‬‬
‫اسرعّاي اٌفٍ‪ٛ‬سا‪٠‬ذ اٌّ‪ٛ‬ظع‪ ٟ‬ف‪ ٟ‬اٌ‪ٛ‬لا‪٠‬ح ِٓ اٌرس‪ٛ‬س عٍ‪ ٝ‬سط‪ٛ‬ح األسٕاْ عٕذ األطفاي‪.‬‬
‫‪ 39‬طفال ِرعا‪ٔٚ‬ا ‪ٚ‬صذ‪١‬ا ِٓ وال اٌجٕس‪٠ ٓ١‬ثٍغ ِر‪ٛ‬سط أعّاسُ٘ (‪ 3-6‬سٕ‪ٛ‬اخ) ادسج‪ٛ‬‬
‫ف‪٘ ٟ‬زٖ اٌذساسح‪ٚ ,‬فما ٌزٌه‪ ِٓ )021( ,‬األظشاس اٌذائّح األ‪ ٌٝٚ‬خاٌ‪١‬ح ِٓ اٌرس‪ٛ‬س‬
‫‪ٚ‬اٌر‪ ٟ‬تزغد تاٌىاًِ ف‪ ٟ‬اٌفُ لسّد إٌ‪ِ ٝ‬جّ‪ٛ‬عر‪ِ :ٓ١‬جّ‪ٛ‬عح اٌخرُ (‪ 61‬ظشس دائّ‪ٟ‬‬
‫أ‪ٚ‬ي) ‪ِٚ‬جّ‪ٛ‬عح اٌخرُ ِع اٌفٍ‪ٛ‬سا‪٠‬ذ (اسرعّاي ٘الَ اٌفٍ‪ٛ‬سا‪٠‬ذ ِ‪ٛ‬ظع‪١‬ا وً ثالثح أش‪ٙ‬ش ٌّذج‬
‫‪ 22‬ش‪ٙ‬ش عٍ‪ 61 ٝ‬ظشس دائّ‪ ٟ‬أ‪ٚ‬ي)‪ .‬جّ‪١‬ع األطفاي اسرذع‪ٛ‬ا ٌرم‪ ُ١١‬خرُ اٌشك ‪ٚ‬وزٌه‬
‫‪ٚ‬ج‪ٛ‬د أ‪ ٚ‬غ‪١‬اب ذس‪ٛ‬س األسٕاْ عٍ‪ ٝ‬فرشاخ ‪ 22ٚ 01 ,02 ,6‬ش‪ٙ‬شا‪.‬‬
‫أظ‪ٙ‬ش اٌرذٍ‪ ً١‬اإلدصائ‪ ٟ‬عذَ ‪ٚ‬ج‪ٛ‬د فش‪ٚ‬ق راخ دالٌح إدصائ‪١‬ح ف‪ٚ ٟ‬ج‪ٛ‬د‬
‫‪ٚ‬غ‪١‬اب اٌرس‪ٛ‬س عٍ‪ ٝ‬سط‪ٛ‬ح األسٕاْ ت‪ ٓ١‬اٌّجّ‪ٛ‬عر‪ ٓ١‬ف‪ٚ ٟ‬لد خط األساس ‪ٚ‬تعذ ‪,6‬‬
‫‪ 22 ٚ 01 ,02‬ش‪ٙ‬شا ف‪ ٟ‬فرشاخ االسرذعاء ٌٍرم‪.ُ١١‬‬
‫واْ ٕ٘ان تعط األدٌح د‪ٛ‬ي ذف‪ٛ‬ق خرُ اٌرج‪٠ٛ‬ف ‪ ٚ‬اٌشك عٍ‪ ٝ‬اسرعّاي اٌفٍ‪ٛ‬سا‪٠‬ذ‬
‫اٌّ‪ٛ‬ظع‪ ٟ‬ف‪ ٟ‬اٌ‪ٛ‬لا‪٠‬ح ِٓ ذس‪ٛ‬س سط‪ٛ‬ح األسٕاْ‪ِ .‬ع رٌه‪ ,‬فأٗ ال ‪٠‬زاي غ‪١‬ش ‪ٚ‬اظخ إٌ‪ٝ‬‬
‫أ‪ِ ٞ‬ذ‪ٕ٘ ٜ‬ان اخرالفاخ ت‪ ٓ١‬فعاٌ‪١‬ح خرُ اٌرج‪٠ٛ‬ف ‪ٚ‬اٌشك ِع ‪ٚ‬تذ‪ ْٚ‬اسرعّاي اٌفٍ‪ٛ‬سا‪٠‬ذ‬
‫‪Journal of Al Rafidain University College‬‬ ‫‪253‬‬ ‫)‪ISSN (1681 – 6870‬‬
‫‪Evaluation of Pit and Fissure‬‬ ‫‪Dr. Huda E. Ali, Dr. Maha A. Al-‬‬ ‫‪Issue No. 33/2014‬‬
‫‪Sealant With and…..‬‬ ‫‪Mashhadaney‬‬

‫اٌّ‪ٛ‬ظع‪.ٟ‬ا ‪ّ٠‬ىٓ إعطاء أ‪ ٞ‬ذ‪ٛ‬ص‪١‬ح ٌٍّّاسسح اٌسش‪٠‬ش‪٠‬ح ‪ٕ٠ٚ‬ثغ‪ ٟ‬إٌظش ف‪ ٟ‬االسرفادج ِٓ‬
‫خرُ اٌرج‪٠ٛ‬ف ‪ٚ‬اٌشك ِع ‪ٚ‬تذ‪ ْٚ‬اسرعّاي اٌفٍ‪ٛ‬سا‪٠‬ذ اٌّ‪ٛ‬ظع‪ِ ٟ‬ذٍ‪١‬ا ‪ٚ‬تشىً فشد‪.ٞ‬‬
‫كلمات مفتاحية‪ :‬ختم التجويف والشق‪ ,‬الوقاية من التسوس‪ ,‬الفلورايد الموضعي‪,‬‬
‫تجربة سريرية‪.‬‬

‫‪Journal of Al Rafidain University College‬‬ ‫‪254‬‬ ‫)‪ISSN (1681 – 6870‬‬