Sealant Application by Interns After Tele-demonstration (TESS)

Clinical Evaluation of Pit and Fissure Sealants Placed by Intern Dental Students After Tele-demonstration Technique

Abstract

Background:

Dental caries remains a major public health issue worldwide, particularly among children. Pit and fissure sealants represent a high-quality, evidence-based preventive measure. However, ensuring the reliability of their application by newly graduated intern dental students trained through tele-education remains an emerging area of growing interest.

Objective:

To evaluate the clinical success rate of pit and fissure sealants placed by intern dental students following tele-demonstration training versus traditional training approaches.

Methods:

This randomized controlled trial involved 100 mandibular first permanent molars in 50 children aged 7 to 9 years, treated by 20 dental interns assigned to two groups using a split-mouth design. One group received direct clinical demonstration, while the other received tele-education via a pre-recorded video. Sealant retention and marginal discoloration were assessed after a 3-month period.

Keywords:

tele-dentistry, tele-demonstration, tele-education, intern dental students, sealants, first permanent molar

Study Overview

• Status: Completed
• Conditions: Dental Caries; Education; Prevention
• Intervention / Treatment: Behavioral: traditional demonstration group; Behavioral: tele-demonstration

Detailed Description

Abstract

Background:

Dental caries continues to be one of the most prevalent chronic diseases worldwide, with the highest incidence occurring among school-aged children. The occlusal surfaces of permanent molars are particularly susceptible due to their deep pits and fissures, which favor plaque accumulation and limit effective cleaning. The application of pit and fissure sealants has been widely recognized as an evidence-based preventive strategy that provides a physical barrier against cariogenic challenges. The quality and longevity of sealant placement, however, largely depend on the clinician's skill and adherence to proper clinical protocols. In recent years, the integration of tele-dentistry into dental education-specifically through tele-demonstration and tele-education-has gained growing attention as a means to enhance learning accessibility, particularly during times of restricted clinical training opportunities. Nevertheless, the clinical efficacy of procedures performed by newly graduated intern dental students following such digital training remains insufficiently explored.

Objective:

This study aimed to evaluate and compare the clinical performance and success rate of pit and fissure sealants applied by intern dental students trained through a tele-demonstration video-based module versus those trained through traditional chair side (face-to-face) demonstration. The primary endpoint was sealant retention, while secondary outcomes included marginal discoloration after a 3-month follow-up period.

Methods:

A randomized controlled split-mouth clinical trial was conducted on a total of 100 mandibular first permanent molars in 50 healthy children aged 7-9 years attending the pediatric dental clinics. Twenty dental interns participated in the study and were randomly allocated into two equal groups based on the mode of training received. Group A interns received conventional in-person clinical demonstrations of the sealant application procedure by a pediatric dentistry specialist. Group B interns received remote tele-demonstration training via a standardized pre-recorded instructional video detailing each clinical step, from tooth isolation and acid etching to sealant application and curing. Clinical evaluation of sealant retention and marginal discoloration after 3 months period. Data were statistically analyzed and p value significance set at p < 0.05.

Keywords:

tele-dentistry, tele-demonstration, tele-education, dental interns, pit and fissure sealants, preventive dentistry, first permanent molar

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Dakahlia Governorate
    • Al Mansurah, Dakahlia Governorate, Egypt, 35516
      • Operative Dentistry Department, Faculty of Dentistry

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Children age extending from 7 - 9 years
• bilaterally caries-prone, sound lower first permanent molars

Exclusion Criteria:

• Teeth with initial carious lesions or cavitated lesions
• children parents or legal guardians were unable to provide informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: tele-demonstration group; trained via pre-recorded video	Behavioral: traditional demonstration group; direct in person clinical demonstration of sealant application
Active Comparator: traditional demonstration group; trained via in person clinical demo	Behavioral: tele-demonstration; tele-education via pre-recorded video tutorial for sealant application

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
sealant retention	The retention rate of sealants was evaluated according to 'Simonsen's criteria' [10]: (a) Total retention - complete coverage of the occlusal surface by the sealant (score 0); (b) Partial loss - sealant present with visible fractures or partial loss of material (score 1); and (c) Total loss - complete absence of the sealant from the occlusal surface (score 2).	3 months post application

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
marginal discoloration	Marginal discoloration was also assessed as either present or absent, as its presence may indicate early signs of marginal leakage.	3 months post application

Collaborators and Investigators

• Sponsor: Mansoura University
• Investigators: Principal Investigator: Ahmed El-sebaai, Lecturer, Faculty of dentistry, Delta University, Egypt

Study record dates

Study Major Dates

• Study Start (Actual): February 25, 2024
• Primary Completion (Actual): February 27, 2025
• Study Completion (Actual): April 27, 2025

Study Registration Dates

• First Submitted: September 20, 2025
• First Submitted That Met QC Criteria: November 15, 2025
• First Posted (Actual): November 18, 2025

Study Record Updates

• Last Update Posted (Actual): November 18, 2025
• Last Update Submitted That Met QC Criteria: November 15, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Stomatognathic Diseases; Tooth Diseases; Tooth Demineralization; Dental Caries
• Other Study ID Numbers: DU:0240221004

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Raw data could be shared
• IPD Sharing Time Frame: After publishing
• IPD Sharing Access Criteria: Principal investigator email
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No