الفهرس 
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Abstract
Aim: To determine the clinical and cost-effectiveness of fluoride varnish (FV) versus resin-based
fissure sealant (RBS) in preventing caries in newly erupted permanent molars in a group of Egyptian
children.
Methodology: This is a randomized clinical trial with two arms, parallel groups, and allocationblinded. The total number of participants was 182, with ages ranging from 6 to 8 years. The
participants were randomly assigned to one of two groups: RBS as a control and FV as an
intervention. The participants were treated by 2 post-graduate students (91) teeth in each part. In part
1, (45) teeth were in the FV group, and (46) teeth were in the RBS group. Of the 91 teeth only 89
teeth completed the follow-up at 6 and 12 months. Outcomes measured were clinical effectiveness
represented by DFS score (Decayed, Filled, Surface teeth in permanent dentition) as primary
outcome. Secondary outcomes were, cost-effectiveness measured by Incremental cost-effectiveness
ratio (ICER) and average cost effectiveness ratio. Acceptability and adverse effects were measured
by a custom-made questionnaire. The time of application was calculated by a stopwatch.
Results: The results showed that FV was not statistically inferior to RBS in clinical effectiveness
(p>0.05) and the effect size was small (r<0.3). Also, results showed that FV was statistically inferior
to RBS regarding treatment costs (p<0.001), and the effect size was large (r<0.5). The average cost
of treatment in the FV group and RBS group, respectively, was (5.43 and 20.74) EGP per tooth after
6 months (sum of baseline and 6 months cost) and (8.03 and 21.81) EGP per tooth after 12 months
(sum of baseline, 6 and 12 months cost). So, regarding cost-effectiveness, and the incremental costeffectiveness ratio after 6 months was (228.51) and after 12 months was (40.89). At the time of
application, the base time results showed that FV had a significantly lower application time than
RBS (p<0.001). While the difference after 6 and 12 months was not statistically significant (p>0.05).
The odds ratio for treatment unacceptability in the FV group was 0.31, indicating that the odds of
treatment unacceptability in the FV group were not statistically inferior to those in the RBS group.
There were no adverse effects in both groups.
Conclusion: The results of our trial demonstrated no significant difference between FV and RBS in
caries prevention. But RBS had a higher cost of treatment than FV after a 12-month follow-up
period. As a result of its lower cost, shorter time, and simplicity, we recommend the use of FV as a
preventive material in dental public health programs, but RBS in a private dental clinic. Both FV and
RBS were acceptable for children. The time of application for FV was shorter than RBS. No adverse
effect for both FV & RBS.
Keywords : Fluoride Varnish, fissure Sealant, Resin based, Sealant,first permanent molars,cost,
clinical effectiveness.