Abstract: In this four-year follow up in vivo controlled study, 112 human permanent first molars, from children between the ages of 6 and 11 years old were used to investigate the viability of the CO$-2$/ laser in promoting carie-free occlusal surfaces in permanent molars, as an isolated form of treatment or associated with conventional fissure sealants. The findings suggest that occlusal caries prevention only by means of CO$-2$/ laser irradiation is not effective; that the utilization of photo-activated sealants, as well as its association with CO$-2$/ laser, applied over the occlusal fissures, are effective means of preventing occlusal caries and that the application of CO$-2$/ laser over occlusal fissures, prior to the application of a photo-activated fissure sealant, improves the retention of the sealant. !21
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