Comparative Evaluation of the Clinical Performance of Two-step and One-step Self-etching Adhesive Systems and Self-etching Self-adhesive Composite in Permanent Molars in Pediatric Patients: A Three-arm Parallel Randomized Clinical Study

IntroductIonOcclusal pits and fissures on permanent teeth are particularly vulnerable to dental caries. 1 This increased susceptibility is largely due to the physical size and intricate morphology of these areas, which create ideal environments for microbial colonization and hinder effective cleaning.These "sheltered" sites are especially challenging to maintain in newly erupted teeth, leading to greater plaque accumulation. 2Epidemiological data reveals that although occlusal surfaces constitute only 12.5% of all tooth surfaces, they account for over two-thirds of carious lesions in children. 3 While fluoride-both systemic and topical-has been widely employed