title: Caries-preventive effect of a one-time application of composite resin and glass ionomer sealants after 5 years.
abstract: The aim of the present trial was to (1) compare the caries-preventive effect of glass ionomer sealants, placed according to the atraumatic restorative treatment (ART) procedure, with composite resin sealants over time and (2) investigate the caries-preventive effect after complete disappearance of sealant material. Forty-six boys and 57 girls, mean age 7.8 years, were randomly divided into two treatment groups in a parallel-group study design. A light-polymerized composite resin sealant material and a high-viscosity glass ionomer were each placed in 180 fully erupted first molars in their respective treatment groups. Evaluation took place annually for 5 years by calibrated examiners. After 5 years, 86% composite resin and 88% glass ionomer sealants did not survive. Three categories of re-exposure periods for caries development in pits and fissures after complete loss of sealants were distinguished: 0-1, 1-2 and 2-3 years. In the 2- to 3-year group, 13 and 3% of pits and fissures previously sealed with composite resin and glass ionomer, respectively, were diagnosed as having developed a dentine lesion. The relative risks (95% CI) of dentine lesion development in surfaces sealed with glass ionomer compared to those sealed with composite resin after 3, 4 and 5 years were 0.22 (0.06-0.82), 0.32 (0.14-0.73) and 0.28 (0.13-0.61), respectively. The relative risks of dentine lesion development in pits and fissures previously sealed with glass ionomer compared with composite resin over re-exposure periods of 1-2 and 2-3 years were 0.26 (0.14-0.48) and 0.25 (0.09-0.68), respectively. We conclude that the caries-preventive effect of high-viscosity glass ionomer sealants, placed using the ART procedure, was between 3.1 and 4.5 times higher than that of composite resin sealants after 3-5 years. Furthermore, high-viscosity (ART) glass ionomer sealants appear to have a four times higher chance of preventing caries development in re-exposed pits and fissures of occlusal surfaces in first molars than light-cured composite resin sealant material over a 1- to 3-year period. A well-designed clinical trial using different types of oral health personnel should be implemented to confirm these initial results.
authors.affiliation: Regional WHO Demonstration, Training and Research Centre for Oral Health, Damascus, Syria.
authors.forename: N
authors.initials: N
authors.lastname: Beiruti
authors.forename: J E
authors.initials: JE
authors.lastname: Frencken
authors.forename: M A
authors.initials: MA
authors.lastname: van't Hof
authors.forename: D
authors.initials: D
authors.lastname: Taifour
authors.forename: W H
authors.initials: WH
authors.lastname: van Palenstein Helderman
mesh_terms: D002327:Cariostatic Agents / Q000627:therapeutic use*; D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D003804:Dentin; D004852:Epoxy Compounds / Q000627:therapeutic use; D005260:Female; D005899:Glass Ionomer Cements / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008689:Methacrylates / Q000627:therapeutic use; D010895:Pit and Fissure Sealants; D019279:Resin Cements / Q000627:therapeutic use*; D055502:Secondary Prevention; D014783:Viscosity
chemical_list: D002327:Cariostatic Agents; D004852:Epoxy Compounds; D005899:Glass Ionomer Cements; D008689:Methacrylates; D010895:Pit and Fissure Sealants; D019279:Resin Cements; C407622:Visio-Seal; C110713:fuji IX