title: Glass ionomer ART sealant and fluoride-releasing resin sealant in fissure caries prevention--results from a randomized clinical trial.
abstract: BACKGROUND
  The relative performance of ART sealant and fluoride-releasing resin sealant in preventing fissure caries in permanent molars was compared in a randomized clinical trial conducted in southern China (ClinicalTrials.gov NCT01829334).
  
  
  METHODS
  After obtaining ethical approval, healthy schoolchildren who had permanent first molars with occlusal fissures which were sound but deep or presented with only incipient caries were recruited for the study. Included molars were randomly allocated into one of four parallel study groups in units of left/right teeth per mouth. Two of the four groups adopted the methods of ART or fluoride-releasing resin sealant placement while the other two groups adopted the topical fluoride application methods. Fissure status of the molars in each group was evaluated every 6 months. Development of dentine caries and sealant retention over 24 months in the molars in the two sealant-using groups was compared in this report. Outcome on cost-effectiveness of all four groups over 36 months will be reported elsewhere.
  
  
  RESULTS
  At baseline, a total of 280 children (383 molars) with mean age 7.8 years were involved for the two sealant groups. After 24 months, 261 children (357 molars) were followed. Proportions of molars with dentine caries were 7.3% and 3.9% in the ART sealant and fluoride-releasing resin sealant groups, respectively (chi-square test, p = 0.171). Life-table survival analysis showed that sealant retention (full and partial) rate over 24 months for the resin sealant (73%) was significantly higher than that (50%) for the ART sealant (p < 0.001). Molar survival (no development of dentine caries) rates in the ART sealant (93%) and fluoride-releasing resin sealant (96%) groups were not significantly different (p = 0.169). Multilevel logistic regression (GEE modeling) accounting for the effects of data clustering and confounding factors confirmed this finding.
  
  
  CONCLUSIONS
  Though the retention of fluoride-releasing resin sealant was better than that of the ART sealant, their effectiveness in preventing fissure caries in permanent molars did not differ significantly over 24 months. ART sealants could be a good alternative when and where resources for resin sealant placement are not readily available.
authors.affiliation: Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong, SAR, China. smilelby@hku.hk.
authors.forename: Bao Ying
authors.initials: BY
authors.lastname: Liu
authors.forename: Yue
authors.initials: Y
authors.lastname: Xiao
authors.forename: Chun Hung
authors.initials: CH
authors.lastname: Chu
authors.forename: Edward Chin Man
authors.initials: EC
authors.lastname: Lo
mesh_terms: D000134:Acid Etching, Dental / Q000379:methods; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000737:chemistry*; D002648:Child; D003188:Composite Resins / Q000737:chemistry; D057087:Dental Atraumatic Restorative Treatment / Q000379:methods*; D003750:Dental Fissures / Q000473:pathology / Q000517:prevention & control*; D003804:Dentin / Q000187:drug effects / Q000473:pathology; D004058:Diffusion; D005260:Female; D005459:Fluorides / Q000008:administration & dosage / Q000737:chemistry*; D005460:Fluorides, Topical / Q000008:administration & dosage; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry*; D006801:Humans; D015993:Life Tables; D008297:Male; D008963:Molar / Q000187:drug effects / Q000473:pathology; D010895:Pit and Fissure Sealants / Q000737:chemistry*; D019279:Resin Cements / Q000737:chemistry*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002327:Cariostatic Agents; C500418:Clinpro Sealant; D003188:Composite Resins; D005460:Fluorides, Topical; D005899:Glass Ionomer Cements; C515713:Ketac Molar Easymix; D010895:Pit and Fissure Sealants; D019279:Resin Cements; D005459:Fluorides