Caries-preventive effect of sealants produced with altered glass-ionomer materials, after 2 years. Caries-Preventive Effect of a One-Time Application of Composite Resin and Glass Ionomer Sealants after 5 Years Do light cured ART conventional high-viscosity glass-ionomer sealants perform better than resin-composite sealants: a 4-year randomized clinical trial. Effectiveness of two new types of sealants: retention after 2 years Retention Rate of Four Different Sealant Materials after Four Years.
OBJECTIVES The aim of the present study was to investigate the caries-preventive effect of sealants produced with a high-viscosity glass-ionomer with an elevated powder-liquid ratio ( ART ) , of having energy added to this glass-ionomer , and that of glass-carbomer , in comparison to that of resin composite sealants . METHODS The r and omized controlled trial covered 407 children , with a mean age of 8 years . At a school compound three dentists placed sealants in pits and fissures of high caries-risk children . Evaluation by two independent evaluators was conducted after 0.5 , 1 and 2 years . The Kaplan-Meier survival method , ANOVA and t-test were used in analyzing the data . RESULTS 1352 first permanent molars were sealed . 6.6 % of children and 6.8 % of sealants dropped out within 2 years . 27 re-exposed pits and fissures , 20 in occlusal and 7 in smooth surfaces , in 25 children , developed a dentin carious lesion . The cumulative survival of dentin carious lesion-free pits and fissures in the  glass-carbomer sealant group was statistically significantly lower ( 97.4 % ) than those in the high-viscosity glass-ionomer with energy supplied ( 99 % ) and the resin-composite ( 98.9 % ) sealant groups . There was no statistically significant difference in the cumulative survival of dentin carious lesion-free pits and fissures , between the high-viscosity glass-ionomer with ( 99 % ) and without ( 98.3 % ) energy supplied sealant groups , after 2 years . SIGNIFICANCE The survival of dentin carious lesion-free pits and fissures was high in all sealant types . More dentin carious lesions were observed in the glass-carbomer sealant group 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 r and omly 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- design ed clinical trial using different types of oral health personnel should be implemented to confirm these initial results OBJECTIVE The hypotheses tested were : the cumulative survival rates of dentin caries lesion-free pits and fissures of ART conventional high-viscosity glass-ionomer sealants with light-curing ( high-intensity LED ) and glass-carbomer sealants are higher than those of conventional ART sealants and resin-composite sealants after 4 years . METHODS The r and omized controlled clinical trial covered 405 children ( mean age 8-years ) . Three dentists placed sealants in pits and fissures of high caries-risk children . Evaluation by two independent evaluators was conducted after 0.5 , 1 , 2 , 3 and 4 years . The Kaplan-Meier survival method , ANOVA and t-test were used in data analyses . RESULTS 1304 first permanent molars were sealed . 12.3 % of children and 15.4 % of sealants dropped out . 46 re-exposed pits and fissures , 39 ( occlusal ) 7 ( free smooth surfaces ) , in 42 children developed a dentin carious lesion . The cumulative survival of dentin caries lesion-free occlusal pits and fissures in ART plus LED group ( 98 % ) was statistically significantly higher than in the resin-composite group ( 96.4 % ) and in the glass-carbomer group ( 94.5 % ) . The cumulative survival of dentin caries lesion-free occlusal pits and fissures in the glass-carbomer group was statistically significantly lower than that in the conventional ART group ( 97.3 % ) . For the free smooth surfaces , there was no statistically significantly difference among the four sealant groups . SIGNIFICANCE Light-cured ART conventional high-viscosity glass-ionomer sealants prevented the occurrence of dentin cavities best The hypotheses tested were : survival rate of fully and partially retained glass-carbomer sealants is higher than those of high-viscosity glass-ionomer , with and without energy supplied , and that of resin composite ; survival rate of fully and partially retained sealants of high-viscosity glass-ionomer with energy supplied is higher than those without energy supplied . The r and omized clinical trial covered 407 children , with a mean age of 8 years . The evaluation took place after 0.5 , 1 and 2 years . Survival of sealant material in occlusal and in smooth surfaces , using the traditional categorization ( fully and partially retained versus completely lost sealants ) and the modified categorization ( fully and more than 2/3 of the sealant retained versus completely lost sealants ) , were dependent variables . The Kaplan – Meier survival method was used . According to both categorizations of partially retained sealants , the survival of completely and partially retained resin composite sealants  in occlusal and in smooth tooth surfaces was statistically significantly higher , and those of glass-carbomer sealants lower , than those of sealants of the other three groups . There was no statistically significant difference in the survival rates of completely and partially retained high-viscosity glass-ionomer sealants with and without energy supplied in occlusal and in smooth surfaces . After 2 years , glass-carbomer sealant  retention was the poorest , adding energy to high-viscosity glass-ionomer sealant did not increase the retention rate and resin composite sealants were retained the longest . We suggest the use of the modified categorization of partially retained sealants in future studies . It seems not necessary to cure high-viscosity glass-ionomer sealants . The use of glass-carbomer sealants can not be recommended yet PURPOSE To test the hypotheses : 1 ) cumulative survival rates of fully and partially retained high-viscosity glass-ionomer ( HVGIC ) ART sealants with heat application and glass-carbomer sealants on occlusal and free-smooth surfaces are both higher than that of resin sealants ; 2 ) cumulative survival rate of fully and partially retained high-viscosity glass-ionomer ART sealant with heat application on occlusal and free-smooth surfaces is higher than that of comparable ART sealants without heat application . MATERIAL S AND METHODS The block-r and omised clinical trial covered 405 eight-year-old children . The HVGIC was Ketac Molar Easymix , the glass carbomer was GlassCarbomer and the resin sealant was Clinpro . Retention rates of sealants on occlusal and free-smooth surfaces using conventional and modified categorisation ( fully and partially retained sealants vs those completely lost [ at least one-third of surface re-exposed ] ) were the dependent variables . The Kaplan-Meier survival method was used . RESULTS The cumulative survival rate of completely and partially retained resin sealants  on occlusal ( 81.2 % ) and free-smooth ( 81 % ) surfaces after 4 years was statistically significantly higher , and that of glass-carbomer sealants ( 10.8 % and 21.1 % , respectively ) was statistically significantly lower than those of the other sealant groups . There was no statistically significant difference in survival rates of completely and partially retained high-viscosity glass-ionomer ART sealants with ( 56 % for both surfaces ) or without heat application ( 56 % ) on occlusal and free-smooth surfaces ( 55.7 % and 59.1 % , respectively ) . CONCLUSIONS Resin sealants had the highest and glass-carbomer sealants the lowest retention rate after 4 years . Application of heat to high-viscosity glass-ionomer ART sealants did not result in a significantly higher sealant retention rate . Use of the modified categorisation for determining sealant retention is advocated
This study confirms the likelihood that remnants of high-viscosity glass-ionomer sealant material are retained and block the deeper parts of pits and fissures even after the sealant appears to have disappeared clinical ly , exercising their carious lesion preventive effect
OBJECTIVES Resin composite sealants are retained longer than low-viscosity glass-ionomer sealants .
Nevertheless , a systematic review showed that there is no evidence that resin composite sealants are superior to low-viscosity glass-ionomers in preventing dentine carious lesion development .
This case study aim ed to investigate reasons for this .