A Prospective Clinical Evaluation of the Retention of Glass Ionomer Cement Versus Resin-Based Pit and Fissure Sealants Among School Children

TL;DR

This study compares how well two types of dental sealants stick to children's teeth, finding that resin-based sealants last longer than glass ionomer ones.

Contribution

The study provides new empirical evidence on the short-term retention of resin-based versus glass ionomer sealants in a school-based pediatric setting.

Findings

Resin-based sealants had significantly higher retention (38%) compared to glass ionomer cement (26%).

Resin-based sealants showed lower failure rates (13%) versus 24% for glass ionomer cement.

Twice-daily toothbrushing was associated with better sealant retention (p = 0.021).

Abstract

Introduction

Dental caries are commonly observed in schoolchildren, particularly on the complex pit and fissure surfaces of permanent molars, which readily trap plaque and debris, making sealants a critical preventive intervention. This prospective comparative clinical study sought to assess the retention rates and clinical performance of glass ionomer cement (GIC) and resin-based sealants in a school-based setting among children aged 7-10 years.

Materials and methods

This study was carried out in government primary schools in Bhopal, India, from June to December 2024. Eighty children with at least one caries-free permanent first molar were non-randomly assigned to two groups (n = 40 per group). Group 1 received a high-viscosity glass ionomer cement (GIC) sealant (Fuji IX GP; GC Corp., Tokyo, Japan), applied using the press-finger technique following polyacrylic acid conditioning. Group 2 received a light-cured, fluoride-releasing resin-based sealant (Clinpro; 3M ESPE, 3M Company, St. Paul, MN), applied after phosphoric acid etching. Sealants were placed by a single operator using a portable device. Retention was evaluated at five months using a custom three-point scoring system (complete, partial, or complete loss), with high intra- and inter-examiner reliability (kappa ≥0.85). Data were analyzed using Chi-square, Mann-Whitney U, and Kaplan-Meier survival tests (p<0.05).

Results

Resin-based sealants showed significantly higher retention, with 38% complete retention compared with 26% for GIC, and lower failure rates (13% versus 24%; p = 0.031). Survival analysis demonstrated greater longevity of resin-based materials, with fissure sites performing better than pits (p = 0.001). Twice-daily toothbrushing was associated with better sealant retention (p = 0.021). No significant differences were found with respect to age, sex, or diet.

Conclusions

Resin-based sealants demonstrated superior short-term retention and durability compared with GIC in schoolchildren. The choice of material should take into account the clinical setting and patient-related factors to optimize caries prevention.

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