A 3-year clinical evaluation of glass-ionomer cements used as fissure sealants

Abstract

Purpose: To evaluate the retention and caries-preventive effectiveness of two ionomeric materials (conventional and resin-modified), used as fissure sealants.

Materials and methods: 100 children (6-8 years old) with a total of 400 permanent first molars received 200 conventional glass-ionomer (Ketac Bond) and 200 resin-modified glass-ionomer (Vitremer) sealants. Additionally, 108 children constituted the control group (432 teeth). Two dentists assisted by dental hygienists performed the sealant application. Clinical evaluations were carried out 6, 12, 24, and 36 months after the sealant application by two other dentists, not carrying out clinical procedures, previously calibrated (Kappa > 0.75).

Results: Total retention rates of 26%, 12%, 3%, and 4% for Ketac Bond and 61%, 31%, 14%, and 13% for Vitremer, being 6, 12, 24, and 36 months after clinical evaluation, respectively. The differences between the two materials were statistically significant. The experimental groups showed a caries incidence of 93%, 78%, 49%, and 56% lower than the control group (P< 0.01) for the four evaluation periods, respectively. In conclusion, the retention rates of ionomeric materials were low. Nevertheless, these materials showed a cariostatic effect, supported by statistically lower caries incidence in experimental groups compared to control group. Presence of active incipient caries was statistically associated with caries incidence in the first molars after 36 months, in relation to either experimental or control group.