Abstract

Objective: To evaluate and compare the caries prevention effectiveness of a resin-based sealant and a glass ionomer sealant on permanent first molars in 7- to 9-years-old school children. Methods: A randomized controlled, examiner-blinded, 5-year clinical trial was conducted in 19 primary schools in Dalian, Liaoning province. Totally 419 children (with 664 first molars) who had at least one sound permanent first molar with deep fissures or fissures with signs of non-cavitated lesions were recruited and stratified and allocated randomly into three parallel groups. A resin-based sealant was used in Group R (136 children with 219 first molars) and a glass ionomer sealant was used in Group G (130 children with 218 first molars). The third group (Group N, 153 children with 227 first molars) with none of the two sealants applied was served as blank control. Follow-up examinations were conducted at 0.5, 1, 2, and 5 years after sealing in order to assess the retention of the sealants and the incidence of caries occurrence. Chi-square test was adopted to compare the differences of caries incidence among the 3 groups. Generalized estimating equations (GEE) was used to analyze the effective factors of caries incidence. Results: During the 5-year follow-up period, 13.4% (23/172) of the teeth in Group R, 22.5% (40/178) of the teeth in Group G and 34.5% (57/165) of the teeth in Group N were diagnosed as having developed cavitated lesions. And the differences in the incidence of caries among the three groups was statistically significant (P<0.05). According to GEE, the resin-based sealant and the glass ionomer sealant were found to be the protection factors and the non-cavitated lesion before sealing was found to be the risk factor. The resin-based sealant was found to be the protection factor to the glass ionomer sealant when the blank control group was removed. Conclusions: Both resin-based sealant and glass ionomer sealant could effectively prevent the permanent first molars from the occurrence of carious lesions in 5 years. The resin-based sealant was superior to the glass ionomer sealant in caries prevention.

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