Glass Ionomer Cement Sealants Research Articles

Caries Preventive Effect and Retention of Moisture Tolerant Resin Based and Glass Ionomer Cement Sealants: A Systematic Review

Caries Preventive Effect and Retention of Moisture Tolerant Resin Based and Glass Ionomer Cement Sealants: A Systematic Review

Survival Analysis of Glass Ionomer Cement and Resin-Based Sealant Retention: A 10-Year Follow-Up Study.

Background and Objective: Sealant application is a proven method to prevent occlusal caries; however, long-term studies on this topic are scarce. This study aimed to assess the survival rate and clinical effectiveness of glass ionomer cement (GIC) and resin-based sealants (RBSs) on second permanent molars over a long-term follow-up period. Materials and methods: Sixteen patients aged 11-13 years with all four completely erupted permanent second molars were enrolled in the study. All patients attended 1-year and 3-year follow-ups; however, one participant did not respond after 10 years and was excluded from the final analyses. The oral health status evaluation was based on WHO criteria. A total of 32 teeth received an RBS (Clinpro), and a further 32 teeth were sealed with GIC (Fuji IX). The sealant retention was determined according to the Kilpatrick criteria after 1 year, 3 years, and 10 years, respectively. Statistical analysis included a chi-square test, the Kaplan-Meier method, and the Cox proportional hazard model. Results: At baseline, seven boys and eight girls participated in the study, with a mean age of 12.3 ± 0.9 years. The 1-year follow-up results revealed that 90% of the RBSs and 43.3% of the GIC sealants were completely retained, and no caries lesions were recorded (p = 0.01). The 3-year follow-up results showed that 23.3% of the RBSs and 0% of the GIC sealants demonstrated complete retention (p = 0.034). Moreover, 10.0% of the occlusal surfaces in the RBS group and 13.3% of the occlusal surfaces in the GIC group were filled (p > 0.05). A total of 6.7% of the RBSs showed complete retention. One-third of the sealed teeth (30.0% of the teeth sealed with RBSs and 36.7% of teeth applied with GIC) were filled after 10 years. The Kaplan-Meier analysis demonstrated a higher survival rate in the RBS group when compared with the GIC over the entire follow-up period (p = 0.001). Conclusions: Although the survival rate of RBSs was higher than GIC sealants, their effectiveness in preventing fissure caries in permanent second molars did not differ significantly over a 10-year follow-up.

Caries-inhibiting Effect of Microencapsulated Active Components in Pit and Fissure Sealants.

The aim of the present in vitro study was to examine the caries-inhibiting effect of a pit and fissure sealant (PFS) containing ion-releasing microcapsules under cariogenic conditions in a biofilm artificial mouth. Forty-eight human third molars were divided into four groups (n=12 per group). Fissures were extended with burs and sealed with experimental PFS. The four groups of specimens were treated as follows: 1) EPFS 1: EPFS (Premier Dental) of increasing viscosity, containing microcapsules loaded with remineralizing agents (calcium, phosphate, and fluoride ions); 2) US: fluoride-releasing PFS (UltraSeal XT plus, UltraDent Products, South Jordan, UT, USA); 3) EPFS 2: experimental PFS of constant viscosity containing microcapsules loaded with calcium, phosphate, and fluoride ions; and 4) FT: glass ionomer cement (GIC) (GC Fuji Triage CAPSULE WHITE glass ionomer cement, GC Europe NV, Leuven, Belgium). FT and US were used as control groups. EPFS 1 and EPFS 2 were the experimental groups. Specimens were stored in distilled water for 14 days at 37°C, subjected to 10,000 thermocycles (5°C and 55°C) and finally exposed to microbiological cycling in a Streptococcus mutans-based artificial mouth for 10 days. Replicas were made for scanning electron microscopic (SEM) evaluation and specimens were cut for fluorescence microscopy. Overall demineralization depths at the margin of Fuji Triage were significantly shallower than in the other groups (p<0.05). Overall demineralization depths adjacent to the experimental pit and fissure sealant EPFS 2 (59±15 μm) were comparable to the values of the resin-based pit and fissure sealant UltraSeal XT plus (58±10 μm, p≥0.05). SEM revealed surface roughness of the GIC-based PFS. The experimental PFS with microcapsules containing active components for remineralization did not show a caries-inhibiting effect compared to a fluoride-releasing resin-based PFS. Lower demineralization depths adjacent to GIC sealants indicate an anticariogenic effect through fluoride ion release.

Comparative effectiveness research of two glass ionomer cements for primary molar fissure sealing

Relevance. A glass ionomer cement (GIC) is the material for primary teeth fissure sealing in children. The research aimed to study the comparative effectiveness of two GIC pit and fissure sealants in primary molars.Materials and methods. Sixty-one children aged 2-5 years (mean 26.99 ± 0.55 months) participated in the study after obtaining the Local Ethical Committee’s permission and the parents’ informed consents. Non-invasive fissure sealing in primary molars was performed according to split-mouth design with two GIC: Fujy-9, GC, Japan (109 teeth, FV-group) and Polyakrilin, TehnoDent, Russia (106 teeth, PV-group). Follow-ups were provided after 6, 12, 18 and 24 months. Complete retention, partial retention or complete loss (%) of the sealants and the frequency (%) of fissure caries development were calculated. The chi-square criterion was used to assess the significance of the differences between the groups at p-value &lt; 0.05.Results. In 6 and 12 months, all the cases demonstrated complete or partial sealant retention and the absence of pit and fissure caries. The following results were found after 24 months: complete GIC retention in 8.6% of molars in FV-group and 1.9% in PV-group, (p &lt; 0.05), partial retention – 78.8% and 79.0% (p &gt; 0.05) respectively, complete loss – 6.7% and 11.4% respectively (p &gt; 0,05). Fissure carious lesions were found only after 18 and 24 months in 2.8% cases in FV-group and 3.8% cases in PV-group, p &gt; 0,05.Conclusions. Both studied GICs for non-invasive primary molar fissure sealing were equally highly effective for pit and fissure caries prevention in children. Annual follow-ups in children are necessary for GIC sealant repair.

Glass Ionomer Sealants Can Prevent Dental Caries but Cannot Prevent Posteruptive Breakdown on Molars Affected by Molar Incisor Hypomineralization: One-Year Results of a Randomized Clinical Trial

To evaluate the preventive effect of glass ionomer cement (GIC) against dental caries and posteruptive breakdown (PEB) on molars affected by molar incisor hypomineralization (MIH). In this randomized clinical trial, 77 children aged 5–9 years with at least 1 MIH-affected molar and without PEB or dentin caries lesions (n = 228) were included and randomly allocated to one of the following groups: (1) MIH-affected molars that remained unsealed and (2) MIH-affected molars that received GIC sealants. Dental caries and PEB were clinically evaluated after 6 and 12 months. Associations between dental caries and PEB with independent variables were evaluated using logistic regression analysis (p < 0.05). The MIH-affected molars allocated to the GIC sealant group were less likely to develop dental caries compared to those allocated to the unsealed group (OR = 0.23; 95% CI 0.06–0.95). Conversely, application of a GIC sealant was not associated with prevention of PEB (p = 0.313). Furthermore, MIH-affected molars presenting yellow-brown opacities were almost 5 times more likely to develop dental caries (p = 0.013) and PEB (p = 0.001) compared to those presenting white-creamy opacities. We can conclude that GIC sealants can prevent dental caries on MIH-affected molars; however, the same protective effect was not observed for PEB.

Non-invasive and micro-invasive treatments to arrest active occlusal carious lesions in erupting permanent molars: A randomized clinical trial.

This study aimed to evaluate the efficacy of non-invasive and micro-invasive treatments on the arrest of occlusal enamel carious lesions in erupting permanent molars. This two-arm randomized clinical trial included 27 subjects, aged 5-11 years, with 64 erupting permanent molars presenting active occlusal enamel carious lesions (as assessed by the International Caries Detection and Assessment System [ICDAS]; scores 1-3). The sample was randomly assigned into two treatment groups: 1) resin-modified glass ionomer cement sealant (Clinpro XT Varnish; 3M ESPE) and 2) 4-week topical fluoride varnish application (Duraphat; Colgate). All children and parents received oral hygiene and dietary instructions. Teeth were evaluated at baseline and 3, 6, 9, and 12 months regarding the eruption stage, biofilm accumulation, as well as severity and activity of the carious lesions. The Kaplan-Meier method was used to evaluate the survival estimates for inactivation of the carious lesions for both treatment groups. Multivariate Cox regression models with shared frailty were performed to identify factors associated with the outcome (p < 0.05). After 12 months, 22% and 3% of the lesions treated with topical fluoride varnish and sealant, respectively remained active. The adjusted model demonstrated that younger children had a higher probability of active enamel carious lesions arresting (hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.22-0.78; p=0.01). However, the probability of active enamel carious lesions arresting after sealant application was 8.85 times higher compared with fluoride varnish applications (p=0.01). Sealing is a more effective approach than fluoride varnish for arresting occlusal enamel carious lesions in erupting permanent molars.

Glass Ionomer Cement Sealant (GC Fuji TRIAGE®) in the Prevention of Post-eruptive Fractures in Molars Affected by Molar-Incisor Hipomineralisation: a Randomized Clinical Trial

Glass Ionomer Cement Sealant (GC Fuji TRIAGE®) in the Prevention of Post-eruptive Fractures in Molars Affected by Molar-Incisor Hipomineralisation: a Randomized Clinical Trial

Very low certainty in evidence suggesting no differences in caries development when comparing glass ionomer cement sealants and resin-based sealants

Alirezaei M, Bagherian A, Sarraf Shirazi A. Glass ionomer cements as fissure sealing materials: yes or no? A systematic review and meta-analysis. JADA. 2018;149(7):640-649.e9. https://jada.ada.org/article/S0002-8177(18)30106-5/fulltext.

Penyerapan Air Dan Kelarutan Bahan Semen Ionomer Kaca Sebagai Penutup Pit Dan Fisur Gigi

BACKGROUND: Pit and fissure sealants are materials that are often used for preventive maintenance, especially on occlusal surfaces of teeth that are susceptible to caries. All restoration materials that come into contact with water will experience 2 mechanisms, namely the absorption of water, which causes matrix swelling and increased mass and water solubility, namely the release of components from unreacted monomers and causing reduced mass. OBJECTIVE: Measure the value of water absorption and solubility of glass ionomer cement as a cover of the pit and fissure of the tooth. METHODS: 18 specimens of glass ionomer cement sealant material manipulated according to the manufacturer's instructions consisted of six specimens measuring 15 mm in diameter and 1 mm in thickness made for each immersion time. The specimen was put into a desiccator at 37°C for 22 hours and then put into another desiccator with a temperature of 23°C for 2 hours. The specimen was weighed with a precision scale of 0.1 mg. Measurements are carried out repeatedly until a constant mass is obtained (M1). Next, the specimen was put into 40 ml of aquabides and stored in a desiccator at 37°C for 1 day, 2 days and 7 days. At the end of each immersion time, the specimen was removed from aquabides, dried with suction paper and vibrated in the air for 15 seconds. Specimens are weighed to get M2. The specimens were reconditioned to the desiccator at 37°C for 22 hours and then put into another desiccator with a temperature of 23°C for 2 hours and this procedure was repeated one day later, then the mass was weighed repeatedly until a constant mass was obtained (M3). RESEARCH RESULTS: The Kruskal-Wallis statistical test shows that there is no significant difference in the average water absorption value and solubility of materials for immersion for 1 day, 2 days and 7 days. CONCLUSIONS AND RECOMMENDATIONS: The absorption rate of glass ionomer cement as a cover of dental pit &amp; fissure decreased until the second day and increased until the seventh day, with an average absorption of water for 1 day immersion of 42.68mg/mm³, 2 days 40, 53mg/mm³ and 7 days 42.99mg/mm³. Solubility value in water of glass ionomer cement as a cover of dental pit &amp; fissure decreased until the second day then increased until the seventh day, with an average solubility of material for immersion for 1 day at 41.46mg/mm³, 2 days 39.39mg/mm³ and 7 days 41,91mg/mm³. It was said that there was no significant difference in the value of water absorption and solubility of materials during the immersion period of 1, 2 and 7 days. It is recommended that in the application of glass ionomer cement as a cover of dental pits and fissures, please note in the provision of varnish or protector to reduce the occurrence of water absorption and solubility of the material. In addition, the pit and fissure of the tooth that has been covered should be controlled 3 months later to find out if the cover is still intact or has been damaged or loose. It is also recommended that there is further research to determine the value of water absorption and solubility of ingredients if soaked in artificial saliva for more than 7 days.

Clinical aspects of Atraumatic Restorative Treatment

The objective of Atraumatic Restorative Treatment is to prevent carious lesion development and to stop its progression. This can be achieved, among other ways, by placing high-viscosity glass-ionomer cement sealants in pits and fissures in the enamel. A second area of utilisation is the treatment of dentine carious lesions. The weakened demineralised dentine can effectively be removed using hand instruments only. An accurately placed sealant-restoration prevents remaining cariogenic bacteria from reigniting the process of decay and allows the residual carious dentine to remineralise. To achieve good results using Atraumatic Restorative Treatment, an oral healthcare provider should complete a programme of instruction and have command of sufficient knowledge of cariology, the principles of treatment and the available restorative materials. High-viscosity glass-ionomer cement is the material of first choice for the prevention of enamel caries and the treatment of dentine carious lesions, but there is a constant search for improvements to this material and for a qualitatively better alternative.

One-year clinical evaluation of the retention of resin and glass ionomer sealants on permanent first molars in children

Aim: To compare the retention of glass ionomer cement (GIC) used as fissure sealant with a resinbased sealant. Methods: Six- to nine-year-old children (n=96) with all permanent first molars in occlusion were examined and assigned to two groups: GIC sealant or resin-based sealant. The sealants were applied according to the manufacturers’ recommendations. The assessment of sealant retention was performed at two-month interval sessions (n=6), when each sample was scored according to the following criteria: complete retention, partial retention or complete loss. The visual and tactile examinations were carried out with a WHO probe, mouth mirror, air syringe and artificial light. The data were submitted to descriptive statistics and survival analysis. Results: A total of 384 occlusal surfaces were analyzed. Independent of the tooth and evaluation time, slightly better results were achieved by the resin-based sealant, but the difference was not statistically significant. Conclusions: GIC and resin-based sealants achieved similar results with regards to retention during a one-year follow-up period.

Retention evaluation of two glass ionomer cement sealants: six-month clinical follow-up

Objective: The aim of this study was to evaluate the retention of glass ionomer sealant, Vitro Molar(r) (DFL) and Ketac Molar Easy Mix(r) (3 m ESPE) as pit and fissure sealants on first permanent molars, fully or partially erupted. Methods: The study sample consisted of 412 molars, among 110 children. The sealant retention was evaluated after 6 months of the application. Results: The results were collected through digital photographs and the retention results were assessed by the following System: score 0 - total retention; score 1 - sealant present in more than 50% of the pit and fissure system; score 2 - sealant present in less than 50% of the pit and fissure system; score 3 - missing sealant. Regarding the presence of the sealants in less than 50% of the occlusal surface, lower percentages were found for the two materials used as follows: score score 2 - Vitro Molar(r) (9,52% examiner 1 and 11.9% examiner 2) and score 2 - Ketac Molar Easy Mix(r)(9.52% examiner 1 and 10.71% examiner 2). Approximately 90% of the teeth sealed with Ketac Molar Easy Mix(r)or Vitro Molar(r) presented total loss (score 3). Thus, there was no statistical difference between the materials and between the examiners (p&gt;0.05). Conclusion: Therefore it was concluded that the sealant retention in the studied population was not satisfactory for any of the materials used.

Report on the clinical technique of thermo-curing glass-ionomer sealant.

Controversy exists regarding the general safety of resin sealants and in particular their use in children, due to the possible leaching of non-polymerized monomers including bisphenol A. A thermally cured high-viscosity glass-ionomer cement (GIC) is suggested as a first-choice sealant material. An innovative approach of thermo-curing the GIC during placement is presented. The step-by-step clinical procedure and rationale for the biomimetic thermo-cured glass-ionomer fissure sealant are introduced and described. A thermally cured GIC sealant may provide long-term caries protection to fissures and pits without the need to maintain and reseal. GICs are both biocompatible and biomimetic resulting in formation of fluorapatite, the ultimate protection against dental caries.

Low-cost glass ionomer cement as ART sealant in permanent molars: a randomized clinical trial.

Clinical trials are normally performed with well-known brands of glass ionomer cement (GIC), but the cost of these materials is high for public healthcare in less-affluent communities. Given the need to research cheaper materials, it seems pertinent to investigate the retention rate of a low-cost GIC applied as atraumatic restorative treatment (ART) sealants in two centers in Brazil. Four hundred and thirty-seven 6-to-8-year-old schoolchildren were selected in two cities in Brazil. The children were randomly divided into two groups, according to the tested GIC applied in the first permanent molars. The retention rate was evaluated after 3, 6 and 12 months. Kaplan-Meier survival analysis and the log-rank test were performed. The variables were tested for association with sealant longevity, using logistic regression analyses (α = 5%). The retention rate of sealants after 12 months was 19.1%. The high-cost GIC brand presented a 2-fold-more-likely-to-survive rate than the low-cost brand (p < 0.001). Significant difference was also found between the cities where the treatments were performed, in that Barueri presented a higher sealant survival rate than Recife (p < 0.001). The retention rate of a low-cost GIC sealant brand was markedly lower than that of a well-known GIC sealant brand.

A Comparative Study of Two High-Viscosity Ionomeric Cements for the Sealing of Newly Erupted Permanent Molars

Objective: To compare the retention and preventive aspects of two different types of high-viscosity glass ionomer cements for newly erupted permanent molars, considering the cost-benefit ratio in relation to public health. Material and Methods: fifty-four children (5-12 years) with erupted molars were selected. One hundred and fifty-four teeth were sealed, 75 with Ketac Molar (KM) and 79 with Vitro Molar (VM). Before and after sealant application, photos were taken and condensation silicone casts were produced in order to better classify tooth eruption stage and to assess the sealant retention rate. Results: Fifty-six percent of teeth sealed with KM showed fully retained material (FR) after the 5-month follow-up period; 18.4 % showed KM in two-thirds of the occlusal surface (partial retention 2- PP2); 23.7 % in one third of the occlusal surface (partial retention 1-PP1); and only 1.3 % of sealed teeth showed total loss (TL). Among teeth sealed with VM, 28.8 % showed total retention (TR) of the sealant after 5 months; 7.5 % of sealants were present in two-thirds of the occlusal surface (PP2); 10% were present in one third of the occlusal surface (PP1), and 53.7 % showed total loss of the sealant (TL). The development of only one active white spot caries lesion after total sealant loss was observed in the VM group. Conclusion: Occlusal surfaces of newly erupted permanent molars sealed with high-viscosity KM glass ionomer cement exhibited higher retention when compared to VM after a 5-the development of carious lesions in sealed teeth was similar in both materials, which confirms the good clinical performance of glass ionomer cement sealants in the evaluation period, being highly significant when considering the cost-benefit ratio in relation to public health (KM cost is 4 times higher than VM cost).

Moisture-tolerant resin-based sealant: A boon

Background and Objectives:Pit and fissure sealants are highly effective in preventing occlusal caries. The present study clinically evaluated and compared the retention and development of caries when sealed with moisture-tolerant resin-based sealant, conventional resin-based sealant with and without a bonding agent, and Glass Ionomer Cement Sealant in young permanent teeth.Materials and Methods:A total of 80 healthy cooperative children aged 6-9 years who were at high caries risk with all four newly erupted permanent first molars were included in the study. Teeth were divided into 4 groups using a full-factorial design, and each of the molars was sealed with the four different sealant material. Evaluation of sealant retention and development of caries was performed at 6 and 12 months using Modified Simonsen's criteria. The data obtained were tabulated and subjected to statistical analysis using Kruskal-Wallis Test and Mann-Whitney Test.Result and Conclusion:The result from the present study indicated that moisture-tolerant resin-based sealant could be successfully used as a pit and fissure sealant because its hydrophilic chemistry makes it less technique sensitive and simplifies the sealant application procedure.

The success rates of a glass ionomer cement and a resin-based fissure sealant placed by fifth-year undergraduate dental students

To evaluate retention and caries prevention of a glass-ionomer cement (GIC) and a resin-based fissure sealant placed by fifth-year undergraduate dental students. The study was conducted according to a split-mouth, randomised clinical trial. Children with at least one pair of caries-free permanent first molars with deep pits and fissures were included in the study. The children were selected from a population that had a high risk for dental caries. Sealant materials were applied by fifth-year undergraduate dental students on 346 fissures of the first permanent molars in 173 children. The ages of the children ranged from 7-15 years (mean 9.4). Two researchers at the clinics supervised all of the procedures. Intra-examiner reproducibility and inter-examiner reproducibility were 0.90 and 0.86, respectively, for the clinical assessment of sealant retention and caries evaluation. GIC sealants were completely lost in 31.9% and resin-based sealants in 16.6% (p<0.05). The total retention rates of GIC sealants and resin-based sealants were 13.8% and 20.8%, respectively. After 24 months, the caries increment was 3.4% for GIC sealants and 4.8% for resin-based sealants (p>0.05). The retention of GIC sealants was markedly inferior to the retention of resin-based sealants; however, GIC when used as a pit and fissure sealant was slightly more effective in preventing occlusal caries.

Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: a meta analysis

The purpose of this quantitative systematic review was to appraise the evidence on the caries-preventive effect of glass ionomer cement (GIC) in relation to resin-based fissure sealants. Nine English and two Portuguese databases were searched (15 January 2008). Randomized clinical trials and systematic reviews were considered for inclusion. Trial exclusion criteria were: drop-out rates > 33%; no randomization; baseline differences in groups not statistically adjusted; and no clinically important outcomes were presented. Two authors reviewed the articles independently. The outcome measure for the caries preventive effect was caries absence on sealed teeth. Of the 112 identified articles, 25 were selected for review. Of these, 14 were excluded and 11 accepted (8 trials; 3 systematic reviews). The accepted reviews provided no evidence of superiority of either sealant material. Six trials were included for meta-analysis. The pooled odds ratio was 0.96, 95% CI 0.62-1.49, indicating no difference in the caries-preventive effect of GIC and resin-based fissure sealant material. This systematic review with meta-analysis found no evidence that either material was superior to the other in the prevention of dental caries. Thus, both materials appear equally suitable for clinical application as a fissure sealant material.

Pits and fissure sealant guidelines

The guideline aims to address four clinical questions relating to the use of pit and fissure sealants:Under what circumstances should sealants be placed to prevent caries?Does placing sealants over early (noncavitated) lesions prevent progression of the lesions?Are there conditions that favour the placement of resin-based versus glass ionomer cement sealants in terms of retention or caries prevention?Are there any techniques that could improve sealants' retention and effectiveness in caries prevention? Medline was searched for all systematic reviews on pit and fissure sealants, and the reference lists of identified reviews were searched for additional references. A second search was carried out to identify clinical studies published after the systematic review were completed. Publications were included that addressed one or more of the identified clinical questions, had a documented search strategy, and were written in English. An expert panel was convened to evaluate the evidence and develop recommendations. The draft recommendations were submitted to a wide range of scientific experts and organisations for review, following which appropriate changes were made. The evidence was classified and clinical recommendations made using a system modified from the approach taken by Shekell et al.(1) The final clinical recommendations were approved by the American Dental Association Council on Scientific Affairs. Plans were not specified for future review and updating of this guideline. Using the evidence grading and recommendation systems described by Shekelle(1) (Table 1 and 2) a number of clinical recommendations were made (see summary in Table 3). A number of topics for additional research to improve the evidence base regarding the use of fissure sealants were identified by the expert panels. These are shown in Table 2.

Evidence-Based Clinical Recommendations for the Use of Pit-and-Fissure Sealants: A Report of the American Dental Association Council on Scientific Affairs

This article presents evidence-based clinical recommendations for use of pit-and-fissure sealants developed by an expert panel convened by the American Dental Association Council on Scientific Affairs. The panel addressed the following clinical questions: Under what circumstances should sealants be placed to prevent caries? Does placing sealants over early (noncavitated) lesions prevent progression of the lesion? Are there conditions that favor the placement of resin-based versus. glass ionomer cement sealants in terms of retention or caries prevention? Are there any techniques that could improve sealants' retention and effectiveness in caries prevention? Staff of the ADA Division of Science conducted a MEDLINE search to identify systematic reviews and clinical studies published after the identified systematic reviews. At the panel's request, the ADA Division of Science staff conducted additional searches for clinical studies related to specific topics. The Centers for Disease Control and Prevention also provided unpublished systematic reviews that since have been accepted for publication. The expert panel developed clinical recommendations for each clinical question. The panel concluded that sealants are effective in caries prevention and that sealants can prevent the progression of early noncavitated carious lesions. These recommendations are presented as a resource to be considered in the clinical decision-making process. As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. The evidence indicates that sealants can be used effectively to prevent the initiation and progression of dental caries.