Glass Ionomer Sealants Research Articles

Effectiveness of glass-ionomer sealant versus fluoride varnish application to prevent occlusal caries among preschool children over 18–24 months – A randomised controlled trial

ObjectivesTo compare the clinical efficacies of 5 % sodium fluoride varnish (NaFV) and glass-ionomer sealant (GIS) in preventing occlusal caries in primary second molars (PSMs). Materials and MethodsA total of 736 children were recruited from 18 kindergartens and randomised into either Group 1- receiving NaFV quarterly, or Group 2 - single placement of GIS at baseline. Interventions were performed on 1431 and 1264 PSMs in Group 1 and Group 2, respectively. The primary outcome was the development of ICDAS≥4 dentine caries at the occlusal surfaces of PSMs. ResultsA total of 736 children (383 in Group 1; 353 in Group 2) received the intervention. After 18–24 months, 479 children with 1764 PSMs were reviewed. Despite a low GIS retention rate of 2.4 % by 18–24 months, only 17.1 % of PSM in the GIS group developed caries into dentine. No significant difference was identified when compared to the proportion of PSMs with caries into dentine in the NaFV group (17.0 %). Regression analysis with GEE revealed that only baseline dft score and plaque level had a significant influence on development of ICDAS≥4 dentine caries in PSMs. ConclusionsQuarterly-applied NaFV and a single placement of medium viscosity GIS have similar clinical efficacies in preventing occlusal caries among preschool children. Clinical SignificanceThere is no significant difference between quarterly-applied NaFV and GIS in preventing occlusal caries at PSMs. Dental clinicians can choose to use either of these preventive methods after considering their own and parents’ preferences, children's cooperation and other practical factors.

Comparative Evaluation of Wear Strength and Compressive Strength of Two Pit and Fissure Sealants with a Nanofilled Resin Coating: An In Vitro Study.

The role of sealants for pits and fissures has been emphasized in caries prevention. Considering the advantages of a surface sealer and the effects of its application over restorative materials; the study is aimed at evaluating two pit and fissure sealants with a nanofilled resin coating. In this in vitro double-blinded study, a total of 60 caries-free extracted third molars were collected and divided into two groups of 30 each receiving either a resin-based sealant (Helioseal F) or a glass ionomer-based sealant (GC Fuji VII). Each sample was then applied with GCoat Plus surface sealer. 15 samples each containing GC Fuji VII and 15 containing Helioseal F were then subjected to wear. Another 15 samples of GC Fuji VII and 15 of Helioseal F were subjected to compressive load. On assessing the wear strength, the weight loss in group I (resin sealant with surface sealer) was 1.73 ± 0.50 (μg) which was statistically significant (p = 0.023). There was no significant difference in comparing the wear depth between both groups. There was a high statistically significant difference when assessing the compressive strength, group II (glass ionomer sealant with surface sealer) had 3566.4 ± 757 (μm) when compared to group I (resin sealant with surface sealer) 1568.53 ± 680 (p ≤ 0.01). Sealants are known for their poor retention and keeping that in mind we designed this study to evaluate the physical properties of sealants with a resin coating over them. Within the limitations of this study, the conclusions are glass ionomer sealant showed greater resistance to wear when compared to the resin-based sealant and the resin-based sealant showed higher compressive strength values than the glass ionomer sealant. Gunasekaran R, Sharmin D, Baghkomeh PN, et al. Comparative Evaluation of Wear Strength and Compressive Strength of Two Pit and Fissure Sealants with a Nanofilled Resin Coating: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(1):31-35.

Noninferiority of Silver Diamine Fluoride vs Sealants for Reducing Dental Caries Prevalence and Incidence

Dental caries is the world's most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure. Silver diamine fluoride (SDF) may provide an alternative therapy to prevent and control caries if shown to be noninferior to sealant treatment. To determine whether school-based application of SDF is noninferior to dental sealants and atraumatic restorative treatment (ART) in the prevalence of dental caries. The Silver Diamine Fluoride Versus Therapeutic Sealants for the Arrest and Prevention of Dental Caries in Low-Income Minority Children (CariedAway) study was a pragmatic noninferiority cluster-randomized clinical trial conducted from February 2018 to June 2023 to compare silver diamine fluoride vs therapeutic sealants for the arrest and prevention of dental caries. Children at primary schools in New York, New York, with at least 50% of the student population reporting as Black or Hispanic and at least 80% receiving free or reduced lunch were included. This population was selected as they are at the highest risk of caries in New York. Students were randomized to receive either SDF or sealant with ART; those aged 5 to 13 years were included in the analysis. Treatment was provided at every visit based on need, and the number of visits varied by child. Schools with preexisting oral health programs were excluded, as were children who did not speak English. Of 17 741 students assessed for eligibility, 7418 were randomized, and 4100 completed follow-up and were included in the final analysis. Participants were randomized at the school level to receive either a 38% concentration SDF solution or glass ionomer sealants and ART. Each participant also received fluoride varnish. Primary study outcomes were the prevalence and incidence of dental caries. A total of 7418 children (mean [SD] age, 7.58 [1.90] years; 4006 [54.0%] female; 125 [1.7%] Asian, 1246 [16.8%] Black, 3648 [49.2%] Hispanic, 153 [2.1%] White, 114 [1.5%] multiple races or ethnicities, 90 [1.2%] other [unspecified], 2042 [27.5%] unreported) were enrolled and randomized to receive either SDF (n = 3739) or sealants with ART (n = 3679). After initial treatment, 4100 participants (55.0%) completed at least 1 follow-up observation. The overall baseline prevalence of dental caries was approximately 27.2% (95% CI, 25.7-28.6). The odds of decay prevalence decreased longitudinally (odds ratio [OR], 0.79; 95% CI, 0.75-0.83) and SDF was noninferior compared to sealants and ART (OR, 0.94; 95% CI, 0.80-1.11). The crude incidence of dental caries in children treated with SDF was 10.2 per 1000 tooth-years vs 9.8 per 1000 tooth-years in children treated with sealants and ART (rate ratio, 1.05; 95% CI, 0.97-1.12). In this school-based pragmatic randomized clinical trial, application of SDF resulted in nearly identical caries incidence compared to dental sealants and ART and was noninferior in the longitudinal prevalence of caries. These findings suggest that SDF may provide an effective alternative for use in school caries prevention. ClinicalTrials.gov Identifier: NCT03442309.

Comparative Evaluation of Sealing Ability of Moisture-tolerant Sealant and Glass Ionomer Sealant Using Stereomicroscope: An In Vitro Study.

The preventive benefits of pit and fissure sealants rely on their retention and sealing ability. The drawback of the conventional pit and fissure sealant is its poor retention due to the presence of moisture. Among the numerous pit and fissure sealants available, newer hydrophilic sealants are ideal for children. This study evaluates and compares the sealing ability of hydrophilic sealant Embrace WetBond with conventionally used glass ionomer sealant under a stereomicroscope. A total of 48 extracted human premolars were randomly divided into two groups (N = 24) and sealed with Embrace WetBond and GC Fuji VII as per manufacturers' instructions. Following thermocycling, the sectioned samples were evaluated for sealant penetration, unfilled space, and total length of fissure under a stereomicroscope at magnifications 2.5×, 4×, and 5×. The values were measured in microns and in various fissure types using the "ImageJ app" to measure the sealant penetrability and sealing ability. The data recorded were statistically evaluated. The penetrability of moisture-tolerant sealant was better (87.8 ± 10.7) compared to that of glass ionomer sealant (73.8 ± 15.5) (p = 0.002). Among the samples, U-type fissure patterns displayed greater penetrability (94.2 ± 6.2), whereas IK-type fissures revealed the lowest degree of penetrability (67.5 ± 7.3). Embrace WetBond is better than glass ionomer sealant with respect to penetrability and sealing ability under stereomicroscope hence recommended as a better sealant for pediatric clinical practice. Priscilla S, Shivashankarappa PG, Mohandoss S, et al. Comparative Evaluation of Sealing Ability of Moisture-tolerant Sealant and Glass Ionomer Sealant Using Stereomicroscope: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S67-S71.

Photobiomodulation and glass ionomer sealant as complementary treatment for hypersensitivity in molar incisor hypomineralisation in children: protocol for a blinded randomised clinical trial

IntroductionPhotobiomodulation has been widely used as a complementary treatment for dentin hypersensitivity, with reports of clinical success. However, the literature offers only one study, in which photobiomodulation was used for...

A concise review of dental sealants in caries management.

This concise review provides an update of the use of dental sealants. Dental sealants protect a tooth from caries development by providing a physical barrier to microorganism colonisation and creating a favorable environment for patients to clean. Some sealants release fluoride ions to promote remineralization. Dental sealants can be applied on pits and fissures of primary and permanent teeth to prevent and arrest early enamel caries. They are effective in caries prevention. The preventive fraction of resin sealant is up to 61% after 5 years. Dental sealants can be classified as resin, glass ionomer and hybrid (compomer or giomer) according to the material. Recent studies from 2012 to 2022 showed resin sealant has a high retention rate of up to 80% after 2 years, whereas glass ionomer sealants is 44%. Chemical etching with 37% phosphoric acid is the standard of care, whereas laser or air-abrasion cannot does not increase the sealant retention rate. Moist control is critical and studies found the use of rubber dam and cotton rolls had similar success for sealant retention. The longevity of dental sealant is also associated with clinical operative factors, including approaches of moisture control, enamel pretreatment, selection of dental adhesive, and time of acid etching.

Comparative evaluation of retention and cariostatic effect of glass ionomer, hydrophobic & hydrophilic resin-based sealants: a systematic review and meta-analysis.

To compare the effectiveness of hydrophilic resin-based versus hydrophobic resin-based and glass-ionomer pit and fissure sealants. The review was registered with Joanna Briggs Institute and followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, Google Scholar, Virtual Health Library, and Cochrane Central Register of Controlled Trials were searched from 2009-2019 using appropriate keywords. We included randomized controlled trials and randomized split-mouth trials conducted among 6-13-year-old children. The quality of included trials was assessed using modified Jadad criteria and risk of bias using guidelines specified by Cochrane. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) guidelines were used to assess the overall quality of studies. We used the random-effects model for meta-analysis. Relative risk (RR) and confidence intervals (CI) were calculated & heterogeneity was tested using I² statistic. Six randomized clinical trials and five split-mouth trials met the inclusion criteria. The outlier augmenting the heterogeneity was omitted. Based on very-low to low-quality evidence, loss of hydrophilic resin-based sealants was less likely as compared to glass-ionomer fissure sealants (4 trials at 6 months; RR = 0.59; CI = 0.40-0.86), while it was similar or slightly lower than hydrophobic resin-based sealants (6 trials at 6 months; RR = 0.96; CI = 0.89-1.03); (6 trials at 12 months; RR = 0.79; CI = 0.70-0.89); (2 trials at 18 months; RR = 0.77; CI = 0.48-0.25). This study revealed that retention of hydrophilic resin-based sealants is better than glass ionomer sealants but similar to hydrophobic resin-based sealants. However, higher-quality evidence is necessary to underpin the outcomes.

Comparative Evaluation of Fluoride Release from Glass Ionomer, Compomer, and Giomer Sealants Following Exposure to Fluoride Toothpaste and Fluoride Varnish: An In Vitro Study.

Applying sealants to the deep pit and fissure area will be an excellent way to stop and slow down tooth caries from developing. Dental sealants that include fluoride are more successful at lowering dental cavities. It is anticipated that exposure to fluoride from dental sealants of various origins may enhance the fluoride release from dental sealants. Therefore, this study's objective was to investigate the amount of fluoride released after using fluoride toothpaste and fluoride varnish from different sealants. Using only a fluoride ion selective electrode, the initial release of fluoride was detected every 24 hours for 15 days. After every measurement, the saliva was refreshed. The samples were split into three identical subgroups and given the respective regimes on the 15th day-subgroup A was given fluoride toothpaste every morning and evening, subgroup B was provided fluoride varnish once, and subgroup C was not given any fluoride regime at all. After another 15 days of fluoride exposure, the fluoride release was monitored. With notable variations across groups over the initial 15 days, glass ionomer sealants (GIS) released more amount of fluoride, second by giomer sealant, and third by resin sealant (p = 0.00). All dental sealants that have been tested released more fluoride when using fluoride toothpaste, with giomer sealants surpassing GIS, followed by resin sealants (p = 0.00). Giomer and resin sealants, fluoride varnish treatment dramatically improves fluoride release in GIS (p = 0.00). The release of fluoride among all dental sealants is improved by using fluoride toothpaste daily and fluoride varnish just once. Senthilkumar A, Chhabra C, Trehan M, et al. Comparative Evaluation of Fluoride Release from Glass Ionomer, Compomer, and Giomer Sealants Following Exposure to Fluoride Toothpaste and Fluoride Varnish: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(6):736-738.

Comparison of Clinical Efficacy of Glass Ionomer-based Sealant using ART Protocol and Resin-based Sealant on Primary Molars in Children.

The present in vivo study aims to evaluate and compare the clinical efficacy and survival rate of resin-based composite sealant (Clinpro Sealant, 3M ESPE, Irvine, California, United States of America) with high viscosity glass ionomer (GI) (Equia Forte, GC India, Patancheru, Telangana, India) using atraumatic restorative treatment (ART) sealant protocol in primary molars. The design of the study was a clinical, prospective split-mouth study. A total of 100 contralateral primary molars were selected and divided into two groups. In group I, children received Equia Forte, and in group II, children received Clinpro Sealant. The follow-up examinations were performed in the 1st and 6th months. Simonsen's criteria were used to check for retention. International Caries Assessment and Detection System II (ICDAS II) criteria were used to check for dental caries. The data obtained were subjected to statistical analysis. At 6 months, there was no statistically significant difference between the groups with regard to retention and caries preventive effect. High-viscosity GI sealants can be applied using the ART protocol and provide an alternative to resin-based sealants. There is a limited number of studies on the performance of ART sealants in primary molars. Thus, the clinical efficacy and survival rate of resin-based composite sealant (Clinpro Sealant, 3M ESPE, Irvine, California, United States of America) with high viscosity GI (Equia Forte, GC India, Patancheru, Telangana, India) using ART sealant protocol in primary molars were evaluated. The research concluded that high-viscosity GI sealants using ART protocol are effective sealants in primary molars. Kaverikana K, Vojjala B, Subramaniam P. Comparison of Clinical Efficacy of Glass Ionomer-based Sealant using ART Protocol and Resin-based Sealant on Primary Molars in Children. Int J Clin Pediatr Dent 2022;15(6):724-728.

Effect of Silver Diamine Fluoride on Caries Arrest and Prevention

Dental caries is the most common global childhood disease. To control caries, the Centers for Disease Control and Prevention recommends school-based caries prevention, and the World Health Organization lists glass ionomer cement and silver diamine fluoride as essential medicines for oral disease. To determine the noninferiority of silver diamine fluoride with fluoride varnish vs traditional glass ionomer sealants with fluoride varnish after 2 years when provided to children via a school-based health care program. The CariedAway study is an ongoing single-blind, cluster randomized, noninferiority trial conducted between February 1, 2019, and June 1, 2023, among 2998 children in 47 New York City primary schools. Children aged 5 to 13 years of any race and ethnicity were recruited from block-randomized schools. Inclusion criteria for schools were a student population of at least 50% Hispanic or Latino or Latina ethnicity and/or Black race and at least 80% of students receiving free or reduced-cost lunch. Statistical analysis is reported through March 2022. Children received a single application of silver diamine fluoride with fluoride varnish or an active comparator of glass ionomer sealants and atraumatic restorations with fluoride varnish. Primary outcomes were caries arrest and incidence after a 2-year follow-up, assessed using mixed-effects multilevel models and clustered 2-sample proportion tests. The noninferiority margin was 10%. Intention-to-treat analysis was performed using multiple imputation. A total of 2998 children (1566 girls [52.2%]; mean [SD] age at baseline, 6.6 [1.2] years; 1397 Hispanic or Latino or Latina children [46.6%]; 874 [29.2%] with untreated dental caries) were recruited and treated from September 16, 2019, to March 12, 2020. Follow-up observations were completed for 1398 children from June 7, 2021, to March 2, 2022. The mean (SE) proportion of children with arrested caries was 0.56 (0.04) after experimental treatment and 0.46 (0.04) after control treatment (difference, -0.11; 95% CI, -0.22 to 0.01). The mean (SE) proportion of patients without new caries was 0.81 (0.02) after experimental treatment and 0.82 (0.02) after control treatment (difference, 0.01; 95% CI, -0.04 to 0.06). Analysis of imputed data for the full sample did not deviate from per-protocol analyses. There were no adverse events. In this randomized clinical trial, silver diamine fluoride with fluoride varnish was noninferior to sealants and atraumatic restorations with fluoride varnish for caries arrest and prevention. Results may support the use of silver diamine fluoride as an arresting and preventive agent in school-based oral health programs. ClinicalTrials.gov Identifier: NCT03442309.

Glass ionomer fissure sealants

Glass ionomer (GI) sealants can be utilised when a resin-based sealant is indicated but cannot be placed due to poor moisture control, resulting from either inadequate tooth eruption or poor patient co-operation. GI is hydrophilic, making it more compatible with the oral environment. Another significant advantage of GI sealants is their action as a fluoride reservoir, aiding in the remineralisation of enamel.

Microleakage and depth of penetration of different materials used as pit and fissure sealants under wet conditions: An Invitro study

Objectives: To compare the effectiveness of 3 types of pit and fissure sealants namely, glass ionomer sealants (GC FUJI VII), high viscosity GIC used as ART sealant (GC Fuji IX EXTRA), and hydrophilic resin sealant (Embrace Wet Bond) when placed under salivary contamination in terms of marginal leakage and depth of penetration.

A novel application of a bioactive material as a pit and fissure sealant: in vitro pilot study evaluating the sealing ability and penetration

PurposeTo compare the sealing ability and penetration of a bioactive material used as pit and fissure sealant to those of glass ionomer sealant.MethodsThis was an in vitro experimental study conducted on 20 permanent teeth. For Group I of ten teeth, ACTIVA BioACTIVE-Base/Liner was applied as a sealant on pits and fissures, and the remaining ten teeth of Group II were sealed using glass ionomer cement. After thermocycling, the apex of the teeth was sealed using composite resin and they were immersed in 1% methylene blue solution, buffered at pH 7 for 24 h. Longitudinal sections were obtained from each tooth for evaluating the sealing ability and penetration, using a binocular light microscope at 4 × magnification. The obtained data were subjected to analysis using the Chi-square test and independent t test.ResultsThe comparison of the sealing ability and sealant penetration, between the two groups, showed statistically no significant difference (p = 0.104 and p = 1.0, respectively).ConclusionBioactive material as a pit and fissure sealant, performed on par with glass ionomer sealant in terms of tested properties like sealing ability and penetration.

Assessment of influence of LED curing units used on microhardness of resin-modified glass ionomer sealants

Aim: Resin modified glass ionomer (RMGI) is class of material that can be used as sealant for preventing and arresting the progression of caries in pits and fissures. As these are hybrid materials, their properties can be affected by factors related to the polymerization process. Therefore, this study aimed to evaluate the influence of different generations of LED curing units (Elipar DeepCure-L and VALO Grand) on Knoop microhardness values (KHN) of RMGI sealants (Clinpro XT and Vitremer). Methods: Forty cylindrical specimens (6mm ø x 1 mm high) were prepared according to the manufacturer’s instructions and divided into four groups (n=10) according to the type of RMGI and LED used. The KHN of the top surface of each sample was calculated 7 days after light-curing. Data were submitted to two-way ANOVA (α = 0.05). Results: Vitremer had higher KHN values than Clinpro XT after using both LEDs (p<0.0001), but especially when light-cured with the use of VALO Grand (p<0.0001). Whereas the KHN value of Clinpro was not influenced by the LED device (p>0.05). Conclusions: Top surface microhardness values of RGMI sealants were affected by both material composition and generations of LED curing units used. Third generation LED curing units seemed to be more efficient for the polymerization of RMGI-based sealants.

Evaluation of Apical Leakage After Root Canal Obturation with Glass Ionomer, Resin, and Zinc Oxide Eugenol Sealers Combined with Thermafil.

BackgroundA hermetic seal at the apical terminus is required for healthy periradicular tissue. Root canal obturation sealers that are used in endodontics are based on zinc oxide eugenol, calcium hydroxide, resins, glass ionomers, silicone, or bioceramics, but no optimal sealer material has been identified to date. Therefore, the aim of this in vitro study was to evaluate apical leakage after crown-down preparation and root canal obturation with Endomethasone N, glass ionomer cement, and EndoRez sealers.Material/MethodsFor this in vitro study, we tested 92 extracted human teeth, which were divided into 3 groups after a preparation technique and obturation with Endomethasone N sealer, glass ionomer cement, and EndoRez sealer in combination with Thermafil obturator. Apical leakage was evaluated and compared among the tested groups using a dye leakage method through a stereomicroscope. The values were measured from the apex to the coronal extent of dye penetration. For statistical analysis, the t test was used for comparison of the arithmetic averages of tested groups.ResultsAfter preparation with rotary files, tested groups obturated with Thermafil obturator in combination with Endomethasone sealer showed higher average dye penetration than tested groups obturated with EndoRez and glass ionomer sealer.ConclusionsAlthough all experimental groups showed dye leakage, the glass ionomer sealer in combination with Thermafil showed the least leakage, compared with EndoRez and Endomethason N.

Silver diamine fluoride, atraumatic restorations, and oral health-related quality of life in children aged 5\u201313 years: results from the CariedAway school-based cluster randomized trial

ObjectiveSilver diamine fluoride (SDF) is a non-surgical treatment for the arrest and prevention of dental caries that results in irreversible black staining of dental decay. The objective of this study was to evaluate the short-term impact of SDF treatment on oral health-related quality of life (OHRQoL) relative to a standard package of glass ionomer sealants and atraumatic restorative treatment (ART) in children aged 5–13 years.MethodsCariedAway is a pragmatic, longitudinal, cluster-randomized non-inferiority trial of non-surgical interventions for caries. Secondary study outcomes included OHRQoL and academic performance. Oral health-related quality of life was measured at each study visit using the Child Oral Health Impact Profile. Change in OHRQoL was assessed using linear regression and non-inferiority was determined using t tests.Results160 children with an average age of 8.7 years completed quality of life assessments. Untreated decay at baseline (approximately 25%) was associated with significantly worse OHRQoL and treatment in both groups resulted in incremental improvement: children receiving SDF improved their OHRQoL scores from 16.44 (SD = 11.12) to 14.62 (SD = 11.90), and those receiving traditional sealants and atraumatic restorations slightly improved from 16.65 (SD = 10.56) to 16.47 (SD = 11.09). Quality of life in children receiving silver diamine fluoride was non-inferior to those receiving sealants and ART at least 6 months post-treatment (mean difference = 1.85, 95% CI = − 2.10, 5.80), and change in OHRQoL did not depend on the severity of baseline decay.ConclusionsOHRQoL is related to untreated dental caries, and observed changes following SDF treatment were non-inferior relative to standard preventive therapies.

Retention and caries-preventive effect of four different sealant materials: A 2-year prospective split-mouth study.

The aim of this observational split-mouth study was to compare the retention and caries protective effect of four different sealant materials in children aged 6-13years during a 2-year follow-up period. Eighty children were included in this study, which was conducted in Blato (Korčula island), Croatia. Each participant received at least two different sealant materials on caries-free permanent molars in two different quadrants. Sealant materials (M1 - glass-ionomer cement; M2, M4 - resin-based filled sealants; M3 - resin-based unfilled sealant) were delivered in a random order. The results of this study showed that M2 (30 teeth, 46.2%) and M4 (27 teeth, 46.6%) showed statistically significantly higher number of teeth with total retention after 2-year follow-up period, in comparison with M1 (10 teeth, 19.2%) or M3 (12 teeth, 20.7%) (p<.001). There was no statistically significant difference in caries occurrence between different groups in which the sealant material was totally retained. According to the results of this study, filled resin-based sealant materials showed better retention during the 2-year follow-up period while both resin-based and glass-ionomer sealants demonstrated protection against dental caries if totally retained on the occlusal surface.

Incidencia de caries en molares primarios después de la colocación de sellantes de ionómero de vidrio

The aim of this study was to determine the cumulative incidence (CI) of decay on primary molars treated with glass ionomer (GI) sealants. We hypothesized that GI sealants would decrease caries incidence in primary molars of young children at high caries risk. Data were collected from 56 children aged 1–5 years participating in a community-based sealant program in Immokalee, FL during 2018–2019. Follow-up was planned for 6 months after the initial sealant placement. The mean (±SD) age at sealant placement was 3.57 (±0.66) years. A mean (±SD) of 6.55 (±1.97) sealants were placed per child. There was a mean of 1.29 decayed primary molars per child at the initial visit. A total of 367 Fuji GI sealants were placed on non-carious/non-restored primary molars, or a mean of 6.55 sealants per child. At follow-up, there were 10 newly decayed primary molars among the teeth that had been sealed or a mean of 0.23±0.66 newly decayed teeth per child. The CI of caries among all sealed teeth was 2.7%, with the highest CI on primary mandibular second molars. Sealants were largely effective in preventing caries in primary molars. GI sealants may be an effective prevention strategy for primary molars among young children at high caries risk.

Progression of Enamel Demineralisation Around Fissure Sealants: Optical Coherence Tomography Study.

To evaluate the progression of enamel demineralisation around fissure sealants using cross-polarisation optical coherence tomography (CP-OCT). Three fissure sealants; Fuji Triage (FJ, GC), Beautisealant (BT, Shofu) and Helioseal resin sealant (HL, Ivoclar Vivadent) were placed in cavities (3 × 0.5 × 1 mm) prepared in bovine enamel blocks (n = 5). After 7-day artificial saliva incubation, specimens were subjected to demineralisation for 4 weeks (pH 4.5). CP-OCT scans (Santec) were acquired for each specimen after 1, 2 and 4 weeks of demineralisation and lesions were quantitatively measured to analyse lesion progression. Repeated-measures ANOVA demonstrated that lesion size was statistically significantly affected by demineralisation period, fissure sealant type, and their interaction (P < 0.001). At 4 weeks, the highest mean value of lesion size was observed in HL group while FJ group showed the lowest. The rate of lesion progression was slower in FJ and statistically significantly different from BT (P < 0.05), which in turn was statistically significantly different than HL (P < 0.001). Fissure sealants that actively release ions are capable of improving the acid resistance of adjacent enamel. Beautisealant showed increased demineralisation inhibition compared to conventional resin sealant, but less than that provided by glass-ionomer sealant.

Glass Ionomer Sealant versus Fluoride Varnish Application to Prevent Occlusal Caries in Primary Second Molars among Preschool Children: A Randomized Controlled Trial

Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3–4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0–1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group – application of 5% NaFV at 3-monthly intervals or GIS group – 1 single placement of GIS. A parental questionnaire was used to collect information on the children’s sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (p = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.