Clinical Performance of Glass-Ionomer Sealants in High Caries Risk Children

Objectives: To evaluate the clinical performance of two conventional glass-ionomer sealants in high caries risk children. 

Methods: Using a single-blind split-mouth randomized design, 413 sealants were applied on sound permanent first molars of 112 children (6-8 years old) after parental consent. Ketac Molar^® (3M/ESPE) and Maxxion^® (FGM) were applied respectively on 195 and 218 teeth by "press finger technique" in a school environment. Teeth were evaluated at 6-, 12-, 18-, 24-month intervals with regard to retention and caries development. The same calibrated dentist performed the baseline and follow-up examinations under natural light, using CPI probes and mirrors, after tooth brushing and gauze-drying (Kappa > 0.84). Clinical success was determined by the absence of caries development. Data was performed for survival analysis using Kaplan-Meier and Log-Rank Tests (p<0.05).

Results: After 24 months, 284 (69%) sealants of 88 children were evaluated, 139 with Ketac Molar and 145 with Maxxion. There were 12% of Ketac Molar and 8% of Maxxion fully and partially retained sealants. Of the original sealed surfaces 78% of Ketac Molar and 87% of Maxxion were totally lost without caries development. While 10%of Ketac Molar and 5% of Maxxion were lost with caries development. There was no significant difference between the survival times for the two sealants (p = 0.46). The probability of cumulative survival rate was 99% (95% Confidential Interval = 97.9% - 100%) that was the same for both materials. 

Conclusions: The clinical performance of the two glass-ionomer sealants was considered satisfactory with a high preventive caries effect within 24 months. Although the sealants placed according to the ART approach showed low retention rates, this approach seems to be appropriate for high caries risk children.