Retention and remineralization effect of moisture tolerant resin-based sealant and glass ionomer sealant on non-cavitated pit and fissure caries: Randomized controlled clinical trial

• Published in: Journal of dentistry Vol. 86; pp. 69 - 74
• Main Authors: Alsabek, Laith, Al-Nerabieah, Zuhair, Bshara, Nada, Comisi, John C.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-07-2019; Elsevier Limited
• Subjects: Acrylic Resins; Clinical trials; Dental Caries; Dental enamel; Dental sealants; Dentistry; Enamel; Germany; Glass; Glass Ionomer Cements; Glass ionomer sealants; Humans; Hydrophilic resin sealants; Ionomers; Lesions; Moisture; Molars; Patients; Pit and Fissure Sealants; Randomization; Remineralization; Resin sealants; Resins; Resins, Synthetic; Retention; Sealants; Sealing compounds; Silicon Dioxide; Single-Blind Method; Statistical analysis; Statistical significance; Teeth; Germany; Resin sealants; Pit and fissure sealants; Retention; Hydrophilic resin sealants; Glass ionomer sealants; Remineralization
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2019.05.027

Pit and fissure sealants are an essential part of preventive dentistry and should be adopted as a crucial part of the minimally invasive dentistry due to their profound benefit to our patients.
The study design is a single-blind, split-mouth, randomized controlled clinical trial. Forty patients between age 6–9 were selected. First permanent molars’ occlusal surfaces with scores of 1, or 2 according to the International Caries Detection and Assessment System II (ICDAS II) and with scores between 14–30 by using DIAGNOdent device (Kavo®, Biberach, Germany) were selected and readings recorded. One side of the mouth was randomly chosen to have either the moisture tolerant resin sealant or the glass ionomer sealant placed, and then the second material was placed on the other side. The retention of these materials was analyzed at 3 and 6 months. The sealants were then removed and DIAGNOdent readings were subsequently taken.
After three months, full retention was found in 38/40 (95%) teeth in Group A (Embrace™ WetBond™) and 35/40 (87.5%) teeth in Group B (Fuji TRIAGE®). Additionally, no sealant suffered a total loss in group A, whereas, three sealants were totally lost (7.5%) in group B. The difference in sealant retention in two groups in this period was not found to be statistically significant (P >  0.05).
At six months, full retention was found in Group A 34/40 (85%) and 25/40 (62.5%) in Group B. Also, the partial loss in Group A was 2/40 (5%) whereas in Group B 7/40 (17.5%). Also, the total loss was 4/40 (10%) and 8/40 (20%) in Group A and B, respectively. The difference in sealant retention in two groups after six months follow-up was found statistically significant (P < 0.05).
The initial mean values of DIAGNOdent readings were 22.42 and 22.8 in Group A and Group B, respectively. After six months, DIAGNOdent mean values revealed a drop in both groups, and this difference was statistically significant. Nevertheless, when Group A was compared to Group B in terms of remineralization effect, the differences were found not to be statistically significant (p > 0.05).
Within the limitation of this study, we affirmed that occlusal caries lesions, which is restrictive to enamel and in need of surgical intervention, can be arrested clinically by sealing the lesion with both a hydrophilic resin sealant and glass ionomer sealant materials. Embrace™ WetBond™ showed superiority over the glass ionomer sealant tested in retention after six months follow up.