The use of dental sealants has been proved to be highly effective in the prevention of pit and fissure caries. This caries-preventive property of sealants is based on the establishment of a seal which prevents nutrients from getting to the fissure microflora. The preventive effects of sealants are maintained as long as they remained completely intact and bonded to the tooth surface.
The aim of this study was to comparatively evaluate glass ionomer and resin based fissure sealants with respect to their duration of treatment, cost of treatment as well as their clinical performance i.e. retention and caries prevention effect over a one-year period.
This was a comparative, prospective, assessor-blinded randomised clinical trial conducted at the Paediatric Dentistry Unit, University of Benin Teaching Hospital, Benin City, Nigeria. It was a split-mouth design in which two fissure sealants (Clinpro®, a light cure Bis-GMA resin-based sealant and GC Fuji Triage®, a glass-ionomer sealant) were randomly placed on 50 matched contralateral pairs of permanent mandibular first molar teeth. The age range of the study participants was from 6 to 10 years, with a mean age of 8.14 + 1.3 years. Twenty eight (56%) of the respondents were male while 22(44%) were female.
At the commencement of the study, sealant was applied on the first molars of 50 children of whom all were available for 3rd month evaluation. Forty nine (49) children were available for the 6th month and 46 children at 12th month evaluation for sealants retention and for presence or absence
of enamel demineralization or caries.
The results showed that it takes a longer chairside time to treat participants with resin based sealant than with glass ionomer sealant. In this study, the mean time for treatment using resin sealant was approximately 5.19 minutes while with glass ionomer sealant was 4.53 minutes and it was statistically significant, (P-value <0.001) Findings from this study also revealed that, the use of resin based sealant was cost effective.
The treatment cost for resin sealant according to this study was five hundred and seventy naira only (N570) and for glass ionomer based sealant was eight hundred and forty naira only (N840.) It is important to state here that the cost of treatment in focus was the cost of purchasing the material divided by the number of tooth surface sealed. Fixed cost, variable cost and cost of clinic maintenance were however disregarded, as such costs would have existed even without the sealant programme.
At the end of the one-year clinical evaluation; findings from this study although not statistically significant, (P value > 0.05) revealed that retention of the resin sealant was superior to glass ionomer based sealant. At the 12 month assessment, 32(69.6%) of resin sealant had total retention as against 27(58.7%) for glass ionomer sealant. No dental caries was however recorded during the 12 months evaluation period for both experimental groups.
Based on findings from this study, it was concluded that less chairside time is requiried for fissure sealing procedures with the use glass ionomer based sealant and the use of resin based fissure sealant was relatively cheaper. The retention of resin sealant was superior to glass ionomer based sealant at the end of one-year and both sealant materials were effective at one-year evaluation in prevention of pit-and-fissure caries. No sign of caries development was noted where sealant had been completely or partially lost.
Recommendations following this study are that: resin based sealant should be the first choice material for fissure sealing and more studies for a longer period and with large samples should be carried out to further evaluate the retention characteristics of resin and glass ionomer based sealants.
