Glass ionomer ART sealants in Chinese school children-6-year results

To evaluate longitudinally ART sealants placed in Chinese school children under field conditions.

191 ART sealants were placed in 140 children, aged 11-14 years, by five assistant dentists in four secondary schools in Deyang, Sichuan Province, China. Teeth selected for sealing were those with pits and fissures that were deep or showing early enamel caries. Teeth were excluded if there was obvious cavitation extending into dentine. Standard instruments and procedures for ART sealants were used. The material used was a high-viscosity glass-ionomer (Ketac-Molar, 3MESPE) that was inserted into the pits and fissures with the "press-finger" technique. The status of the sealants was evaluated annually over 6 years after placement by the same examiner who was not involved in the placement of the sealants using explorers, mouth-mirrors and an intra-oral fibre-optic light. No missing sealants were replaced during the study.

107 sealants (56% of the original) were examined after 6 years. The cumulative survival rates of the sealants (partially or fully retained) after 2, 4 and 6 years were 79%, 68% and 59%, respectively. Caries prevention lagged the fall in sealant survival but remained high throughout the study period, being over 90% in the first 4 years and 85% after 6 years.

ART sealants placed under field conditions in Chinese schoolchildren have a high retention rate. Missing sealants should be replaced to maintain their preventive efficacy.

The sealing of pits and fissures can be an effective caries preventive approach. Resin-based sealants have the disadvantage in that they require an optimal level of moisture control during placement. In children and in outreach situations glass ionomer ART sealants, which are more moisture tolerant, can offer a viable alternative.