Child Clinical Trial
Official title:
Glass Ionomer Sealant Versus Fluoride Varnish Application to Prevent Occlusal Caries Among Preschool Children - a Randomized Controlled Trial
The current study compares the efficacy of glass ionomer fissure sealant versus topical application of 5% sodium fluoride varnish in prevention of occlusal caries among preschool children.
Topical fluoride varnish (TFV) with 5% sodium fluoride in its content has proven effective in
preventing caries among children and adolescents. Its reduction in DMFT is well supported by
Cochrane reviews and clinical trials. However, its effect in preventing pit and fissure
caries in primary dentition has not been assessed.
Pit and fissure sealants have been a recommended procedure in preventing caries development
in permanent molars. Multiple systematic reviews and clinical trials have concluded that
fissure sealants are significantly more effective than topical fluoride varnishes in
preventing occlusal caries in permanent molars. However, a recent Cochrane review suggested
that there was still insufficient evidence to determine superiority of resin or glass ionomer
fissure sealants over topical fluoride varnishes for occlusal caries prevention, due to the
lack of reliable results and low quality of evidence.
Also, most studies were conducted on permanent first molars among school children, whom
cooperation and moisture control can be easily achieved. However, application of fissure
sealants, especially resin-based sealant, in very young children can be a technique-sensitive
procedure. Compared with a mean treatment time of less than 3 minutes for varnish
application, application of resin-based sealants required over 15 minutes. Moisture control
is also of paramount importance for the retention and success of resin-based sealants, which
may be difficult among young preschool children.
Glass-ionomer sealants can chemically bond to enamel and are more tolerable to inadequate
moisture control. As its application requires less clinical steps, glass-ionomer sealant is
comparatively more acceptable to younger patients and can be used in outreach settings with a
large number of participants. The fluoride releasing ability is also beneficial in preventing
caries especially at adjacent tooth surfaces. However, its retention rate is significantly
lower than that of resin-based sealants, its success rate in preventing fissure caries in
very young patients is still unknown.
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