Evaluation of Glass Ionomer Sealants Placed According to the Art Approach in a Community with High Caries Experience: 1-year Follow-up

The aim of this study was to investigate the retention rates and effect on occlusal caries incidence of two glass ionomers used as sealants, placed according to the Atraumatic Restorative Treatment (ART) approach, in a high caries-risk community. A total of 150 newly erupted first molars of 42 schoolchildren, between 6-8 years of age were selected. The teeth were divided into two groups: experimental and control groups. In the experimental group, 76 teeth were sealed using Vidrion R-SS White (conventional GIC) and in the control group, 74 teeth were sealed using ChemFlex-Dentsply (high-viscosity conventional GIC). The sealants were applied by one operator following the "press finger technique", described in the ART-WHO manual. Two calibrated independent examiners carried out the evaluation according to the ART criteria. The intra and inter-examiner agreements were 0.84 and 0.81, respectively. Data were submitted to Mann-Whitney and Chi-square tests (p<0.05). At the 1-year follow-up, 136 (90.7%) sealants were evaluated. In the control group: 28 (41.8%) of the sealants were partially or completely retained, 38 (56.7%) completely lost, and 1 (1.5%) was replaced by another treatment. In the experimental group, 30 (43.5%) of the sealants were partially or completely retained, 38 (55.1%) were clinically scored as complete loss and 1 (1.4%) were replaced by another treatment. Seven sealants in both groups were not evaluated. Secondary caries was not observed in both groups. There was no statistically significant difference between the retention (p=0.49) and effect on caries incidence rates for both groups (p=0.84). The clinical performance of the glass ionomer sealants of both groups was considered satisfactory with a high success rate (98.5%). Although the sealants placed according to the ART approach showed retention rates lower than 50% after 1 year in newly erupted first molars, this approach seems to be appropriate for communities with high caries experience.