Purpose: The purpose of this study was to compare the two year clinical performance of two fissure sealants, placed with and without tooth preparation.
Methods: A total of 25 children, between 6-10 years of age, had sealants placed and evaluated for two years at six monthly intervals. All the four first permanent molars of each patient were used in split mouth design and subjected to two different sealants with and without tooth preparation. Teeth were evaluated for defects, retention and development of caries.
Results: Among the teeth subjected to preparation, 60% of those sealed with glass ionomers and 32% of those sealed with resin sealants showed total loss of sealants at the end of two years. Among the teeth sealed with no preparation, 100% of those sealed with glass ionomers and 80% of those sealed with resin showed total loss. Resin based sealants offered better long term retention compared to glass ionomer-based fissure sealants. Tooth preparation improved the retention of sealants irrespective of the material used. Highest retention was seen in resin sealants with tooth preparation, and lowest retention was seen in glass ionomer-based sealants without preparation. There was a significant increase in caries in teeth sealed after preparation with either material. Teeth sealed with resin sealants exhibited significantly higher caries development compared to teeth sealed with glass ionomers.
Conclusion: In the current study, resin-based sealants were found to be superior to glass ionomer-based sealants, and tooth preparation improved retention. Loss of sealants seemed to predispose tooth to development of caries, especially in cases where teeth preparation was done.