Occlusal caries formation in vitro: comparison of resinmodified glass ionomer with fluoride-releasing sealant

The purpose of this laboratory study was to evaluate caries-like lesion formation in occlusal enamel adjacent to a light-cured resin-modified glass ionomer utilized as a pit and fissure sealant and a conventional light-cured, fluoride-releasing sealant. Fluoride-free prophylaxis was done on occlusal surfaces of 12 caries-free mandibular molar teeth that had not been exposed to the oral cavity. Occlusal surface morphology was examined by SEM on the uncoated specimens. Each tooth was then sectioned into 2 portions buccolingually, producing mesial and distal tooth halve. Occlusal surfaces of mesial tooth halves were prepared for an experimental light-cured resin-modified glass ionomer (RMG) sealant (PH-SE II, ESPE), and for comparison, a light-cured fluoride-releasing pit and fissure (PFS) sealant (Helioseal F, Ivoclar) was placed on occlusal surfaces of the corresponding distal tooth halves. The sealed occlusal surfaces were examined uncoated by SEM to compare RMG and PFS adaptation. After thermocycling in artificial saliva, caries-like lesions were formed in the occlusal surfaces adjacent to RMG and PFS. Longitudinal sections were taken for comparison of lesion formation adjacent to RMG and PFS. Mean lesion depths in occlusal surfaces were 64 +/- 17 mm for RMG, and 116 +/- 27 mm for PFS (p < 0.05, paired t-test). Occlusal lesions terminated at the point where bonding occurred between the occlusal enamel and RMG or PFS. SEM surface topography demonstrated adequate adaptation of the materials with obliteration of the typical pit and fissure surface morphology by both RMG and PFS. While both the resin-modified glass ionomer and fluoride-releasing sealant materials protected the pit and fissure enamel from caries development, the resin-modified glass ionomer reduced the extent of caries involvement in the adjacent unsealed occlusal incline enamel, when compared with the resin sealant.

1. Kaste LM, Selwitz HR, Oldakowski RJ, Brunelle JA, Winn DM, Brown, LJ. Coronal caries in the primary and permanent dentition of children and adolescents 1-17 years of age: United States, 1988-1991. J Dent Res 75(Spec Iss): 631-41, 1996.

2. Brown LJ, Kaste LM, Selwitz RH, Furman LJ. Dental caries and sealant usage in US children, 1988-1991: selected findings from the third national health and nutrition examination survey. JADA 127: 335-43, 1996.

3. Hicks MJ, Flaitz CM. The acid-etch technique in caries prevention: pit and fissure sealants and preventive restorations. In: Pediatric Dentistry: Infancy through Adolescence. 3rd Edition, Editor JR Pinkham, 481-521, 1999.

4. Louie R, Brunelle JA, Maggiore ED. Caries prevalence in Head Start Children, 1986-87. J Public Health Dent 50: 299-306, 1990.

5. Holt RD. The pattern of caries in a group of 5-year-old children and in the same cohort at 9 years of age. Community Dent Health 12: 93-9, 1995.

6. Stahl JW, Katz RV. Occlusal caries incidence in college students: implications for sealants. J Dent Res 1992;71:(AADR Abst): 250, 1992.

7. Stahl JW, Katz RV. Occlusal dental caries incidence and implications for sealant programs in a US college student population. J Public Health Dent 53: 212-7,1994.

8. Foreman JF. Sealant prevalence and indication in a young military population. JADA 125: 182-7, 1994.

9. Romcke RG, Lewis DW, Maze BD. Retention and maintenance of fissure sealants over 10 years. Can Dent J 56: 235-41, 1990.

10. Simonsen RJ. Retention and effectiveness of a pit and fissure sealants at 10 years. Quint Int 20: 75-81, 1989.

11. Simonsen RJ. Retention and effectiveness of dental sealants after 15 years. JADA 122: 34-8, 1991.

12. Dennison JB, Straffon LH, More FG. Evaluating tooth eruption on sealant efficacy. JADA 121: 610-7, 1990.

13. Straffon LH, Dennison JB. Clinical evaluation comparing sealant and amalgam after 7 years: final report. JADA 117: 751-9, 1988.

14. IADR Sealant Symposium. J Dent Res 70(Spec Iss): 266, 1991.

15. Sterritt GR, Frew RA, Rozier RG. Evaluation of Guamamian dental caries prevention programs after 13 years. J Public Health Dent 54: 153-62, 1994.

16. Sterritt GR, Frew RA, Rozier RG. Evaluation of a school-based flu-oride mouthrinsing and clinic-based sealant program on a non-fluo-ridated island. Community Dent Oral Epidemiol 18: 288-97, 1990.

17. Selwitz RH, Nowjack-Raymer R, Driscoll WS. Evaluation after 4 years of the combined use of fluoride and dental sealants. Community Dent Oral Epidemiol 23: 30-7, 1995.

18. Winkler MM, Descepper EJ, Dean JA. Using a resin-modified glass ionomer as an occlusal sealant: a one-year clinical study JADA 127: 1508-12, 1996.

19. Aranda M, Garcia-Godoy F Clinical evaluation of the retention and wear of a light-cured pit and fissure glass ionomer sealant. J Clin Pediatr Dent 19: 273-5, 1995.

20. Komatsu H, Shimokobe H, Kawakamis I, Yoshimura M. Caries-preventive effect of glass ionomer sealant reapplication: study presents three-year results. JADA 125: 543-9, 1994.

21. Forss H, Saarnium J, Seppa L. Comparison of glass-ionomer and resin-based fissure sealants: a 2-year clinical trial. Community Dent Oral Epidemiol 22: 21-8, 1994.

22. Mills RW, Ball IA. A clinical trial to evaluate the retention of a silver-cement-ionomer used as a fissure sealant. Oper Dent 18: 148- 53, 1993.

23. Ovrebo RC, Raadal M. Microleakage in fissures sealed with resin or glass ionomer cement. Scand J Dent Res 98: 66-71, 1990.

24. Torppa-Saarinen E, Seppa L. Short-term retention of glass ionomer sealants. Proc Finn Dent Soc 86: 83-6, 1990.

25. Mejare I, Mjor IA. Glass ionomer and resin-based fissure sealants: a clinical study. Scand J Dent Res 98: 345-50, 1990.

26. McKenna EF, Grundy GE. Glass ionomer cement fissure sealants applied by operative dental auxiliaries: retention rates after one year. Aust Dent J 32: 200-2, 1987.

27. Frencken JE, Songpaisan Y, Phantumvanit P, Pilot T. An atraumatic restorative treatment (ART) technique: evaluation after one year. Int Dent J 44: 460-6, 1994.

28. Phantumvanit P, Songpaisan Y, Pilot T, Frencken JE. Atraumatic restorative treatment (ART): a three-year community field trial in Thailand - survival of one-surface restorations in the perma-nent dentition. J Public Health Dent 56: 141-8, 1996.

29. Bynum AM, Donly KJ. Enamel de/remineralization on teeth adjacent to fluoride releasing materials without fluoride dentifrice. J Dent Child 66: 89-92, 1999.

30. Donly KJ, Segura A,Wefel JS, Hogan MM. Evaluating the effects of fluoride-releasing dental materials on adjacent interproximal caries. JADA 130: 817-25, 1999.

31. Forsten L. Short and long term fluoride release from glass ionomers and other fluoride-containing filling materials in vitro. Scand J Dent Res 98: 179-85, 1990.

32. Donly KJ, Souto M. Caries inhibition of glass ionomers. Am J Dent 7: 122-4, 1994.

33. Donly KJ, Nelson JJ. Fluoride release of restorative materials exposed to a fluoridated dentifrice. J Dent Child 64: 249-50, 1997.

34. Donly KJ, Kerber L. Demineralization inhibition at glass-ionomer cement and amalgam restoration margins in conjunction with additional fluoride regimens. Spec Care Dentist 19: 24-8, 1999.

35. Segura A, Donly KJ, Stratmann RG. Enamel remineralization on teeth adjacent to Class II glass ionomer restorations. Am J Dent 10: 247-50, 1997.