Efficacy of Sealing with Glass Ionomer Cement and Transversal Brushing Technique in Erupting First Molars: 18-Month Clinical Follow-Up

Josiane Ferreira Corteleti, Caroline Miki Ota, Thais Gimenez, Mariana Minatel Braga, José Carlos Imparato


Objective: To verify the effectiveness of sealing with glass ionomer cement and transversal brushing in the prevention and treatment of initial caries lesions in erupting permanent molars of children aged 5-7 years. Material and Methods: Healthy teeth with ICDAS scores 1 or 2 were selected. One hundred and thirty-one children (79 teeth in the control group - 75 teeth in the test group) were randomly assigned into the two experimental groups: (1) transversal brushing technique for plaque control with conventional flat bristles and fluoridated dentifrice or (2) sealing the occlusal surfaces with glass ionomer cement (Vitro Molar®). Follow-up was performed for 18 months and the survival analysis was applied to test the occurrence of lesion progression. Results: The mean age of children was 5.4 years and it was verified that, by examining the initial tooth condition, the probability of progression was 66% lower when the tooth had initial caries lesions than when it was healthy; the probability of molar progression was about 74% lower in the test group compared to the control group. The mean time for lesion development in the test group (16.8 months; SD = 0.5) was greater than that in the control group (16.5 months; SD = 0.5; p=0.008). Conclusion: Sealing reduces the progression of caries disease in initial lesions when compared to the transversal brushing technique.


Dental Caries; Toothbrushing; Pit and Fissure Sealants; Molar

Full Text:



Fejerskov O. Concepts of dental caries and their consequences for understanding the disease. Community Dent Oral Epidemiol 1997; 25(1):5-12. doi: 10.1111/j.1600-0528.1997.tb00894.x.

Baciu D, Danila I, Balcos C, Gallagher JE, Bernabé E. Caries experience among Romanian schoolchildren: Prevalence and trends 1992-2011. Community Dent Health 2015; 32(2):93-7.

Iheozor-Ejiofor Z, Worthington HV, Walsh T, O’Malley L, Clarkson JE, Macey R, et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015; (18)6; CDO010856. doi: 10.1002/14651858.

Ripa LW. Occlusal sealants: Rationable and review of clinical trial. Clin Prev Dent 1982; 4(2):3-10.

Karlzén-Reuterving G, Van Dijken JW. A three-years follow-up of glass ionomer cement and resin fissure sealants. J Dent Child 1995; 62(2):108-10.

Mejare I, Axelsson S, Dahlen G, Espelid I, Norlund A, Tranaeus S, et al. Caries risk assessment. A systematic review. Acta Odontol Scand 2014; 72(2):81-91.

Al-Jobair A, Al-Hammad N, Alsadhan S, Salama F. Retention and caries-preventive effect of glass ionomer and resin-based sealants: An 18-month-randomized clinical trial. Dent Mater J 2017; (36):654-61. doi: 10.4012/dmj.2016-225.

Silva EL, Januário MVS, Vasconcelos MG, Vasconcelos RG. Therapeutic approach to carious lesions: When and how to treat. Rev Bras Ciên Saúde 2017; 21(2):173-80. doi: 10.4034/RBCS.2017.21.02.11.

Carvalho JC, Ekstrand KR, Thylstrup A. Results after 1 year of non-operative occlusal caries treatment of erupting permanent first molars. Community Dent Oral Epidemiol 1991; 19(1):23-8. doi: 10.1111/j.1600-0528.1991.tb00099.x.

Alves LS, Zenkner JE, Wagner MB, Damé-Teixeira, Susin C, Maltz M. Eruption stage of permanent molars and occlusal caries activity/arrest. J Dent Res 2014; 93(7 Suppl):114S-119S. doi: 10.1177/0022034514537646.

Rogers HJ, Morgan AG, Batley H, Deery C. Why, what and how: Caries control for eruption molars. Dent Update 2015; 42(2):154-6. doi: 10.12968/denu.2015.42.2.154.

Carvalho JC. Caries process on occlusal surfaces: Evolving evidence and understanding. Caries Res 2014; 48(4):339-46. doi: 10.1159/000356307.

Braga MM, Mendes FM, De Benedetto MS, Imparato JCP. Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: A pilot study. J Dent Child 2009; 76(1):28-33.

Gonçalves AF, de Oliveira Rocha R, Oliveira MD, Rodrigues CR. Clinical effectiveness of toothbrushes and toothbrushing methods of plaque removal on partially erupted occlusal surfaces. Oral Health Prev Dent 2007; 5(1):33-7.

Frazao P. Effectiveness of the bucco-lingual technique within a school-based supervised toothbrushing program on preventing caries: A randomized controlled trial. BMC Oral Health 2011; 11:11. doi: 10.1186/1472-6831-11-11.

Luzia TLO, Silveira ADS. Therapeutic use of dental sealants. Rev Dig Acad Paraense Odontol 2017;1(1):41-6.

Frencken JE. Atraumatic restorative treatment and minimal intervention dentistry. Br Dent J 2017; 223(3):183-9. doi: 10.1038/sj.bdj.2017.664.

Mickenautsch S, Yengopal V. Caries-preventive effect of high-viscosity glass ionomer and resin-based fissure sealants on permanent teeth: A systematic review of clinical trials. PLoS One 2016; 11(1):e0146512. doi: 10.1371/journal.pone.0146512.

Romitti FMG, Imparato JCP, Manzano TP. Characterization of mechanical properties, fluoride release and colour stability of dental sealants. Braz Res Pediatr Dent Integr Clin 2016; 16(1):149-58. doi: 10.4034/PBOCI.2016.161.16.

Gonçalves PSP, Kobayashi TY, Oliveira TM, Honório HM, Rios D, Silva SMB. Pit and fissure sealants with different materials: Resin based x glass ionomer cement – Results after six months. Braz Res Pediatr Dent Integr Clin 2016; 16(1):15-23. doi: 10.4034/PBOCI.2016.161.02.

Chestnutt IG, Playle R, Hutchings S, Morgan-Trimmer S, Fitzsimmons D, Aawar N, Angel L, et al. Fissure seal or fluoride varnish? A randomized trial of relative effectiveness. J Dent Res 2017; 96(7):754-61. doi: 10.1177/0022034517702094.

Arrow P. Oral hygiene in the control of occlusal caries. Community Dent Oral Epidemiol 1998; 26(5):324-30. doi: 10.1111/j.1600-0528.1998.tb01968.x.

Frencken JE, Wolke J. Clinical and SEM assessment of ART high-viscosity glass-ionomer sealtants after 8-13 years in 4 teeth. J Dent 2009; 38(1):59-64. doi: 10.1016/j.jdent.2009.09.004.

Sidhu SK, Nicholson JW. A review of glass-ionomer cements for clinical dentistry. J Funct Biomater 2016; 7(3). pii: E16. doi: 10.3390/jfb7030016.

Souza ESS, Bezerra ACB, Amorim RFSG, Leme TDP. Caries diagnosis in the mixed dentition using ICDAS II. Braz Res Pediatr Dent Integr Clin 2015; 15(1):13-21. doi: 10.4034/PBOCI.2015.151.02.

Chesters RK, Pitts NB, Matuliene G, Kvedariene A, Huntington E, Bendinskaite R, et al. An abbreviated caries clinical trial design validated over 24 months. J Dent Res 2002; 81(9):637-40. doi: 10.1177/154405910208100912.

Heller KE, Reed SG, Bruner FW, Eklund SA, Burt BA. Longitudinal evaluation of sealing molars with and without incipient dental caries in a public health program. J Public Health Dent 1995; 55(3):148-53.

Bustamante-Teixeira MT, Faerstein E, Latorre MR. Survival analysis techniques. Cad Saúde Pública 2002; 18(3):579-94. doi: 10.1590/S0102-311X2002000300003.

DOI: http://dx.doi.org/10.4034/PBOCI.2018.181.96