Use of a Glass Ionomer Sealant in Permanent First Molars affected by Molar Hypomineralisation: A 12-Month Clinical Study

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ABSTRACT

Aim

To evaluate the survival rate and clinical status of a glass ionomer (GI) sealant in hypomineralised permanent first molars (PFMs), as well as to assess the occurrence of post-eruptive breakdown (PEB) and measure dentin hypersensitivity in the sealed molars over a 12-month follow-up period.

Methods

Fifty-two hypomineralised PFMs, with at least two-thirds of their crown erupted, exhibiting opacities on the occlusal surface, no caries or PEB, were sealed using a GI sealant (GC Fuji Triage®). Clinical evaluation was performed using the United States Public Health Service (USPHS) criteria. PEB was clinically diagnosed. In-office dentin hypersensitivity to thermal stimuli (air spray) was measured using the Wong-Baker Faces Pain Rating Scale (WBFPRS); at-home hypersensitivity to thermal (eating/drinking cold foods/beverages) and mechanical (brushing) stimuli was assessed by interviewing the patients. PFMs were evaluated at baseline, immediately after treatment and at 3-, 6-, and 12-month follow-ups.

Results

The sealant survival rate at the 12-month follow-up was 63.26% (n = 49). Survival probability was significantly higher for fully erupted PFMs compared to partially erupted ones (p = 0.028) and teeth with white – creamy opacities compared to those with yellow – brown opacities (p = 0.0071). PFMs with fully retained sealants received “Alpha” scores for all evaluated USPHS criteria. Seven cases of secondary caries – all occurring in PFMs with partially retained sealants – and six cases of PEB – all located on cusps – were diagnosed. Mean WBFPRS values improved from 4.75 at baseline to 2 at the 12-month follow-up, while at-home dentin hypersensitivity decreased by 18.9%.

Conclusion

Fully retained GI sealants were effective in preventing secondary caries and reducing dentin hypersensitivity in hypomineralised PFMs; however, they did not prevent PEB.

Statistics

A descriptive statistical analysis was performed. Survival curves were estimated using the Kaplan-Meier method with 95% confidence intervals. Comparisons of Kaplan-Meier curves were conducted using the log-rank test (p < 0.05).

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