A Prospective Clinical Evaluation of the Retention of Glass Ionomer Cement Versus Resin-Based Pit and Fissure Sealants Among School Children

Introduction Dental caries are commonly observed in schoolchildren, particularly on the complex pit and fissure surfaces of permanent molars, which readily trap plaque and debris, making sealants a critical preventive intervention. This prospective comparative clinical study sought to assess the retention rates and clinical performance of glass ionomer cement (GIC) and resin-based sealants in a school-based setting among children aged 7-10 years. Materials and methods This study was carried out in government primary schools in Bhopal, India, from June to December 2024. Eighty children with at least one caries-free permanent first molar were non-randomly assigned to two groups (n = 40 per group). Group 1 received a high-viscosity glass ionomer cement (GIC) sealant (Fuji IX GP; GC Corp., Tokyo, Japan), applied using the press-finger technique following polyacrylic acid conditioning. Group 2 received a light-cured, fluoride-releasing resin-based sealant (Clinpro; 3M ESPE, 3M Company, St. Paul, MN), applied after phosphoric acid etching. Sealants were placed by a single operator using a portable device. Retention was evaluated at five months using a custom three-point scoring system (complete, partial, or complete loss), with high intra- and inter-examiner reliability (kappa ≥0.85). Data were analyzed using Chi-square, Mann-Whitney U, and Kaplan-Meier survival tests (p<0.05). Results Resin-based sealants showed significantly higher retention, with 38% complete retention compared with 26% for GIC, and lower failure rates (13% versus 24%; p = 0.031). Survival analysis demonstrated greater longevity of resin-based materials, with fissure sites performing better than pits (p = 0.001). Twice-daily toothbrushing was associated with better sealant retention (p = 0.021). No significant differences were found with respect to age, sex, or diet. Conclusions Resin-based sealants demonstrated superior short-term retention and durability compared with GIC in schoolchildren. The choice of material should take into account the clinical setting and patient-related factors to optimize caries prevention.