Contemporary materials for the prevention of occlusal carious lesions

Prevention of occlusal caries has been a longstanding challenge in dentistry, evolving appropriately from invasive mechanical techniques toward increasingly adhesive and bioactive strategies. Early attempts, such as the application of silver nitrate and preventive restorations, were limited by questionable efficacy and unnecessary removal of sound tooth structure. The advent of adhesive dentistry and the acid-etching technique enabled the development of resin-based sealants, providing a minimally invasive and effective method for fissure protection. Over time, sealant materials have evolved through four generations, introducing improved polymerization mechanisms, fillers, and fluoride release to enhance wear resistance, retention, and antibacterial properties. However, conventional glass ionomer cements (GICs) demonstrate lower mechanical strength and retention compared to resin-based sealants. Subsequently, resin-modified GICs were developed to address these shortcomings while maintaining fluoride release. More recently, hybrid materials such as compomers and giomers have combined the advantages of composites and GICs, offering improved adhesion, esthetics, and release of bioactive ions—although their fluoride release remains lower than that of conventional GICs. Overall, the evolution of pit and fissure sealants reflects a transition from invasive preventive approaches to minimally invasive, bioactive, and fluoride-releasing materials.