Short-Term Effectiveness of Sealants After Silver Fluoride Application on MIH-Molars

Objectives: This study aimed to evaluate the clinical effectiveness of glass ionomer sealants (GIS) and resin-based sealants (RBS) applied either immediately or one week after silver fluoride (SF) application on permanent molars affected by molar-incisor hypomineralization (MIH) in high-caries-risk children.
Methods: Seventy-six molars affected by MIH with ICDAS 1-2 lesions were selected from 41 children aged 6 to 14 years. The teeth were randomly assigned to six groups: RBS or GIS applied one week after SF treatment, and RBS or GIS applied immediately after SF, either with cotton-drying or rinsing. Hypersensitivity, caries progression, and sealant retention were evaluated for each group at 1, 6, and 12 months. Hypersensitivity was measured using the Schiff Cold Sensitivity Scale(SCASS). Sealants were clinically assessed using modified USPHS criteria.
Results: Statistical analysis was performed using Fisher’s Exact Test and the Friedman test. Since this is a preliminary report, some expected values in cells were low, analyses were conducted by material type or overall. Of the 76 sealants, four had retention failures at the 12-months, all within the GIS group(14.3%, n=28; p = 0.016, Fisher’s Exact Test). Retention failures occurred in 17.6% of GIS applied one-week after SF application(n=17), compared to 1.7%(n=59) in the immediate application group. At 12-months, caries was observed in only one case in the RBS group. Among the 30 MIH-molars with initial hypersensitivity, there was a significant reduction in SCASS scores across all evaluation points compared to baseline(p < 0.001, Friedman test).
Conclusions: Within the limitations of a short observational period, it was observed that sealants applied after SF significantly reduced sensitivity, while GIS demonstrated lower retention rates compared to RBS at the 12-month follow-up. Further research with a larger sample size and longer follow-up is currently underway to explore the effects of rinsing or drying methods for SF in the immediate application groups.