Methods: This was a randomized controlled clinical trial. Children who had at least one sound first permanent molar with deep fissures or fissures with signs of non-cavitated lesions were recruited. They were randomly allocated into three groups. HeliosealF, a light-cured resin-based sealants, FUJIVII, a light-cured glass ionomer sealants were used, and the control group was blank. Follow-up examinations were conducted at 6, 12, and 24 month after sealing to examine the sealants retention and caries incidence. The cost-effectiveness of two sealants was analyzed.
Results: A total of 664 teeth in 419 children were recruited. At 24m evaluation, significant differences in the incidence of dental cries were found among the three groups (p<0.05). The tooth-level preventive fractions were 79.6% for HeliosealF and 54.4% for FUJIVII. Logistic regression using generalized estimating equations showed that HeliosealF (OR=0.18, p<0.05) , FUJIVII (OR=0.46, p<0.05) were protective factors while non-cavitated lesion at baseline(OR=5.25, p<0.05) was the risk factor for caries incidence. No significant difference in the protective efficiency of HeliosealF and FUJIVII was found (p>0.05). To prevent one tooth decay, 8.2 teeth were needed to be sealed for HeliosealF and 12.6 teeth for FUJIVII. The cost of materials were 29.73 yuan for HeliosealF and 22.57 yuan for FUJIVII. Therefore, HeliosealF would be more cost-effective if the common cost of the two sealants was higher than 1.63 yuan, and otherwise, FUJIVII would be more cost-effective.
Conclusions: Both resin-based sealants and glass ionomer sealants can reduce the incidence of caries. Neither of the two sealants was superior to the other. The social-economic background and medical service level should be considered when choosing a proper sealant in a public health program of sealants.