How it works and clinical effectiveness
As well as being highly effective for prevention of dental caries,30 placing a well-sealed fissure sealant over a carious lesion will arrest it and stop it from progressing.57,58,59,60
While shallow or moderately deep lesions are likely to be successfully managed, there is not enough evidence to make recommendations for deeper lesions for long-term management. Although they may provide a good seal, they will not add much to the strength of the tooth. Their application is limited to teeth where there is less weakening of the tooth structure (that is, less extensive lesions) and the tooth structure can support them. In cases where the lesion is extensive, the sealant may not be able to withstand breakdown of the lesion surface if the forces are high.
Although they have a lower retention rate than resin sealants, the therapeutic effect of GIC on the tooth seems to balance the bulk material loss. There is good evidence to support a high caries-preventive effect from high-viscosity glass-ionomer sealants.30 However, there is little directly comparable evidence, as yet, on their relative performances sealing dentinal carious lesions.