ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Composite Resin Sealants Are More Cost- and Time-Effective Than Glass Ionomer Sealants
Clinical Question In terms of cost and time, are glass ionomer sealants as effective as composite resin-based sealants?
Clinical Bottom Line Glass ionomer sealants require more time to apply and have an average cost higher than composite resin sealants; resin sealants also have better retention at 2, 3 and 5 years, adding to their cost effectiveness. This is supported by a prospective randomized clinical trial that compared the cost and time effectiveness of different ionomer-based sealants to composite resin sealants. In addition, composite resin sealants have a four-fold higher retention rate after 5 years.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24799118Goldman/2014Chinese children aged 7 to 9Randomized Controlled Trial
Key resultsThis RCT compared the cost and time effectiveness of high-viscosity glass ionomer both with and without heat curing, LED-cured glass-carbomer, and LED-cured composite resin sealants. There was no difference in cost or time among the glass ionomer groups, which took 8.09 minutes and cost $8.39, whereas the composite resin group required 5.4 minutes and cost $3.30. Cost per sealant included personnel time and was presented in 2010 U.S. dollars.
#2) 22137936Kuhnisch/201298 clinical trials, 12 field trialsMeta-Analysis
Key resultsComposite resin sealants have greater retention over a 5-year period than glass ionomer sealants. The retention rates at 5 years for composite resin sealants was found to be 83.8%, for glass ionomer sealants, 19.3% .
Evidence Search Sealants, Glass Ionomer, Time Cost
Comments on
The Evidence
There is a lack of evidence related to this question, as also identified by the author of the cited article (Goldman, 2014). The study cited was a community-based approach conducted in China. It was a prospective blinded RCT where patient and examiner were blinded. While personnel time was accounted for in the cost, the hourly wage for the operator or auxiliary were not stated, nor were the actual cost of the materials. There was a four-week laboratory and field-training program to introduce the practitioners to the different sealant systems. A meta analysis (Kuhnisch, 2012) was included as a second reference to demonstrate that the retention rates of composite resin sealants is greater and further adds to their cost-effectiveness.
Applicability This CAT, while based on an article designed to address community-based dental concerns, is also applicable to the general dentist deciding the type of sealant to be used in their practice.
Specialty/Discipline (Public Health) (General Dentistry) (Periodontics)
Keywords Pit Fissure Sealant, Resin, Glass Ionomer, Time, Retention
ID# 2783
Date of submission: 11/20/2014spacer
E-mail lewismp@uthscsa.edu
Author Mark Lewis, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Kyumin Whang, PhD
Faculty mentor/Co-author e-mail whang@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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