Clinical performance of resin infiltration and different sealant modalities in noncavitated pits and fissures: a split-mouth randomized controlled trial.

OBJECTIVE

To compare the clinical performance of resin infiltration and different pit and fissure sealants in young permanent molars.

METHOD AND MATERIALS: This split-mouth randomized controlled trial evaluated 128 permanent molars with noncavitated occlusal lesions (ICDAS 0-2) in 32 children aged 7 to 14 years. Teeth were randomly allocated to four groups (n = 32 per group): resin infiltration (Group A), moisture-tolerant resin sealant (Group B), flowable nanohybrid composite (Group C), and a combination of group A and C (Group D). Outcomes assessed were ICDAS scores, DIAGNOdent values, marginal integrity, marginal discoloration, and retention at baseline, 6, and 12 months using generalized estimating equations (GEE) (P .05).

RESULTS

Significant reduction or stabilization in ICDAS scores occurred over time across all groups (P .001). Group A demonstrated significantly higher likelihood of ICDAS stabilization than Group C (OR 1.85; 95% CI 1.10-3.12; P = .021). Group D showed significantly lower lesion progression than Group B (OR 1.72; 95% CI 1.05-2.95; P = .034). At 12 months, retention was high, with only six teeth requiring revision (Group A, n = 1; Group B, n = 2; Group C, n = 3; Group D, n = 0). No significant intergroup differences in DIAGNOdent values or marginal integrity were observed (P > .05).

CONCLUSION

All four evaluated modalities demonstrated significant short-term cariostatic activity. Infiltration-based approaches, particularly the combination approach, demonstrated superior clinical performance by yielding minimal lesion progression, high retention rates, and the lowest incidence of clinical revision in high-caries-risk children.