Avaliacao clinica dos selantes realizados com cimento de ionomero de vidro modificado por resina (vitremer©) em molares deciduos / Clinical evaluation of a resin-modifi ed glass ionomer cement (Vitremer©) used as pit-and-fissure sealant in primary molars

RESUMO

Objetivo: Avaliar a eficacia preventiva do cimento de ionomero de vidro modificado por resina (Vitremer) utilizado como selante em molares deciduos, apos seis meses de sua aplicacao. Metodo: Foram selados o molar superior direito e inferior esquerdo com CIV-mr (G2) e os dentes antagonistas ficaram sem selamento (grupo controle G1) em uma amostra de 30 criancas com 24 a 60 meses de idade. Apos 6 meses os selantes foram avaliados por dois examinadores previamente calibrados, com isolamento relativo, apos profilaxia e sob a luz do refletor. Para avaliacao dos selantes empregou-se criterio quanto a retencao, presenca de carie secundaria, e descoloracao marginal. Alem disso, registrou-se o indice de higiene bucal medio (IHB) e o indice de carie (ceo-s). Os dados foram analisados pelo teste exato de Fisher com nivel de significancia de 5%. Resultados: De um total de 58 dentes, 96,55% permaneceram livres de carie dentaria, com retencao total e parcial de 94,64%, embora sem relacao evidente entre os grupos selante/controle e carie dentaria. Houve associacoes entre o ceo-s com a descoloracao marginal do selante e com o IHB, sendo que o IHB satisfatorio mostrou ausencia de carie dentaria. Houve efetividade do selamento oclusal quanto a prevencao da carie e uma satisfatoria retencao quando considerada a retencao parcial. Conclusao: O cimento de ionomero de vidro modificado por resina pode ser uma alternativa promissora como selante oclusal em molares deciduos, desde que incorporado a uma serie de medidas educativas e preventivas, considerando o fator de risco da crianca.

ABSTRACT

Objective: To evaluate the preventive efficacy of a resin modified glass ionomer cement (RMGIC) (Vitremer) used as a pit-and-fissure sealant in primary molars 6 months after placement. Method: In a sample of 30 children aged 24 to 60 months, the maxillary right and mandibular left primary molars were sealed with the RMGIC (G2) while their antagonists were not sealed (G1 - control group). Six months after sealant placement, the sealants were assessed by two previously calibrated examiners after professional prophylaxis and relative isolation, with the direct illumination of the dental chairs light reflector. The following criteria were considered for evaluation of the sealants retention, presence of secondary caries, and marginal staining. In addition, the mean oral hygiene index (OHI) and the caries index (dmf-t) were assessed. Data were analyzed statistically bythe Fishers exact test at a significance level of 5%. Results: From a total of 58 teeth, 96.55% were caries free, with total or partial retention of 94.64% of the sealants, though without an evident relationship between the sealant/control groups and dental caries. There was association between dmf-t and sealers marginal staining and OHI; satisfactory OHI showed absence of dental caries. Occlusal sealing was effective with respect to caries prevention and showed satisfactory retention as far as partial retention is considered. Conclusion: The RMGIC can be a promising alternative as an occlusal sealant in primary molars, as far as a series of educative and preventive are adopted, according to the childs caries risk factor.