The purpose of this study is to compare the clinical success between preventive resin restoration, and pit and fissure sealant in terms of retention and caries prevention on first permanent molar. Data were collected from the patients’ case records in Pediatric Dentistry clinic. Records of children who had done their sealants and preventive resin in their first permanent molar were reviewed. 61 patients had preventive resin restoration and 56 pit and fissure sealant done in permanent first molar 2 years ago were included and called for clinical review. Participants were between 6-10 years. Visual and tactile assessment was done to detect the integrity of preventive resin restoration and pit and fissure sealants under 4 categories whether the sealant or PRR is total lost, partial lost, completely present, carious. Data was analyzed using descriptive statistics. At the end of 2 years, sealants showed 64.3 % total retention, 21.4% partial retention and 10.7% complete loss when compared to PRR which showed 62.2% total retention, 14% partial retention and 4.9% complete loss. Preventive resin restoration have more tendency to have caries, while teeth with pit and fissure sealants does not (18% vs. 3.6%). As a conclusion, pit and fissure sealants have marginally higher retention compared to preventive resin restoration on permanent molars. Pit and fissure sealant is better in terms of caries prevention compared to preventive resin restoration
