This study was performed to examine the 9-year success of the composite resin/sealant restoration, which uses sealing for prevention of fissure caries rather than cavity extension for prevention. Three hundred thirty-two Class I restorations were placed in the occlusal surfaces of 240 permanent molar teeth in 114 children aged 6 to 14. Cavity preparations were made in occlusal surfaces, and caries was removed with no attempt to create any additional retention or remove undermined enamel. Exposed dentin was covered with Dycal and the cavity was restored with Radipaque Adaptic, which was then covered with Delton fissure sealant. Incipient lesions confined to the enamel were restored only with Delton. After 9 years, 79 restorations in 28 subjects were examined for sealant retention, marginal staining, and the presence of dental caries. Forty-three restorations (54%) had completely retained sealants, 20 (25%) had sustained partial loss, and 16 (20%) of the restorations had lost all sealant. Dental caries occurred in 19 (25%) of the restorations that had sealant loss. An additional 16 teeth had proximal caries unrelated to the occlusal restoration. These findings demonstrated that the composite resin/sealant (preventive resin) restoration produced excellent long-term results.