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Performance of pit and fissure sealants according to tooth characteristics: A systematic review and meta-analysis


Papageorgiou, Spyridon N; Dimitraki, Dionysia; Kotsanos, Nikolaos; Bekes, Katrin; van Waes, Hubertus (2017). Performance of pit and fissure sealants according to tooth characteristics: A systematic review and meta-analysis. Journal of Dentistry, 66:8-17.

Abstract

OBJECTIVE: Aim of this systematic review was to assess the clinical performance of sealants on various teeth in an evidence-based manner.
SOURCES: Five databases were searched from inception to February 2017.
DATA: Randomized clinical studies on humans.
METHODS: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, Paule-Mandel random-effects meta-analyses of Relative Risks (RRs) and their 95% confidence intervals (CIs) were calculated.
RESULTS: A total of 16 randomized clinical trials with 2778 patients (male/female 49.1%/50.9%) and an average age of 8.4 years were included. No significant difference in either caries incidence of sealed teeth or sealant retention could be found according to (i) mouth side (right versus left), (ii) jaw (upper versus lower), (iii) and tooth type (1st permanent molar versus 2nd permanent molar/1st permanent molar versus 2nd deciduous molar/1st deciduous molar versus 2nd deciduous molar), based on evidence of very low to low quality. On the other side, compared to 1st permanent molars, sealed premolars were significantly less likely to develop caries (3 trials; RR=0.12; 95% CI=0.03 to 0.44; P=0.001) and less likely to experience loss of the sealant (5 trials; RR=0.33; 95% CI=0.20 to 0.54; P=0.001), both based on low to moderate quality evidence.
CONCLUSIONS: The performance of pit and fissure sealants does not seem to be negatively affected by mouth side, jaw, and tooth type, apart from the exception of a favorable retention on premolars.
CLINICAL SIGNIFICANCE: Based on existing evidence, pit and fissure sealants can be effectively applied on any deciduous or permanent posterior teeth without adverse effects on their clinical performance.

Abstract

OBJECTIVE: Aim of this systematic review was to assess the clinical performance of sealants on various teeth in an evidence-based manner.
SOURCES: Five databases were searched from inception to February 2017.
DATA: Randomized clinical studies on humans.
METHODS: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, Paule-Mandel random-effects meta-analyses of Relative Risks (RRs) and their 95% confidence intervals (CIs) were calculated.
RESULTS: A total of 16 randomized clinical trials with 2778 patients (male/female 49.1%/50.9%) and an average age of 8.4 years were included. No significant difference in either caries incidence of sealed teeth or sealant retention could be found according to (i) mouth side (right versus left), (ii) jaw (upper versus lower), (iii) and tooth type (1st permanent molar versus 2nd permanent molar/1st permanent molar versus 2nd deciduous molar/1st deciduous molar versus 2nd deciduous molar), based on evidence of very low to low quality. On the other side, compared to 1st permanent molars, sealed premolars were significantly less likely to develop caries (3 trials; RR=0.12; 95% CI=0.03 to 0.44; P=0.001) and less likely to experience loss of the sealant (5 trials; RR=0.33; 95% CI=0.20 to 0.54; P=0.001), both based on low to moderate quality evidence.
CONCLUSIONS: The performance of pit and fissure sealants does not seem to be negatively affected by mouth side, jaw, and tooth type, apart from the exception of a favorable retention on premolars.
CLINICAL SIGNIFICANCE: Based on existing evidence, pit and fissure sealants can be effectively applied on any deciduous or permanent posterior teeth without adverse effects on their clinical performance.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Orthodontics and Pediatric Dentistry
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:November 2017
Deposited On:27 Feb 2018 19:52
Last Modified:08 Aug 2018 00:00
Publisher:Elsevier
ISSN:0300-5712
OA Status:Green
Publisher DOI:https://doi.org/10.1016/j.jdent.2017.08.004
PubMed ID:28797916

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