Pits and fissure sealant guidelines. Summary guideline

The guideline aims to address four clinical questions relating to the use of pit and fissure sealants:Under what circumstances should sealants be placed to prevent caries?Does placing sealants over early (noncavitated) lesions prevent progression of the lesions?Are there conditions that favour the placement of resin-based versus glass ionomer cement sealants in terms of retention or caries prevention?Are there any techniques that could improve sealants' retention and effectiveness in caries prevention?

Medline was searched for all systematic reviews on pit and fissure sealants, and the reference lists of identified reviews were searched for additional references. A second search was carried out to identify clinical studies published after the systematic review were completed. Publications were included that addressed one or more of the identified clinical questions, had a documented search strategy, and were written in English. An expert panel was convened to evaluate the evidence and develop recommendations. The draft recommendations were submitted to a wide range of scientific experts and organisations for review, following which appropriate changes were made. The evidence was classified and clinical recommendations made using a system modified from the approach taken by Shekell et al.(1) The final clinical recommendations were approved by the American Dental Association Council on Scientific Affairs.

Plans were not specified for future review and updating of this guideline.

Using the evidence grading and recommendation systems described by Shekelle(1) (Table 1 and 2) a number of clinical recommendations were made (see summary in Table 3).

A number of topics for additional research to improve the evidence base regarding the use of fissure sealants were identified by the expert panels. These are shown in Table 2.