Longevity of materials for pit and fissure sealing--results from a meta-analysis

This meta-analysis investigates the clinical retention of pit and fissure sealants in relation to observation time and material type.

A search in the MEDLINE, EMBASE and CENTRAL databases identified 2944 abstracts (published prior to 9/30/2011), of which 485 clinical publications were analyzed in detail. A total of 146 articles included information about sealant retention, with a minimum observation time of 2 years. These publications were analyzed to determine the retention rates of the various materials studied (UV-light-, light- and auto-polymerizing resin-based sealants, fluoride-releasing materials, compomers, flowable composites and glass-ionomer-cement-based sealants). The meta-analysis used random effects models for longitudinal logistic regression and Bayesian statistics.

As part of the systematic review, 98 clinical reports and 12 field trial reports were identified. Auto-polymerizing sealants had the longest observation time (up to 20 years) and were found to have a 5-year retention rate of 64.7% (95%CI=57.1-73.1%), which was estimated from the meta-analysis model. Resin-based light-polymerizing sealants and fluoride-releasing products showed similar 5-year retention rates (83.8%, 95%CI=54.9-94.7% and 69.9%, 95%CI=51.5-86.5%, respectively) for completely retained sealants. In contrast to these high retention rates, poor retention rates were documented for UV-light-polymerizing materials, compomers and glass-ionomer-cement-based sealants (5-year retention rates were <19.3%). Retention rates for UV-light-polymerizing materials, compomers and glass-ionomer-cement-based sealants were classified as inferior.

The results of this meta-analysis suggested that resin-based sealants can be recommended for clinical use. The faster and less error-prone clinical application of light-polymerizing materials, however, makes them the preferred choice for daily dental practice.