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

Aim of this systematic review was to assess the clinical performance of sealants on various teeth in an evidence-based manner.

Five databases were searched from inception to February 2017.

Randomized clinical studies on humans.

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.

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.

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.

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.