Sealants generally show equal performance regardless of tooth type and position

Area of Science:

• Dental Public Health
• Evidence-Based Dentistry
• Clinical Trials

Background:

• Pit and fissure sealants are crucial for preventing dental caries.
• Understanding sealant performance across different anatomical locations is essential for optimizing treatment strategies.

Purpose of the Study:

• To systematically evaluate and compare the clinical performance of pit and fissure sealants across various sites and tooth types.
• To synthesize evidence on sealant retention rates and caries incidence based on anatomical location and tooth morphology.

Main Methods:

• Conducted a meta-analysis of randomized clinical trials (RCTs) sourced from multiple databases (PubMed, CENTRAL, LILACS, Scopus, etc.).
• Included 16 RCTs with 2,778 participants, analyzing caries incidence and sealant retention.
• Assessed risk of bias using the Cochrane Risk of Bias tool and performed meta-analyses of Relative Risks (RRs).

Main Results:

• No significant differences in caries incidence or sealant retention were found for mouth side, arch (maxilla vs. mandible), or between molars and primary molars (very low to low quality evidence).
• Sealed premolars demonstrated significantly lower caries incidence and sealant loss compared to first permanent molars (low to moderate quality evidence).

Conclusions:

• Pit and fissure sealants exhibit comparable efficacy in terms of retention and caries prevention across different oral sites and tooth types, with a notable exception for premolars.
• Premolars show more favorable outcomes, suggesting potential differences in sealant effectiveness based on tooth morphology.
• The overall evidence quality is very low to moderate, necessitating caution in interpreting findings and guiding clinical practice.