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Evidence-based Dentistry Mar 2023To compare the effectiveness of hydrophilic resin-based versus hydrophobic resin-based and glass-ionomer pit and fissure sealants. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To compare the effectiveness of hydrophilic resin-based versus hydrophobic resin-based and glass-ionomer pit and fissure sealants.
METHODS
The review was registered with Joanna Briggs Institute and followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, Google Scholar, Virtual Health Library, and Cochrane Central Register of Controlled Trials were searched from 2009-2019 using appropriate keywords. We included randomized controlled trials and randomized split-mouth trials conducted among 6-13-year-old children. The quality of included trials was assessed using modified Jadad criteria and risk of bias using guidelines specified by Cochrane. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) guidelines were used to assess the overall quality of studies. We used the random-effects model for meta-analysis. Relative risk (RR) and confidence intervals (CI) were calculated & heterogeneity was tested using I² statistic.
RESULTS
Six randomized clinical trials and five split-mouth trials met the inclusion criteria. The outlier augmenting the heterogeneity was omitted. Based on very-low to low-quality evidence, loss of hydrophilic resin-based sealants was less likely as compared to glass-ionomer fissure sealants (4 trials at 6 months; RR = 0.59; CI = 0.40-0.86), while it was similar or slightly lower than hydrophobic resin-based sealants (6 trials at 6 months; RR = 0.96; CI = 0.89-1.03); (6 trials at 12 months; RR = 0.79; CI = 0.70-0.89); (2 trials at 18 months; RR = 0.77; CI = 0.48-0.25).
CONCLUSION
This study revealed that retention of hydrophilic resin-based sealants is better than glass ionomer sealants but similar to hydrophobic resin-based sealants. However, higher-quality evidence is necessary to underpin the outcomes.
Topics: Child; Humans; Adolescent; Cariostatic Agents; Dental Caries; Acrylic Resins; Silicon Dioxide; Pit and Fissure Sealants
PubMed: 36882497
DOI: 10.1038/s41432-023-00850-2 -
Community Dentistry and Oral... Feb 2018To systematically review the literature on economic evaluations of dental sealants and examine the costs and effectiveness of caries prevention using sealants.
OBJECTIVES
To systematically review the literature on economic evaluations of dental sealants and examine the costs and effectiveness of caries prevention using sealants.
METHODS
Of 21 full-text articles examined, a total of 13 were included in this study. These studies are grouped by the type of intervention as follows: (i) sealants compared with no sealants; (ii) sealants compared with other forms of caries prevention; (iii) resin-based sealants compared with glass-ionomer sealants; (iv) different sealing strategies in primary teeth; (v) different sealing strategies in permanent teeth; and (vi) sealants based on school- or clinic-based setting of delivery. All currency is reported in constant 2010 US$.
RESULTS
Cost-effectiveness analyses differed due to varying study designs, assumptions, sealant delivery settings, outcomes, caries risk assessment and study durations. Findings varied on the cost-effectiveness of sealants compared with other caries-preventive strategies. Under the assumption of equal caries risk, always sealing primary molars appeared to be the most effective strategy, whereas risk-based sealing was the optimal strategy with differing caries risk. Studies that assessed sealing strategies in permanent teeth reported that risk-based sealing was more cost-effective than not sealing, but they differed on the cost-effectiveness of risk-based seal compared with non-risk-based seal. Sealants delivered in school settings had mixed results on costs but were as equally effective as sealants delivered in private practices.
CONCLUSIONS
The cost-effectiveness of sealants is dependent on the conditions of delivery. The list of cost-effectiveness ratios for each intervention can support policy makers to estimate expected returns on their investments in dental sealants.
Topics: Cost-Benefit Analysis; Dental Caries; Health Care Costs; Humans; Pit and Fissure Sealants
PubMed: 28876472
DOI: 10.1111/cdoe.12326 -
Journal of the American Dental... Jul 2018The aim of this systematic review and meta-analysis was to evaluate the ability of glass ionomer cements (GICs) and resin-based sealants (RBSs) to prevent the occurrence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The aim of this systematic review and meta-analysis was to evaluate the ability of glass ionomer cements (GICs) and resin-based sealants (RBSs) to prevent the occurrence of caries and their retention in standards-based clinical studies.
TYPES OF STUDIES REVIEWED
The authors conducted a literature search (from database inception through September 20, 2017) to identify studies for inclusion in this systematic review. The authors assessed the quality of the evidence with the modified Jadad scale and performed the meta-analysis by using a random-effects model.
RESULTS
The authors considered 20 studies on caries prevention and 28 studies on retention that met the inclusion criteria for the meta-analysis. The results of the meta-analysis for caries development showed no significant difference (odds ratio, 0.938; 95% confidence interval, 0.647 to 1.359; P = .734). However, the result for the retention rate showed the advantage of RBSs (odds ratio, 6.006; 95% confidence interval, 3.226 to 11.183; P = .000).
CONCLUSIONS AND PRACTICAL IMPLICATIONS
There was no difference between the percentage of caries development with use of GICs as fissure sealing material compared with that for the conventional RBSs, but the retention rate of conventional RBSs was much higher than that of the GICs.
Topics: Databases, Factual; Dental Caries; Glass Ionomer Cements; Humans; Pit and Fissure Sealants
PubMed: 29735163
DOI: 10.1016/j.adaj.2018.02.001 -
International Journal of Paediatric... Nov 2016Occlusal sealants are an effective method for caries prevention, although the effectiveness of different application strategies has not been established yet. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Occlusal sealants are an effective method for caries prevention, although the effectiveness of different application strategies has not been established yet.
AIM
This systematic review compared the retention rate of sealants placed on occlusal surfaces following the use of self-etch adhesive systems and traditional acid etching, with or without the application of adhesive system.
DESIGN
Literature searching was carried out until June 2015 in PubMed/MEDLINE, CENTRAL, and ClinicalTrials databases selecting randomized clinical trials that evaluated self-etch adhesive systems associated with pit and fissure sealants in primary or permanent molars comprising retention as outcome. From 683 potentially eligible studies, 10 were selected for full-text analysis and 5 were included in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the bias risk. Pooled-effect estimates were obtained by comparing the retention failure rate between groups (self-etch systems vs acid etching with or without adhesive systems).
RESULTS
Significant difference was found between groups, favoring the control group (prior acid etching) (P < 0.05), which showed lower failure rate in the retention of occlusal sealants. High heterogeneity was found on the meta-analysis. Most trials showed good evidence strength.
CONCLUSIONS
Occlusal sealants applied with self-etch systems show lower retention throughout time than sealants applied in the conventional approach, regardless of the use of adhesive systems.
Topics: Acid Etching, Dental; Cariostatic Agents; Child; Dental Caries; Dental Cements; Humans; Molar; Pit and Fissure Sealants
PubMed: 26590954
DOI: 10.1111/ipd.12214 -
Annals of Medicine and Surgery (2012) Feb 2024Lateral internal sphincterotomy (LIS) has been the gold standard for treating chronic anal fissure (CAF) that persists despite other measures. The authors aim to... (Review)
Review
BACKGROUND
Lateral internal sphincterotomy (LIS) has been the gold standard for treating chronic anal fissure (CAF) that persists despite other measures. The authors aim to evaluate the effects of the close method (CLIS) of performing LIS as compared to the open method (OLIS).
METHODS
Databases were searched for relevant studies and results were screened to identify eligible articles, and all concerned outcomes were pooled as odd ratio (OR) or mean difference (MD) with 95% CI in the meta-analysis models using RevMan 5.4.
RESULTS
Pooled data from 16 trials with 1,711 patients with idiopathic CAF showed that the CLIS has significant lower risk of delayed fissure healing [OR: 0.28, 95% CI (0.10, 0.77), = 0.01], duration of hospital stay [MD: -0.82 with 95% CI (-1.07, -0.57), < 0.00001] and postoperative visual analogue pain score (VAPS) at 24 h [MD: -0.30 with 95% CI (-0.39, -0.21), < 0.00001]. Also, the risk of overall complications [OR: 0.33 with 95% CI (0.19, 0.55), < 0.0001], incontinence [OR: 0.28 with 95% CI (0.20, 0.38), < 0.00001], and postoperative pain [OR: 0.56 with 95% CI (0.35, 0.91), = 0.02] was significantly lower with CLIS.
CONCLUSION
CLIS is a safer option than OLIS for treating anal fissure. The risk of delayed fissure healing, incontinence, post-op pain and overall complication was significantly lower. However, the risk of surgical site infection, postoperative bleeding and recurrence did not differ. Future research with more prolonged follow-up is necessary to document recurrence reliably.
PubMed: 38333259
DOI: 10.1097/MS9.0000000000001593 -
La Clinica Terapeutica 2016
Review
Topics: Cost-Benefit Analysis; Dental Caries; Humans; Pit and Fissure Sealants
PubMed: 26980637
DOI: 10.7417/T.2016.1914 -
International Journal of Environmental... May 2019(1) Background: Bisphenol A (BPA) based dental resins are commonly used in preventive and reparative dentistry. Since some monomers may remain unpolymerized in the...
(1) Background: Bisphenol A (BPA) based dental resins are commonly used in preventive and reparative dentistry. Since some monomers may remain unpolymerized in the application of dental resin, they dissolve in the saliva. (2) Methods: The literature search was carried out in Pubmed, Cochrane and Embase databases. Randomized controlled trials, cohort studies and case-control studies that evaluated BPA levels in human urine, saliva and/or blood were included. (3) Results: The initial search had 5111 results. A total of 20 studies were included in the systematic review. Most studies showed an increase of the levels of bisphenol A 1 h after treatments with composite resins and dental sealants. One week after treatments the levels were decreased. (4) Conclusions: Some clinical precautions should be taken to decrease the release of BPA, namely the use of rubber dam, the immediate polishing of all resins used, or the use of glycerin gel to avoid non-polymerization of the last resin layer, and mouthwash after treatment. Another preventive measure in addition to the above-mentioned is the use of the smallest possible number of restorations or sealants, a maximum of four per appointment. These measures are even more important in children, adolescents and pregnant women.
Topics: Animals; Benzhydryl Compounds; Case-Control Studies; Cohort Studies; Humans; Phenols; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Resins, Synthetic
PubMed: 31075949
DOI: 10.3390/ijerph16091627 -
Scientific Reports Feb 2020The high prevalence and heavy socio-economic burden for caries of first permanent molars (FPMs) make the prevention of this disease a major public health goal. Current... (Meta-Analysis)
Meta-Analysis
The high prevalence and heavy socio-economic burden for caries of first permanent molars (FPMs) make the prevention of this disease a major public health goal. Current guidelines recommend a preference of fissure sealant (FS) over fluoride varnish (FV) based on two recent systematic reviews. However, evidences of these two studies are weak because of scarce data and some limitations. Besides, an up-to-date large scale randomized controlled trial (RCT) reported commensurate effectiveness of these two techniques. Thus, in order to more accurately compare the clinical efficacy between FS and FV on caries prevention for FPMs, we carried out this systematic review and meta-analysis. A total of 8 RCTs involving 3289 participants and 6878 FPMs fulfilled the inclusion criteria. Our meta-analysis for the first time showed that there was no statistical difference on caries incidence or occlusal DMFS increment between sealant group and fluoride varnish group at 2~3 years' follow-up. In that sense, biannual applications of FV or FS may be equally effective on caries prevention for FPMs. These results do not support routine recommendation of FS over FV, thus shedding light on current conceptions. Our findings endow clinicians with a window to reconsider the choice between these two techniques.
Topics: Dental Caries; Fluorides, Topical; Guidelines as Topic; Humans; Molar; Pit and Fissure Sealants
PubMed: 32055001
DOI: 10.1038/s41598-020-59564-5 -
Dental Materials : Official Publication... May 2020This systematic literature review and meta-analysis compared the clinical retention of primed or adhesively bonded sealants to that of conventional sealant materials. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This systematic literature review and meta-analysis compared the clinical retention of primed or adhesively bonded sealants to that of conventional sealant materials.
METHODS
A search of the MEDLINE, EMBASE and CENTRAL databases identified 3707 abstracts published prior to 12/31/2017, of which 335 clinical publications were analysed in detail. A total of 67 studies included information about sealant retention after 24, 36, or 60 months of follow-up. A meta-analysis using a random effects model was conducted to calculate the pooled estimate of the retention rates for the five groups of sealants. Subgroup moderator analysis was performed to compare the pooled retention rate estimate (RRE) of primed sealants against those of the other groups.
RESULTS
Primed sealants had a 2-year pooled RRE of 43.2% (95% CI: 30.5-55.8), which was significantly inferior to those of auto-polymerizing (80.8%, 95% CI: 72.2-89) and light-polymerizing sealants (68.4%, 95% CI: 60.2-76.7). Fluoride-releasing and light-polymerizing sealants had the highest 3-year pooled RREs (86.4%, 95% CI: 73.4-99.3 and 83.1%, 95% CI: 75.6-90.7, respectively).
SIGNIFICANE
The results of this meta-analysis suggest that primed sealants cannot be fully recommended for clinical practice due to their moderate survival rates. Auto-polymerizing, light-polymerizing and fluoride-releasing sealants continue to be considered the reference standards for pit and fissure sealants. However, future generations and developments of primed sealant materials may change this position.
Topics: Dental Caries; Fluorides; Humans; Pit and Fissure Sealants
PubMed: 32061445
DOI: 10.1016/j.dental.2020.02.001 -
Journal of the American Dental... Feb 2023
Meta-Analysis Review
Plain language summary for "Direct materials for restoring caries lesions: systematic review and meta-analysis-a report of the American Dental Association Council on Scientific Affairs".
Topics: United States; Humans; American Dental Association; Dental Caries Susceptibility; Dental Caries; Pit and Fissure Sealants; Language
PubMed: 36610924
DOI: 10.1016/j.adaj.2022.10.007