-
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 -
The Journal of Evidence-based Dental... Jun 2020The use of pit and fissure sealants have been well supported in permanent teeth, but no concrete evidence is available to support this procedure in primary molars. This... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The use of pit and fissure sealants have been well supported in permanent teeth, but no concrete evidence is available to support this procedure in primary molars. This review aims to systematically assess randomized controlled trials and summarize the evidence on the effectiveness of different sealants in prevention and arrest of the pit and fissure occlusal caries in primary molars of children.
MATERIALS AND METHODS
Four electronic databases were searched from inception to March 2018. Seven studies were included in the qualitative and quantitative syntheses. Two reviewers independently selected studies, extracted data, assessed risk of bias using the revised Cochrane risk of bias tool, and evaluated the certainty in the evidence adopting the Grading of Recommendations Assessment Development and Evaluation approach. Odds ratio and retention rate of different sealants were recalculated and analyzed.
RESULTS
This review identified no significant difference in the overall caries incidence and progression when evaluated over 24 months between (1) resin-based sealant (RBS) and glass ionomer sealants (GIS) or resin-modified GIS; (2) conventional and newly developed RBS; (3) autopolymerized and light-polymerized RBS; (4) RBS with topical fluoride application and topical fluoride alone; and (5) RBS with topical fluoride application and resin infiltration with topical fluoride application. The pooled estimates of the mean retention rates of RBS and GIS on primary molars over an 18-months period were 85.94% and 23.18%, respectively. The certainty in the evidence of each outcome was determined as low or very low mainly because of high risk of overall bias and imprecision.
CONCLUSION
There are currently insufficient well-controlled randomized controlled clinical trials to determine whether sealants are beneficial in preventing or arresting noncavitated occlusal caries in the primary molars.
Topics: Child; Dental Caries; Dentition, Permanent; Fluorides, Topical; Humans; Molar; Pit and Fissure Sealants
PubMed: 32473795
DOI: 10.1016/j.jebdp.2020.101404 -
Nigerian Journal of Clinical Practice Jun 2022Evidence-based information should be provided to clinicians to explain the effectiveness of hydrophilic and hydrophobic forms of resin based sealants (RBSs). (Meta-Analysis)
Meta-Analysis
BACKGROUND
Evidence-based information should be provided to clinicians to explain the effectiveness of hydrophilic and hydrophobic forms of resin based sealants (RBSs).
AIM
To assess and evaluate the retention and cariostatic effect of hydrophilic and hydrophobic RBSs in primary and/ or permanent teeth with at least a follow-up period of 3 months.
MATERIALS AND METHODS
Five databases were searched up to September 2021 for randomized and non-randomized clinical trials (RCTs and non-RCTs) that evaluated the retention and cariostatic effect of hydrophilic and hydrophobic RBSs. Two authors nominated the papers, extracted data, and assessed the risk of bias.
RESULTS
By comparing the retention rate and caries incidence between groups, pooled-effect estimates of included articles were generated. After removing duplicates from the 2,810 titles found, only 1938 remained. Twelve of these were thoroughly examined. A total of 12 papers met the inclusion criteria in qualitative analysis: seven RCTs and five non-RCTs. Only ten studies were included in the meta-analysis: five RCTs and five non-RCTs. After 12 months of follow-up, no significant difference was found in the retention of hydrophilic and hydrophobic RBSs with and without a bonding agent. After 12 months of follow-up, no significant difference was found in the cariostatic effect of hydrophilic and hydrophobic RBSs.
CONCLUSION
There was no statistically significant difference in retention and the cariostatic impact was found between hydrophilic and hydrophobic RBSs.
Topics: Cariostatic Agents; Dental Caries; Dentition, Permanent; Humans; Pit and Fissure Sealants
PubMed: 35708429
DOI: 10.4103/njcp.njcp_1863_21 -
BMC Oral Health Sep 2019This systematic review aimed to assess the clinical effects of laser preparation compared to other types of chemical or mechanical preparation of tooth surfaces used in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This systematic review aimed to assess the clinical effects of laser preparation compared to other types of chemical or mechanical preparation of tooth surfaces used in fissure sealant placement.
METHODS
A systematic literature search was conducted up to January 2019, through Pubmed, Scopus, Medline/EMBASE via OVID and the Cochrane library. Only randomized clinical trials were included.
RESULTS
Five studies were included in the systematic review and three were included in the meta-analysis. All the studies used acid-etching as a comparator to lasers. All the included studies were rated as having an overall high risk of bias introduced by performance bias. Three studies assessed the clinical effects of fissure sealants placed by acid or laser etching, one compared acid etching versus laser combined with acid etching and one investigated the influence of lasers on the objective and subjective parameters of stress during sealant application in children. The meta-analysis showed no significant difference between laser preparation and conventional acid-etching preparation at 3- (P = 0.08), 6- (P = 0.49), and 12-month (P = 0.87) follow-ups. One study reported that laser preparation as an adjunct to acid-etching enhanced the retention rate. No significant difference in the incidence of caries was reported. And no significant differences were found in heart rates, oxygen saturation or degree of the patient dental anxiety between acid-etching and laser preparation.
CONCLUSION
The present limited evidence suggests that lasers could be an effective pretreatment method. The retention rate was similar to that of conventional acid etching. However, the included studies had an overall high risk of bias and more rigorously designed research is needed.
Topics: Acid Etching, Dental; Child; Dental Anxiety; Dental Caries; Humans; Lasers, Solid-State; Pit and Fissure Sealants
PubMed: 31477081
DOI: 10.1186/s12903-019-0892-4 -
Pediatric Dentistry Sep 2023The purpose of this study was to review the in vitro literature on shear bond strength (SBS) and microleakage of pit and fissure sealant materials in contaminated... (Meta-Analysis)
Meta-Analysis
The purpose of this study was to review the in vitro literature on shear bond strength (SBS) and microleakage of pit and fissure sealant materials in contaminated (water, human, or artificial saliva) and non-contaminated conditions. PubMed, Web of Science™, Scopus, Embase™, and Cochrane Library databases were used as data sources. Of the 974 studies identified, 56 were considered eligible for full-text screening and 32 were selected for data extraction. The meta-analysis demonstrated that contaminated conditions decreased the SBS of the sealants by 4.33 MPa. In the contaminated subgroup analysis, both unfilled (Clinpro™, 3M™) and filled (FluroShield, Dentsply) resin-based sealants achieved a similar SBS (P=0.82). Regarding the outcome measurements, extensive methodological heterogeneity was found among the studies for SBS measurements (I 2 equals greater than or equal to 84 percent; P<0.001), whereas homogeneity was found for microleakage (I 2 equals 84 percent; P=0.85). When evaluating resin-based sealants, the level of microleakage in the contaminated and non- contaminated groups was not significantly different (P=0.1). Surface contamination decreases the bond strength between contaminated enamel and both unfilled and filled resin-based sealants, which affects the clinical effectiveness of sealants.
Topics: Humans; Pit and Fissure Sealants; Bisphenol A-Glycidyl Methacrylate; Dental Bonding; Saliva; Dental Enamel; Shear Strength; Materials Testing
PubMed: 37904265
DOI: No ID Found -
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 -
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 -
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 -
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 -
Acta Odontologica Scandinavica Jan 2022To identify the best available approach to avoid initial caries lesions progression in primary teeth. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To identify the best available approach to avoid initial caries lesions progression in primary teeth.
MATERIALS AND METHODS
Search was performed in MEDLINE/Pubmed, Web of Science, Embase and CENTRAL databases until March 2021. Studies compared treatment options to avoid the initial caries lesion progression with at least 12 months of follow-up were included. Network meta-analyses were conducted considering the non-progression of caries lesions as an outcome.
RESULTS
Potentially eligible studies were screened ( = 2820) and eleven were included. Six studies evaluated the use of fluoride varnish, resin infiltration, sealing, and toothbrushing/flossing on proximal initial caries lesions. When considering occlusal surfaces, only two studies evaluating the ozone gas, fluoride varnish, resin infiltration, and sealants were included. For buccal/lingual surfaces, three studies evaluating toothbrushing, CPP-ACP paste, fluoride varnish, and resin infiltration were included. For all types of surfaces, the resin infiltration showed the best probability to avoid the progression of initial caries lesions.
CONCLUSION
The limited number of included studies, most with a high risk of bias and lack of hard outcomes, such as frank cavitation, makes it not feasible to recommend a specific management approach for initial caries lesion control in primary teeth with a high certainty of evidence. PROSPERO: #CRD42016037781.
Topics: Dental Caries; Dental Caries Susceptibility; Humans; Network Meta-Analysis; Pit and Fissure Sealants; Tooth, Deciduous
PubMed: 34102948
DOI: 10.1080/00016357.2021.1928748