-
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 Dentistry Nov 2017Aim of this systematic review was to assess the clinical performance of sealants on various teeth in an evidence-based manner. (Review)
Review
OBJECTIVE
Aim of this systematic review was to assess the clinical performance of sealants on various teeth in an evidence-based manner.
SOURCES
Five databases were searched from inception to February 2017.
DATA
Randomized clinical studies on humans.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
CLINICAL SIGNIFICANCE
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.
Topics: Child; Databases, Factual; Dental Caries; Dentition, Permanent; Female; Humans; Male; Meta-Analysis as Topic; Molar; Mouth; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Tooth, Deciduous
PubMed: 28797916
DOI: 10.1016/j.jdent.2017.08.004 -
The Cochrane Database of Systematic... Jul 2017Dental sealants were introduced in the 1960s to help prevent dental caries, mainly in the pits and fissures of occlusal tooth surfaces. Sealants act to prevent bacteria... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Dental sealants were introduced in the 1960s to help prevent dental caries, mainly in the pits and fissures of occlusal tooth surfaces. Sealants act to prevent bacteria growth that can lead to dental decay. Evidence suggests that fissure sealants are effective in preventing caries in children and adolescents compared to no sealants. Effectiveness may, however, be related to caries incidence level of the population. This is an update of a review published in 2004, 2008 and 2013.
OBJECTIVES
To compare the effects of different types of fissure sealants in preventing caries in occlusal surfaces of permanent teeth in children and adolescents.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched: Cochrane Oral Health's Trials Register (to 3 August 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 7), MEDLINE Ovid (1946 to 3 August 2016), and Embase Ovid (1980 to 3 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 3 August 2016. No restrictions were placed on language or date of publication.
SELECTION CRITERIA
Randomised controlled trials (RCTs) comparing sealants with no sealant or a different type of sealant material for preventing caries of occlusal surfaces of premolar or molar teeth in children and adolescents aged up to 20 years. Studies required at least 12 months follow-up. We excluded studies that compared compomers to resins/composites.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened search results, extracted data and assessed risk of bias of included studies. We presented outcomes for caries or no caries on occlusal surfaces of permanent molar teeth as odds ratio (OR) or risk ratio (RR). We used mean difference (MD) for mean caries increment. All measures were presented with 95% confidence intervals (CI). We conducted meta-analyses using a random-effects model for comparisons where there were more than three trials; otherwise we used the fixed-effect model. We used GRADE methods to assess evidence quality.
MAIN RESULTS
We included 38 trials that involved a total of 7924 children; seven trials were new for this update (1693 participants). Fifteen trials evaluated the effects of resin-based sealant versus no sealant (3620 participants in 14 studies plus 575 tooth pairs in one study); three trials with evaluated glass ionomer sealant versus no sealant (905 participants); and 24 trials evaluated one type of sealant versus another (4146 participants). Children were aged from 5 to 16 years. Trials rarely reported background exposure to fluoride of trial participants or baseline caries prevalence. Resin-based sealant versus no sealant: second-, third- and fourth-generation resin-based sealants prevented caries in first permanent molars in children aged 5 to 10 years (at 24 months follow-up: OR 0.12, 95% CI 0.08 to 0.19, 7 trials (5 published in the 1970s; 2 in the 2010s), 1548 children randomised, 1322 children evaluated; moderate-quality evidence). If we were to assume that 16% of the control tooth surfaces were decayed during 24 months of follow-up (160 carious teeth per 1000), then applying a resin-based sealant would reduce the proportion of carious surfaces to 5.2% (95% CI 3.13% to 7.37%). Similarly, assuming that 40% of control tooth surfaces were decayed (400 carious teeth per 1000), then applying a resin-based sealant would reduce the proportion of carious surfaces to 6.25% (95% CI 3.84% to 9.63%). If 70% of control tooth surfaces were decayed, there would be 19% decayed surfaces in the sealant group (95% CI 12.3% to 27.2%). This caries-preventive effect was maintained at longer follow-up but evidence quality and quantity was reduced (e.g. at 48 to 54 months of follow-up: OR 0.21, 95% CI 0.16 to 0.28, 4 trials, 482 children evaluated; RR 0.24, 95% CI 0.12 to 0.45, 203 children evaluated). Although studies were generally well conducted, we assessed blinding of outcome assessment for caries at high risk of bias for all trials (blinding of outcome assessment is not possible in sealant studies because outcome assessors can see and identify sealant). Glass ionomer sealant versus no sealant: was evaluated by three studies. Results at 24 months were inconclusive (very low-quality evidence). One sealant versus another sealant: the relative effectiveness of different types of sealants is unknown (very low-quality evidence). We included 24 trials that directly compared two different sealant materials. Comparisons varied in terms of types of sealant assessed, outcome measures chosen and duration of follow-up. Adverse events: only four trials assessed adverse events. No adverse events were reported.
AUTHORS' CONCLUSIONS
Resin-based sealants applied on occlusal surfaces of permanent molars are effective for preventing caries in children and adolescents. Our review found moderate-quality evidence that resin-based sealants reduced caries by between 11% and 51% compared to no sealant, when measured at 24 months. Similar benefit was seen at timepoints up to 48 months; after longer follow-up, the quantity and quality of evidence was reduced. There was insufficient evidence to judge the effectiveness of glass ionomer sealant or the relative effectiveness of different types of sealants. Information on adverse effects was limited but none occurred where this was reported. Further research with long follow-up is needed.
Topics: Acrylic Resins; Adolescent; Child; Child, Preschool; Dental Caries; Dental Occlusion; Dentition, Permanent; Humans; Molar; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Silicon Dioxide
PubMed: 28759120
DOI: 10.1002/14651858.CD001830.pub5 -
Journal of Oral and Maxillofacial... Feb 2018The purpose of this study was to describe distances from commonly used anatomic landmarks to the main trunk of the facial nerve during parotid surgery.
PURPOSE
The purpose of this study was to describe distances from commonly used anatomic landmarks to the main trunk of the facial nerve during parotid surgery.
MATERIALS AND METHODS
A systematic search of the published literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies from January 1, 1990 to January 1, 2017 that measured distances to the main trunk of the facial nerve from common anatomic landmarks were eligible. Inclusion criteria were English-language articles with distances measured from the main trunk of the facial nerve to anatomic landmarks. The primary outcome variable was the distance from the respective anatomic landmarks. Other variables included surgical approach, year, and existential status of subject (cadaveric or living).
RESULTS
The search yielded 1,412 studies (1,397 by PubMed, 15 by reference searching), with 10 studies meeting the inclusion criteria. Within the 10 studies, there were 30 reported means and 375 dissected cadavers. The most common incision was the standard preauricular incision; the mean distances to the facial trunk from landmarks were 13.6 ± 11.0 mm (n = 6 reported means) for the tragal pointer, 8.79 ± 3.99 mm (n = 7 reported means) for the posterior belly of the digastric muscle, 10.5 ± 1.4 mm (n = 4 reported means) for the tip of the mastoid process, 14.99 ± 1.68 mm (n = 3 means) for the transverse process of C1, 3.79 ± 2.92 mm (n = 6 means) for the tympanomastoid fissure, 9.80 ± 0 mm (n = 1 mean) for the styloid process, and 11.77 ± 1.42 mm (n = 3 means) for the external auditory meatus. Formal assessment of inter-study variability could not be assessed because of the small number of studies and measurements.
CONCLUSION
There are substantial variations in measurements from anatomic landmarks to the main trunk of the facial nerve in the literature. Therefore, multiple landmarks can be used to identify the main trunk of the facial nerve during parotid surgery. The distances reported in this study can guide surgeons during parotid surgery to decrease the risk of facial nerve damage.
Topics: Anatomic Landmarks; Facial Nerve; Humans; Parotid Diseases
PubMed: 28738189
DOI: 10.1016/j.joms.2017.06.039 -
The Journal of Clinical Pediatric... 2017The aim of this systematic review and meta-analysis is to answer the focused question: Does the application of phosphoric acid, Er:YAG laser and air abrasion enamel... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The aim of this systematic review and meta-analysis is to answer the focused question: Does the application of phosphoric acid, Er:YAG laser and air abrasion enamel conditioning methods previous to the oclusal sealant application in human permanent molars influence the microleakage?
STUDY DESIGN
A literature research was carried out in the Pubmed Medline, Web of Science, Scopus and Cochrane databases using with the MeSH terms and keyword search strategy. A supplemental hand search of the references of retrieved articles was also performed. Inclusion criteria comprised ex vivo studies (extracted teeth) with permanent human teeth that used chemical (phosphoric acid) or mechanical (Er:YAG laser and air abrasion) conditioning methods previous the sealant application. The studies should evaluate microleakage as an outcome. Meta-analysis pooled plot were obtained comparing the microleakage after pre-treatment with phosphoric acid, Er:YAG and air abrasion enamel conditioning for sealant application using RevMan software.
RESULTS
The search resulted in 164 articles, 55 records were excluded because they were duplicated. The analysis of titles and abstracts resulted in the exclusion of 105 studies. Four studies were included in the systematic review and the meta-analysis. According to the risk of bias evaluation, the four studies were considered low risk of bias. The meta-analysis showed that phosphoric acid had lower microleakage than Er:YAG laser (p < 0.001) and air abrasion (p < 0.001), with heterogeinity of I = 0% and I = 71%, respectively. It was not found statistical difference when compared phosphoric acid and phosphoric acid combined with Er:YAG laser and air abrasion (p > 0.05).
CONCLUSION
The evidence supports that the pretreatment with phosphoric acid leads lower microleakage in oclusal sealants than Er:YAG laser and air abrasion.
Topics: Air Abrasion, Dental; Dental Leakage; Dental Materials; Humans; Lasers, Solid-State; Phosphoric Acids; Pit and Fissure Sealants
PubMed: 28422595
DOI: 10.17796/1053-4628-41.3.167 -
American Journal of Preventive Medicine Mar 2017A recently updated Community Guide systematic review of the effectiveness of school sealant programs (SSPs) still found strong evidence that SSPs reduced dental caries... (Review)
Review
CONTEXT
A recently updated Community Guide systematic review of the effectiveness of school sealant programs (SSPs) still found strong evidence that SSPs reduced dental caries among schoolchildren. This follow-up systematic review updates SSP cost and benefit information from the original 2002 review.
EVIDENCE ACQUISITION
Using Community Guide economic review methods, the authors searched the literature from January 2000 to November 20, 2014. The final body of evidence included 14 studies-ten from the current search and four with cost information from the 2002 review. Nine studies had information on SSP costs; six on sealant benefit (averted treatment costs and productivity losses); four on SSP net cost (cost minus benefit); and three on net cost to Medicaid of clinically delivered sealants. The authors imputed productivity losses and discounted costs/outcomes when this information was missing. The analysis, conducted in 2015, reported all values in 2014 U.S. dollars.
EVIDENCE SYNTHESIS
The median one-time SSP cost per tooth sealed was $11.64. Labor accounted for two thirds of costs, and time to provide sealants was a major cost driver. The median annual economic benefit was $6.29, suggesting that over 4 years the SSP benefit ($23.37 at a 3% discount rate) would exceed costs by $11.73 per sealed tooth. In addition, two of four economic models and all three analyses of Medicaid claims data found that SSP benefit to society exceeded SSP cost.
CONCLUSIONS
Recent evidence indicates the benefits of SSPs exceed their costs when SSPs target schools attended by a large number of high-risk children.
Topics: Child; Cost-Benefit Analysis; Dental Caries; Humans; Medicaid; Models, Economic; Pit and Fissure Sealants; School Dentistry; United States
PubMed: 27865653
DOI: 10.1016/j.amepre.2016.10.004 -
Journal of Dentistry Dec 2016We systematically reviewed treatment modalities for MIH-affected molars and incisors. (Review)
Review
OBJECTIVES
We systematically reviewed treatment modalities for MIH-affected molars and incisors.
DATA
Trials on humans with ≥1 MIH molar/incisor reporting on various treatments were included. Two authors independently searched and extracted records. Sample-size-weighted annual failure rates were estimated where appropriate. The risk of bias was assessed using the Newcastle-Ottawa scale.
SOURCES
Electronic databases (PubMed, Embase, Cochrane CENTRAL, Google Scholar) were screened, and hand searches and cross-referencing performed.
STUDY SELECTION
Fourteen (mainly observational) studies were included. Ten trials (381 participants) investigated MIH-molars, four (139) MIH-incisors. For molars, remineralization, restorative or extraction therapies had been assessed. For restorative approaches, mean (SD) annual failure rates were highest for fissure sealants (12[6]%) and glass-ionomer restorations (12[2]%), and lowest for indirect restorations (1[3]%), preformed metal crowns (1.3 [2.1]%) and composite restorations (4[3]%). Ony study assessed extraction of molars in young patients (median age 8.2 years), the majority of them without malocclusions, but third molars in development. Spontaneous alignment of second molars was more frequent in the maxilla (55%) than the mandible (47%). For incisors, desensitizing agents successfully managed hypersensitivity. Micro-abrasion and composite veneers improved aesthetics.
CONCLUSIONS
Few, mainly moderate to high-risk-studies investigated treatment of MIH. Remineralization or sealants seem suitable for MIH-molars with limited severity and/or hypersensitivity. For severe cases, restorations with composites or indirect restorations or preformed metal crowns seem suitable. Prior to tooth extraction as last resort factors like the presence of a general malocclusion, patients' age and the status of neighboring teeth should be considered. No recommendations can be given for MIH-incisors.
CLINICAL SIGNIFICANCE
Dentists need to consider the specific condition of each tooth and the needs and expectations of patients when deciding how to manage MIH. Strong recommendations are not possible based on the current evidence.
Topics: Dental Calculus; Dental Enamel Hypoplasia; Humans; Incisor; Maxilla; Molar; Pit and Fissure Sealants
PubMed: 27693779
DOI: 10.1016/j.jdent.2016.09.012 -
Journal of the American Dental... Dec 2016The authors of this systematic review and meta-analysis had 2 aims: to evaluate fissure sealant retention with and without the use of a preparation method and to compare... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The authors of this systematic review and meta-analysis had 2 aims: to evaluate fissure sealant retention with and without the use of a preparation method and to compare fissure sealant retention using the preparation-only method before sealant placement with the conventional acid-etching procedure.
TYPES OF STUDIES REVIEWED
The authors conducted a literature search (from database inception through June 2, 2016) 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 12 studies (8 for the first part and 4 for the second part) that met the inclusion criteria for the systematic review and meta-analysis. In the analysis of the first part of the systematic review, the authors found that the preparation method before acid etching had a significant positive effect on fissure sealant retention (odds ratio, 3.262; 95% confidence interval, 1.782-5.971; P = .001). In the analysis of the second part of the systematic review, the authors found that there were no significant differences between the preparation-only method and the conventional acid-etching method in terms of fissure sealant retention (odds ratio, 1.241; 95% confidence interval, 0.534-2.888; P = .616).
CONCLUSIONS AND PRACTICAL IMPLICATIONS
The use of a preparation method before fissure sealant application can increase sealant retention. However, preparation alone cannot substitute the conventional acid-etching method before sealant placement.
Topics: Acid Etching, Dental; Dental Caries; Humans; Pit and Fissure Sealants; Surface Properties; Tooth Preparation
PubMed: 27666005
DOI: 10.1016/j.adaj.2016.08.003 -
The Cochrane Database of Systematic... Sep 2016Successful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one... (Review)
Review
BACKGROUND
Successful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one of the most widely used isolation methods in dental restorative treatments. The evidence on the effects of rubber dam usage on the longevity of dental restorations is conflicting. Therefore, it is important to summarise the available evidence to determine the effects of this method.
OBJECTIVES
To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients.
SEARCH METHODS
We searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 17 August 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 7) in the Cochrane Library (searched 17 August 2016), MEDLINE Ovid (1946 to 17 August 2016), Embase Ovid (1980 to 17 August 2016), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 17 August 2016), SciELO BIREME Virtual Health Library (1998 to 17 August 2016), Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 30 August 2016), VIP (in Chinese) (1989 to 30 August 2016), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 30 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (including split-mouth trials) assessing the effects of rubber dam isolation for restorative treatments in dental patients.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We resolved disagreement by discussion.
MAIN RESULTS
We included four studies that analysed 1270 participants (among which 233 participants were lost to follow-up). All the included studies were at high risk of bias. We excluded one trial from the analysis due to inconsistencies in the presented data.The results indicated that dental restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). It also showed that the rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations.
AUTHORS' CONCLUSIONS
We found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct restorative treatments may lead to a lower failure rate of the restorations, compared with the failure rate for cotton roll usage. Further high quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.
PubMed: 27648846
DOI: 10.1002/14651858.CD009858.pub2 -
Journal of the American Dental... Aug 2016National Health and Nutrition Examination Survey 2011-2012 data indicated that, in the United States, nearly one-fourth of children and over one-half of adolescents... (Review)
Review
Sealants for preventing and arresting pit-and-fissure occlusal caries in primary and permanent molars: A systematic review of randomized controlled trials-a report of the American Dental Association and the American Academy of Pediatric Dentistry.
BACKGROUND
National Health and Nutrition Examination Survey 2011-2012 data indicated that, in the United States, nearly one-fourth of children and over one-half of adolescents experienced dental caries in their permanent teeth. The purpose of this review was to summarize the available clinical evidence regarding the effect of dental sealants for the prevention and management of pit-and-fissure occlusal carious lesions in primary and permanent molars, compared with a control without sealants, with fluoride varnishes, or with other head-to head comparisons.
TYPE OF STUDIES REVIEWED
The authors included parallel and split-mouth randomized controlled trials that included at least 2 years of follow-up, which they identified using MEDLINE (via PubMed), Embase, LILACS, the Cochrane Central Register of Controlled Trials, and registers of ongoing trials. Pairs of reviewers independently conducted the selection of studies, data extraction, risk of bias assessments, and quality of the evidence assessments by using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Of 2,869 records screened, the authors determined that 24 articles (representing 23 studies) proved eligible. Moderate-quality evidence suggested that participants who received sealants had a reduced risk of developing carious lesions in occlusal surfaces of permanent molars compared with those who did not receive sealants (odds ratio [OR], 0.15; 95% confidence interval [CI], 0.08-0.27) after 7 or more years of follow-up. When the authors compared studies whose investigators had compared sealants with fluoride varnishes, they found that sealants reduced the incidence of carious lesions after 7 or more years of follow-up (OR, 0.19; 95% CI, 0.07-0.51); however, this finding was supported by low-quality evidence. On the basis of the evidence, the authors could not provide a hierarchy of effectiveness among the studies whose investigators had conducted head-to-head comparisons. The investigators of 2 trials provided information about adverse events, but they did not report any adverse events.
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Available evidence suggests that sealants are effective and safe to prevent or arrest the progression of noncavitated carious lesions compared with a control without sealants or fluoride varnishes. Further research is needed to provide information about the relative merits of the different types of sealant materials.
Topics: Adolescent; Child; Dental Caries; Dental Fissures; Humans; Molar; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Tooth, Deciduous
PubMed: 27470524
DOI: 10.1016/j.adaj.2016.06.003