Chris Deery1. 1. Department of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Abstract
DATA SOURCES: Medline and The Cochrane Library. STUDY SELECTION: Randomised controlled trials or systematic reviews that considered retention or the effectiveness of resin-based sealants after different surface-cleaning procedures were included. Only English language studies were considered. DATA EXTRACTION AND SYNTHESIS: Data were extracted by one author and a summary retention rate calculated separately for the studies that used the same type of surface-cleaning method or toothbrush prophylaxis. The studies were weighted by the reciprocal of their squared standard error. RESULTS: All of the sealant manufacturers' instructions for use (IFU) recommended cleaning the tooth before acid etching. None of the IFU directly stated that a handpiece was required to perform the cleaning, but five IFU implied the use of handpiece prophylaxis. None of the IFU recommended surface-altering procedures in caries-free teeth. Direct evidence from two clinical trials showed no difference in complete sealant retention between surfaces cleaned mechanically with pumice or prophylaxis paste and those cleaned with air-water syringe or dry toothbrushing. Indirect evidence from 10 studies found that weighted summary retention by year after sealant placement in studies that used toothbrush prophylaxis was greater than or equivalent to values for studies that used handpiece prophylaxis. CONCLUSIONS: The results indicate that retention of sealants after a supervised toothbrush cleaning by the patient was at least as high as those associated with a traditional handpiece prophylaxis. These findings may translate into lower costs for materials, equipment and personnel.
DATA SOURCES: Medline and The Cochrane Library. STUDY SELECTION: Randomised controlled trials or systematic reviews that considered retention or the effectiveness of resin-based sealants after different surface-cleaning procedures were included. Only English language studies were considered. DATA EXTRACTION AND SYNTHESIS: Data were extracted by one author and a summary retention rate calculated separately for the studies that used the same type of surface-cleaning method or toothbrush prophylaxis. The studies were weighted by the reciprocal of their squared standard error. RESULTS: All of the sealant manufacturers' instructions for use (IFU) recommended cleaning the tooth before acid etching. None of the IFU directly stated that a handpiece was required to perform the cleaning, but five IFU implied the use of handpiece prophylaxis. None of the IFU recommended surface-altering procedures in caries-free teeth. Direct evidence from two clinical trials showed no difference in complete sealant retention between surfaces cleaned mechanically with pumice or prophylaxis paste and those cleaned with air-water syringe or dry toothbrushing. Indirect evidence from 10 studies found that weighted summary retention by year after sealant placement in studies that used toothbrush prophylaxis was greater than or equivalent to values for studies that used handpiece prophylaxis. CONCLUSIONS: The results indicate that retention of sealants after a supervised toothbrush cleaning by the patient was at least as high as those associated with a traditional handpiece prophylaxis. These findings may translate into lower costs for materials, equipment and personnel.