Jan Kühnisch1, Ahmed Bedir2, Yi-Fang Lo3, Andreas Kessler3, Toni Lang3, Ulrich Mansmann4, Roswitha Heinrich-Weltzien5, Reinhard Hickel3. 1. Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany. Electronic address: jkuehn@dent.med.uni-muenchen.de. 2. Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany; Institute of Medical Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany. 3. Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany. 4. Institute of Medical Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany. 5. Department of Preventive and Paediatric Dentistry, University Hospital Jena, Jena, Germany.
Abstract
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.
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.