Comparison of the Success Rate of Filled and Unfilled Resin-Based Fissure Sealants: A Systematic Review and Meta-analysis
Abstract
Objectives: Incorporation of fillers might improve the physical properties of sealants. This systematic review and meta-analysis evaluated the retention and caries development rate of filled and unfilled fissure sealants.
Materials and Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The PubMed, Scopus, Embase, Cochrane Database of Systematic Reviews, and ISI Web of Knowledge were searched until October 24, 2019. The risk of bias (ROB) was assessed for the included studies based on the Cochrane collaboration common scheme for bias, and the meta-analysis was performed through a random effects model.
Results: The search resulted in 6,336 unrepeated relevant studies. After the title, abstract and full-text screening, 19 studies with 26 comparing groups were finally included in this systematic review and meta-analysis. According to the included studies, both retention rate and caries development in filled and unfilled resin-based sealants did not significantly differ within 2 years of follow-up.
Conclusion: Since there was no significant difference in the retention rate and caries development between filled and unfilled sealants, it seems that the final decision should be made uniquely for each patient according to the type of fissure, patient’s age, habits, etc.
1. Zhang Y, Wang Y, Chen Y, Chen Y, Zhang Q, Zou J. The clinical effects of laser preparation of tooth surfaces for fissure sealants placement : a systematic review and meta- analysis. BMC Oral Health. 2019 Sep;19(1):203.
2. Prabakar J, John J, Arumugham IM, Kumar RP, Srisakthi D. Comparative evaluation of retention, cariostatic effect and discoloration of conventional and hydrophilic sealants - A single blinded randomized split mouth clinical trial. Contemp Clin Dent. 2018 Sep;9(Suppl 2):S233–9.
3. Cvikl B, Moritz A, Bekes K. Pit and fissure sealants-A comprehensive review. Dent J. 2018 Jun;6(2):18.
4. Naaman R, El-Housseiny AA, Alamoudi N. The use of pit and fissure sealants-A literature review. Dent J. 2017 Dec;5(4):34.
5. Yazici AR1, Karaman E, Baseren M, Tuncer D, Yazici E US. Clinical evaluation of a nanofilled fissure sealant placed with different adhesive systems: 24-month results. Oper Dent. 2009 Nov-Dec;34(6):642–7.
6. Alsabek L, Al-nerabieah Z, Bshara N, Comisi JC. Retention and remineralization effect of moisture tolerant resin-based sealant and glass ionomer sealant on non-cavitated pit and fi ssure caries : Randomized controlled clinical trial. J Dent. 2019 Jul;86(May):69–74.
7. Reddy VR, Chowdhary N, Mukunda KS, Kiran NK, Kavyarani BS, Pradeep MC. Retention of resin ‑ based filled and unfilled pit and fissure sealants: A comparative clinical study. Contemp Clin Dent. 2015 Mar;6(suppl 1):10–5.
8. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S , eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.handbook.cochrane.org. Accessed March 23, 2019.
9. Huedo-Medina T, Sanchez-Meca J, Botella J. Assessing heterogeneity in meta-analysis : Q statistic or I2 index ? Psychol Methods. 2006 Jun;11(2):193–206.
10. Deeks JJ, Higgins JPT, Altman DG. Chapter 9: analysing data and undertaking meta-analyses. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 (updated July 2017). The Cochrane Collaboration; 2017. Available at: http://handbook.cochrane.org. Accessed July 29, 2020
11. Hassan AM, Mohammed SG. Effectiveness of seven types of sealants: Retention after one year. Int J Clin Pediatr Dent. 2019 Mar-Apr;12(2):96–100.
12. Kumaran P. Clinical evaluation of the retention of different pit and fissure sealants : A 1-year study. Int J Clin Pediatr Dent. 2013 Sep;6(December):183–7.
13. Bhat PK, Konde S, Raj SN KN. Moisture ‑ tolerant resin ‑ based sealant : A boon. Contemp Clin Dent. 2013 Jul;4(3):343–8.
14. Dukic W, Dukic OL, Milardovic S, Vindakijevic Z. Clinical comparison of flowable composite to other fissure sealing materials--a 12 months study. Coll Antropol. 2007 Dec;31(4):1019–24.
15. Baca P, Bravo M, Baca AP, Jimenez A, Gonzalez-Rodriguez MP, Jiménez A, et al. Retention of three fissure sealants and a dentin bonding system used as fissure sealant in caries prevention: 12-month follow-up results. Med Oral Patol Oral Cir Bucal. 2007 Oct;12(6):459–63.
16. Khatri SG, Samuel SR, Acharya S, Patil S, Madan K. Retention of Moisture-tolerant and Conventional Resin-based Sealant in Six-to Nine-year-old Children. Pediatr Dent. 2015 Jul-Aug;37(4):366.
17. Unal M, Oztas N. Remineralization capacity of three fissure sealants with and without gaseous ozone on non-cavitated incipient pit and fissure caries. J Clin Pediatr Dent. 2015 Summer;39(4):364–70.
18. Mohanraj M, Prabhu R, Thomas E, Kumar S. Comparative evaluation of hydrophobic and hydrophilic resin-based sealants: A clinical study. J Contemp Dent Pr. 2019 Jul;20(7):812–7.
19. Mathur S, Pandit IK, Srivatava N, Gugnani N, Gupta M. Clinical evaluation of various recently used pit and fissure sealants: A12month study. Int J Clin Dent. 2012 Jan;5(3):253–62.
20. Kargul B, Tanboga I, Gulman N. A comparative study of fissure sealants Helioseal Clear Chroma ® and Delton ® FS + : 3 year results. Eur Arch Paediatr Dent. 2009 Dec;10(4):218–22.
21. Lygidakis NA, Oulis KI. A comparison of Fluroshield with Delton fissure sealant: four year results. Pediatr Dent. 1999 Nov;21(7):429–31.
22. do Rego MA, de Araujo MA, Augusto M, Atnèlia M, Araújo M De. A 2-year clinical evaluation of fluoride-containing pit and fissure sealants placed with an invasive technique. Quintessence Int. 1996 Feb;27(2):99–103.
23. Boksman R, Meconneil B, Carson E. A 2-year clinical evaluation of two pit and fissure sealants placed with and without the use of a bonding agent. Quintessence Int. 1993 Feb;24(2):131–4.
24. Elkwatehy WMA, Bukhari OM. The efficacy of different sealant modalities for prevention of pits and fissures caries: A randomized clinical trial. J Int Soc Prev Community Dent. 2019 Mar-Apr;9(2):119–28.
25. Kobayashi TY, Rios D, Andrade MA De. A two-year clinical evaluation of fluoride and non-fluoride resin-based pit-and-fissure sealants. Braz Dent J. 2015 Nov-Dec;26(139):678–84.
26. Schlueter N, Klimek J, Ganss C. Efficacy of a moisture-tolerant material for fissure sealing: a prospective randomised clinical trial. Clin Oral Investig. 2013 Apr;17(3):711–6.
27. Morphis TL, Toumba KJ. Retention of two fluoride pit-and-fissure sealants in comparison to a conventional sealant. Int J Paediatr Dent. 1998 Sep;8(3):203–8.
28. Koch MJ, Garcia-Godoy F, Mayer T, Staehle HJ, García-godoy MJKF, Mayer T, et al. Clinical evaluation of Helioseal F fissure sealant. Clin Oral Investig. 1997 Dec;1(4):199–202.
29. Gizani S. Pit and fissure sealants. In: Bekes K, editor. Pit and fissure sealants. 1st ed., Springer; 2018. p. 23–34.
30. Wright JT, Crall JJ, Fontana M, Gillette EJ, Nový BB, Dhar V, et al. Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: A report of the American Dental Association and the American Academy of Pediatric Dentistry. J Am Dent Assoc. 2016 Aug;147(8):672-82.e12.
31. Garg N, Indushekar KR, Saraf BG, Sheoran N, Sardana D. Comparative evaluation of penetration ability of three pit and fissure sealants and their relationship with fissure patterns. J Dent (Shiraz, Iran). 2018 Jun;19(2):92–9.
32. Subramaniam P, Babu KL, Naveen HK. Effect of tooth preparation on sealant success--an in vitro study. J Clin Pediatr Dent. 2009 Summer;33(4):325–31.
33. Tilliss TS, Stach DJ, Hatch RA, Cross-Poline
GN. Occlusal discrepancies after sealant therapy. J Prosthet Dent. 1992 Aug;68(2):223–8.
34. Galo R, Contente MMMG, Borsatto MC. Wear of two pit and fissure sealants in contact with primary teeth. Eur J Dent. 2014 Sep;8(2):241–8.
35. Cagetti MG, Carta G, Cocco F, Sale S, Congiu G, Mura A, et al. Effect of fluoridated sealants on adjacent tooth surfaces: A 30-month randomized clinical trial. J Dent Res. 2014 May;93(7 Suppl):59S-65S.
36. Beun S, Bailly C, Devaux J, Leloup G. Physical, mechanical and rheological characterization of resin-based pit and fissure sealants compared to flowable resin composites. Dent Mater. 2012 Apr;28(4):349–59.
37. Kim K-H, Ong JL, Okuno O. The effect of filler loading and morphology on the mechanical properties of contemporary composites. J Prosthet Dent. 2002 Jan;87(6):642–9.
38. Khatri CA, Stansbury JW, Schultheisz CR, Antonucci JM. Synthesis, characterization and evaluation of urethane derivatives of Bis-GMA. Dent Mater. 2003 Nov;19(7):584–8.
39. Braga RR. Calcium phosphates as ion-releasing fillers in restorative resin-based materials. Dent Mater. 2019 Jan;35(1):3–14.
40. Welbury R, Raadal M, Lygidakis NA. EAPD guidelines for the use of pit and fissure sealants. Eur J Paediatr Dent. 2004 Sep;5(3):179–84.
41. Yılmaz Y, Beldüz N, Eyüboglu O. A two-year evaluation of four different fissure sealants. Eur Arch Paediatr Dent. 2010 Apr;11(2):88–92.
42. Autio-Gold JT. Clinical evaluation of a medium-filled flowable restorative material as a pit and fissure sealant. Oper Dent. 2002 Jul-Aug;27(4):325–9.
43. Van Bebber L, Campbell PM, Honeyman AL, Spears R, Buschang PH. Does the amount of filler content in sealants used to prevent decalcification on smooth enamel surfaces really matter? Angle Orthod. 2010 Jan;81(1):134–40.
44. Rock WP, Weatherill S, Anderson RJ. Retention of three fissure sealant resins. The effects of etching agent and curing method. Results over 3 years. Br Dent J. 1990 Apr;168(8):323–5.
45. Hatibovic-Kofman S, Wright GZ, Braverman I. Microleakage of sealants after conventional, bur, and air-abrasion preparation of pits and fissures. Pediatr Dent. 1998 May-Jun;20(3):173–6.
46. Kantovitz KR, Moreira KM, Pascon FM, Nociti Jr. FH, Machado Tabchoury CP, Puppin-Rontani RM. Penetration of Filled and Unfilled Resin Sealants on Different Enamel Substrates. Pediatr Dent. 2016 Nov;38(7):472–6.
2. Prabakar J, John J, Arumugham IM, Kumar RP, Srisakthi D. Comparative evaluation of retention, cariostatic effect and discoloration of conventional and hydrophilic sealants - A single blinded randomized split mouth clinical trial. Contemp Clin Dent. 2018 Sep;9(Suppl 2):S233–9.
3. Cvikl B, Moritz A, Bekes K. Pit and fissure sealants-A comprehensive review. Dent J. 2018 Jun;6(2):18.
4. Naaman R, El-Housseiny AA, Alamoudi N. The use of pit and fissure sealants-A literature review. Dent J. 2017 Dec;5(4):34.
5. Yazici AR1, Karaman E, Baseren M, Tuncer D, Yazici E US. Clinical evaluation of a nanofilled fissure sealant placed with different adhesive systems: 24-month results. Oper Dent. 2009 Nov-Dec;34(6):642–7.
6. Alsabek L, Al-nerabieah Z, Bshara N, Comisi JC. Retention and remineralization effect of moisture tolerant resin-based sealant and glass ionomer sealant on non-cavitated pit and fi ssure caries : Randomized controlled clinical trial. J Dent. 2019 Jul;86(May):69–74.
7. Reddy VR, Chowdhary N, Mukunda KS, Kiran NK, Kavyarani BS, Pradeep MC. Retention of resin ‑ based filled and unfilled pit and fissure sealants: A comparative clinical study. Contemp Clin Dent. 2015 Mar;6(suppl 1):10–5.
8. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S , eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.handbook.cochrane.org. Accessed March 23, 2019.
9. Huedo-Medina T, Sanchez-Meca J, Botella J. Assessing heterogeneity in meta-analysis : Q statistic or I2 index ? Psychol Methods. 2006 Jun;11(2):193–206.
10. Deeks JJ, Higgins JPT, Altman DG. Chapter 9: analysing data and undertaking meta-analyses. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 (updated July 2017). The Cochrane Collaboration; 2017. Available at: http://handbook.cochrane.org. Accessed July 29, 2020
11. Hassan AM, Mohammed SG. Effectiveness of seven types of sealants: Retention after one year. Int J Clin Pediatr Dent. 2019 Mar-Apr;12(2):96–100.
12. Kumaran P. Clinical evaluation of the retention of different pit and fissure sealants : A 1-year study. Int J Clin Pediatr Dent. 2013 Sep;6(December):183–7.
13. Bhat PK, Konde S, Raj SN KN. Moisture ‑ tolerant resin ‑ based sealant : A boon. Contemp Clin Dent. 2013 Jul;4(3):343–8.
14. Dukic W, Dukic OL, Milardovic S, Vindakijevic Z. Clinical comparison of flowable composite to other fissure sealing materials--a 12 months study. Coll Antropol. 2007 Dec;31(4):1019–24.
15. Baca P, Bravo M, Baca AP, Jimenez A, Gonzalez-Rodriguez MP, Jiménez A, et al. Retention of three fissure sealants and a dentin bonding system used as fissure sealant in caries prevention: 12-month follow-up results. Med Oral Patol Oral Cir Bucal. 2007 Oct;12(6):459–63.
16. Khatri SG, Samuel SR, Acharya S, Patil S, Madan K. Retention of Moisture-tolerant and Conventional Resin-based Sealant in Six-to Nine-year-old Children. Pediatr Dent. 2015 Jul-Aug;37(4):366.
17. Unal M, Oztas N. Remineralization capacity of three fissure sealants with and without gaseous ozone on non-cavitated incipient pit and fissure caries. J Clin Pediatr Dent. 2015 Summer;39(4):364–70.
18. Mohanraj M, Prabhu R, Thomas E, Kumar S. Comparative evaluation of hydrophobic and hydrophilic resin-based sealants: A clinical study. J Contemp Dent Pr. 2019 Jul;20(7):812–7.
19. Mathur S, Pandit IK, Srivatava N, Gugnani N, Gupta M. Clinical evaluation of various recently used pit and fissure sealants: A12month study. Int J Clin Dent. 2012 Jan;5(3):253–62.
20. Kargul B, Tanboga I, Gulman N. A comparative study of fissure sealants Helioseal Clear Chroma ® and Delton ® FS + : 3 year results. Eur Arch Paediatr Dent. 2009 Dec;10(4):218–22.
21. Lygidakis NA, Oulis KI. A comparison of Fluroshield with Delton fissure sealant: four year results. Pediatr Dent. 1999 Nov;21(7):429–31.
22. do Rego MA, de Araujo MA, Augusto M, Atnèlia M, Araújo M De. A 2-year clinical evaluation of fluoride-containing pit and fissure sealants placed with an invasive technique. Quintessence Int. 1996 Feb;27(2):99–103.
23. Boksman R, Meconneil B, Carson E. A 2-year clinical evaluation of two pit and fissure sealants placed with and without the use of a bonding agent. Quintessence Int. 1993 Feb;24(2):131–4.
24. Elkwatehy WMA, Bukhari OM. The efficacy of different sealant modalities for prevention of pits and fissures caries: A randomized clinical trial. J Int Soc Prev Community Dent. 2019 Mar-Apr;9(2):119–28.
25. Kobayashi TY, Rios D, Andrade MA De. A two-year clinical evaluation of fluoride and non-fluoride resin-based pit-and-fissure sealants. Braz Dent J. 2015 Nov-Dec;26(139):678–84.
26. Schlueter N, Klimek J, Ganss C. Efficacy of a moisture-tolerant material for fissure sealing: a prospective randomised clinical trial. Clin Oral Investig. 2013 Apr;17(3):711–6.
27. Morphis TL, Toumba KJ. Retention of two fluoride pit-and-fissure sealants in comparison to a conventional sealant. Int J Paediatr Dent. 1998 Sep;8(3):203–8.
28. Koch MJ, Garcia-Godoy F, Mayer T, Staehle HJ, García-godoy MJKF, Mayer T, et al. Clinical evaluation of Helioseal F fissure sealant. Clin Oral Investig. 1997 Dec;1(4):199–202.
29. Gizani S. Pit and fissure sealants. In: Bekes K, editor. Pit and fissure sealants. 1st ed., Springer; 2018. p. 23–34.
30. Wright JT, Crall JJ, Fontana M, Gillette EJ, Nový BB, Dhar V, et al. Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: A report of the American Dental Association and the American Academy of Pediatric Dentistry. J Am Dent Assoc. 2016 Aug;147(8):672-82.e12.
31. Garg N, Indushekar KR, Saraf BG, Sheoran N, Sardana D. Comparative evaluation of penetration ability of three pit and fissure sealants and their relationship with fissure patterns. J Dent (Shiraz, Iran). 2018 Jun;19(2):92–9.
32. Subramaniam P, Babu KL, Naveen HK. Effect of tooth preparation on sealant success--an in vitro study. J Clin Pediatr Dent. 2009 Summer;33(4):325–31.
33. Tilliss TS, Stach DJ, Hatch RA, Cross-Poline
GN. Occlusal discrepancies after sealant therapy. J Prosthet Dent. 1992 Aug;68(2):223–8.
34. Galo R, Contente MMMG, Borsatto MC. Wear of two pit and fissure sealants in contact with primary teeth. Eur J Dent. 2014 Sep;8(2):241–8.
35. Cagetti MG, Carta G, Cocco F, Sale S, Congiu G, Mura A, et al. Effect of fluoridated sealants on adjacent tooth surfaces: A 30-month randomized clinical trial. J Dent Res. 2014 May;93(7 Suppl):59S-65S.
36. Beun S, Bailly C, Devaux J, Leloup G. Physical, mechanical and rheological characterization of resin-based pit and fissure sealants compared to flowable resin composites. Dent Mater. 2012 Apr;28(4):349–59.
37. Kim K-H, Ong JL, Okuno O. The effect of filler loading and morphology on the mechanical properties of contemporary composites. J Prosthet Dent. 2002 Jan;87(6):642–9.
38. Khatri CA, Stansbury JW, Schultheisz CR, Antonucci JM. Synthesis, characterization and evaluation of urethane derivatives of Bis-GMA. Dent Mater. 2003 Nov;19(7):584–8.
39. Braga RR. Calcium phosphates as ion-releasing fillers in restorative resin-based materials. Dent Mater. 2019 Jan;35(1):3–14.
40. Welbury R, Raadal M, Lygidakis NA. EAPD guidelines for the use of pit and fissure sealants. Eur J Paediatr Dent. 2004 Sep;5(3):179–84.
41. Yılmaz Y, Beldüz N, Eyüboglu O. A two-year evaluation of four different fissure sealants. Eur Arch Paediatr Dent. 2010 Apr;11(2):88–92.
42. Autio-Gold JT. Clinical evaluation of a medium-filled flowable restorative material as a pit and fissure sealant. Oper Dent. 2002 Jul-Aug;27(4):325–9.
43. Van Bebber L, Campbell PM, Honeyman AL, Spears R, Buschang PH. Does the amount of filler content in sealants used to prevent decalcification on smooth enamel surfaces really matter? Angle Orthod. 2010 Jan;81(1):134–40.
44. Rock WP, Weatherill S, Anderson RJ. Retention of three fissure sealant resins. The effects of etching agent and curing method. Results over 3 years. Br Dent J. 1990 Apr;168(8):323–5.
45. Hatibovic-Kofman S, Wright GZ, Braverman I. Microleakage of sealants after conventional, bur, and air-abrasion preparation of pits and fissures. Pediatr Dent. 1998 May-Jun;20(3):173–6.
46. Kantovitz KR, Moreira KM, Pascon FM, Nociti Jr. FH, Machado Tabchoury CP, Puppin-Rontani RM. Penetration of Filled and Unfilled Resin Sealants on Different Enamel Substrates. Pediatr Dent. 2016 Nov;38(7):472–6.
| Issue | Vol 19 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v19i10.8855 | |
| Keywords | ||
| Pit and Fissure Sealants Composite Resins Meta-Analysis as Topic | ||
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How to Cite
1.
Bagheri E, Sarraf Shirazi A, Shekofteh K. Comparison of the Success Rate of Filled and Unfilled Resin-Based Fissure Sealants: A Systematic Review and Meta-analysis. Front Dent. 2022;19.
