Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong.
Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
J Evid Based Dent Pract. 2020 Jun;20(2):101404. doi: 10.1016/j.jebdp.2020.101404. Epub 2020 Jan 29.
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.
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.
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.
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.
窝沟封闭剂在恒牙中已得到广泛应用，但对于乳磨牙是否也同样适用，目前尚无确凿证据。本综述旨在系统评估随机对照试验，并总结不同封闭剂在预防和控制儿童乳磨牙窝沟点隙龋中的有效性证据。
从建库至 2018 年 3 月，我们检索了 4 个电子数据库。纳入了 7 项研究进行定性和定量综合分析。两名评审员独立选择研究、提取数据、使用修订后的 Cochrane 偏倚风险工具评估偏倚风险，并采用推荐评估、制定与评价分级方法评估证据确定性。对不同封闭剂的比值比和保留率进行重新计算和分析。
本综述发现，在 24 个月的评估期内，（1）树脂型封闭剂（RBS）与玻璃离子体封闭剂（GIS）或树脂改良型玻璃离子体封闭剂；（2）传统型和新型 RBS；（3）自聚型和光固化型 RBS；（4）含氟涂料应用的 RBS 和单独含氟涂料应用的 RBS；（5）含氟涂料应用的 RBS 和含氟涂料应用的树脂渗透技术 RBS 之间，总体龋齿发生率和进展无显著差异。在 18 个月期间，RBS 和 GIS 对乳磨牙的平均保留率的汇总估计值分别为 85.94%和 23.18%。由于总体偏倚和不准确性风险较高，每个结局的证据确定性均被确定为低或极低。
目前尚无充分的、良好对照的随机对照临床试验来确定封闭剂是否有益于预防或控制乳磨牙的非龋性窝沟龋。
