Paemanukornruk Yodsapat, Luksamijarulkul Nicha, Gaewkhiew Piyada
Department of Community Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, 10400, Thailand.
BMC Oral Health. 2025 May 23;25(1):768. doi: 10.1186/s12903-025-06158-0.
There have been limited previous reviews on the use of sealants in high-caries-risk children that include multiple study designs. This systematic review aimed to evaluate the preventive effect of sealants on high-caries-risk children and compare the effectiveness of sealants between high-caries-risk children and lower-caries-risk children.
An initial protocol was developed following the PRISMA guidelines. A comprehensive literature search was performed across several electronic databases, including PubMed, the Cochrane Library, Embase and Google Scholar. Experimental or observational studies that examined resin-based sealants for preventing caries over at least 12 months in high-caries-risk children, identified by individual risk assessment, were included. Comparison groups were moderate- or low-risk children or no sealant; if unavailable, only intervention data were used. The risk of bias was assessed via the RoB2 tool and the Newcastle‒Ottawa Scale.
A total of 1651 unique records were identified, 20 of which were included in this systematic review. Studies comparing only sealed teeth among different caries risk groups have indicated that high-caries-risk children have a greater risk of developing new carious lesions than low- or moderate-risk children do. In contrast, the effect of sealants was negligible in low-caries-risk children when compared between sealed and nonsealed teeth. Additionally, caries experience was the primary criterion used across all included studies.
Resin-based sealants are still recommended for high-caries-risk children. However, generalizability and an appropriate threshold for risk assessment remain unclear owing to the limited number of studies from low- to middle-income countries and variability in risk assessment methods.
PROSPERO Registration number CRD42023473013.
Not applicable.
以往针对高龋风险儿童使用窝沟封闭剂的综述较少，且涵盖多种研究设计。本系统评价旨在评估窝沟封闭剂对高龋风险儿童的预防效果，并比较高龋风险儿童与低龋风险儿童使用窝沟封闭剂的有效性。
按照PRISMA指南制定了初始方案。通过多个电子数据库进行全面的文献检索，包括PubMed、Cochrane图书馆、Embase和谷歌学术。纳入通过个体风险评估确定的、研究树脂基窝沟封闭剂在高龋风险儿童中预防龋齿至少12个月的实验性或观察性研究。比较组为中度或低风险儿童或未使用窝沟封闭剂的儿童；若无可比组，则仅使用干预数据。通过RoB2工具和纽卡斯尔-渥太华量表评估偏倚风险。
共识别出1651条独特记录，其中20条纳入本系统评价。仅比较不同龋风险组中已封闭牙齿的研究表明，高龋风险儿童比低或中度风险儿童发生新龋损的风险更高。相比之下，在低龋风险儿童中，比较已封闭和未封闭牙齿时，窝沟封闭剂的效果可忽略不计。此外，龋病经历是所有纳入研究中使用的主要标准。
仍建议高龋风险儿童使用树脂基窝沟封闭剂。然而，由于来自低收入和中等收入国家的研究数量有限以及风险评估方法的变异性，其普遍性和风险评估的适当阈值仍不明确。
PROSPERO注册号CRD42023473013。
不适用。
