Comparison of glass ionomer and resin fissure sealant for retention and caries prevention on permanent first and second molar: a systematic review

Abstract

           Background and Objective: There is a high prevalence of dental caries worldwide involving the schoolchildren of all regions. Pit and fissure sealants are widely used as an important part of dental caries prevention. A variety of sealant materials with different properties are commonly used, however Glass Ionomer (GI) sealant and resin sealant are popular materials. Glass Ionomer can provide chemical bond with dentine and enamel. without etching and good efficiency in caries prevention through fluoride releasing process around enamel. while resin sealant have a good retention with enamel in humid environment, resistance to attrition. This study aimed to investigate the effectiveness of retention and caries prevention between glass ionomer sealant and resin sealant on permanent first and second molar, in schoolchildren aged 6-12 years. Methods: We systematically searched for studies of split-mouth trials published in English or Thai language from electronic databases; MEDLINE, SCOPUS, Web of Science, Science Direct, Thai-Journal Citation Index (TCI), including hand searching and reference lists from its inception through December 2016. Two review authors independently assessed studies for I) eligibility using Covidence program, II) determining risk of bias in accordance with Cochrane guidelines, (7 domains), and considering 2 domains for overall quality of each studies III) extracting data using standardized and pilot data extraction form. Additionally, we assessed the quality of evidence for each outcome using GRADE approach. Any disagreements between the reviewers resolved through discussion and/or consulted with content expert.

          Results: Searching yield 611 records (including 199 duplicates), met inclusion criteria. Of ten studies, five studies were at high risk of bias, while the remaining five studies were at unclear risk of bias. The quality of the evidence using GRADE for sealant retention and dental caries ranged from Low to Very low. Found a statistically significant difference in sealant retention between GI and resin sealant at (i) 6 months (RR (random) 0.69; 95% CI 0.54, 0.89; 218 participants; 2 studies; I²= 49%) (Very low) , (ii) 9 months (RR (random) 0.14; 95% CI 0.06, 0.32 ; 412 participants; 1 studies) (Very low), and (iii) 7 years (RR (random) 0.23; 95% CI 0.12, 0.43 ; 194 participants; 1 study) (Very low) and also for dental caries at 2 years ( RR (random) 0.54; 95% CI 0.37, 0.79; 628 participants; 3 studies; I² =0%) (Very low)

          Conclusion: Study findings need to be interpreted with caution because of the included studies were at high or unclear risk of bias, small number of included studies at each follow-up time point, small sample size, and high heterogeneity. There is a need of well-designed split-mouth randomized controlled trials with good randomization procedure, rigorous and clearly defined outcome and outcome measure, as well as adequate sample size.