Validity of Sealant Retention as Surrogate for Caries Prevention – A Systematic Review
Open Access
- 23 October 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (10), e77103
- https://doi.org/10.1371/journal.pone.0077103
Abstract
To appraise the clinical literature in determining whether loss of complete sealant retention as surrogate endpoint is directly associated with caries occurrence on sealed teeth as its clinical endpoint and to apply the appraised evidence in testing the null-hypothesis that the retention/caries ratio between different types of sealant materials (resin and glass-ionomer cement) is not statistically significant ( = Prentice criterion for surrogate endpoint validity). Databases searched PubMed/Medline, Directory of Open Access Journals; IndMed, Scielo. Systematic reviews were checked for suitable trials. The search terms: “fiss* AND seal*” and “fissure AND sealant” were used. Article selection criteria were: clinical trial reporting on the retention and caries occurrence of resin and/or glass-ionomer cement (GIC) fissure sealed permanent molar teeth; minimum 24-month follow-up period; systematic review or meta-analysis. Datasets and information were extracted from accepted trials. The principle outcome measure was the ratio of Risk of loss of complete retention to the Risk of caries occurrence per sealant type (RCR). Risk of bias was assessed in trials and sensitivity analysis with regard to potential confounding factors conducted. The null-hypothesis was tested by graphical and statistical methods. The risk of loss of complete retention of sealant materials was associated with the risk of caries occurrence for resin but not for GIC based sealants. The difference between RCR values of the two sealant types was statistically significant (p<0.05). The null-hypothesis was rejected. The current clinical evidence suggests that complete retention of pit and fissure sealants may not be a valid surrogate endpoint for caries prevention as its clinical endpoint. Further research is required to corroborate the current results.Keywords
This publication has 27 references indexed in Scilit:
- Retention Loss of Resin Based Fissure Sealants - a Valid Predictor for Clinical Outcome?The Open Dentistry Journal, 2013
- Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: An update of systematic review evidenceBMC Research Notes, 2011
- Microtensile bond strength to ground enamel by glass-ionomers, resin-modified glass-ionomers, and resin composites used as pit and fissure sealantsJournal of Dentistry, 2005
- Complexities of an Evidence-Based Clinical PracticeJournal of Evidence-Based Dental Practice, 2004
- Glass ionomer and resin‐based fissure sealants: a clinical studyEuropean Journal of Oral Sciences, 1990
- Microleakage in fissures sealed with resin or glass ionomer cementEuropean Journal of Oral Sciences, 1990
- Surrogate endpoints in clinical trials: Definition and operational criteriaStatistics in Medicine, 1989
- The release of fluoride and other chemical species from a glass-ionomer cementBiomaterials, 1985
- A review of published fissure sealant trials using multiple regression analysisJournal of Dentistry, 1982
- Retention and effectiveness of a chemically polymerized pit and fissure sealant after 2 yearsEuropean Journal of Oral Sciences, 1978