ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Pit and Fissure Sealants for Preventing Dental Decay in Permanent Teeth of Children and Adolescents
Clinical Question The objective was to evaluate the caries prevention of pit and fissure sealants in children and adolescents.
Clinical Bottom Line Sealing is a recommended procedure to prevent caries of the occlusal surfaces of permanent molars. The effectiveness of sealants is obvious at high caries risk but information on the benefits of sealing specific to different caries risks is lacking. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18843625Ahovuo-Saloranta/2009Randomised or quasi-randomised controlled trials of at least 12 months in duration comparing sealants with no sealant or sealants from different classes of materials for preventing occlusal caries in children and adolescents under 20 years. The primary outcome was the increment in the numbers of carious occlusal surfaces of premolars and molars.Meta-Analysis
Key resultsSixteen studies were included in the review; 7 studies provided data for comparison of sealant versus control without sealant and 10 studies for comparison of sealant versus sealant. Five split-mouth studies and one parallel group study with 5 to 10 year old children found a significant difference in favour of second or third generation resin-based sealants on first permanent molars, compared to a control without sealant, with a pooled RR of 0.13 (95% confidence interval (CI) 0.09 to 0.20), 0.22 (95% CI 0.15 to 0.34), 0.30 (95% CI 0.22 to 0.40), and 0.40 (95% CI 0.31 to 0.51) at 12, 24, 36 and 48-54 months follow up, respectively. Further, one of those studies with 9 years of follow up found significantly more caries in the control group compared to resin sealant group; 27% of sealed surfaces were decayed compared to 77% of surfaces without sealant. The results of the studies comparing different sealant materials were conflicting.
Evidence Search PEBMED: Dental sealants Limit: Meta-Analysis
Comments on
The Evidence
The evidence was adequate. This is the benefit of finding an Cochrane Review article relating to your topic of choice.
Applicability Sealing is a recommended procedure to prevent caries of the occlusal surfaces of permanent molars. The effectiveness of sealants is obvious at high caries risk but information on the benefits of sealing specific to different caries risks is lacking. Furthermore, dental sealants can easily be placed by the dentist or his staff members to prevent decay on the posterior teeth of children and adolescents.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry) (Basic Science)
Keywords ;pit and fissure sealant*; OR pit-and-fissure-sealant* OR (fissure* AND seal*) OR & resin seal*; OR & dental seal*; OR & tooth seal OR & ;enamel seal*; OR ;glass ionomer*; OR glass-ionomer* OR resin*) AND seal*)
ID# 273
Date of submission: 11/19/2009spacer
E-mail JonesCJ@uthscsa.edu
Author Christopher Jones, DDS
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Sukhman Kaur (San Antonio, Texas) on 04/02/2012
A search was conducted on PubMed on this topic and was completed on April 2, 2012. The publication used on this CAT form is the most updated and relevant evidence related to this clinical question.
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