title: The effectiveness of sealants in managing caries lesions.
abstract: A barrier to providing sealants is concern about inadvertently sealing over caries. This meta-analysis examined the effectiveness of sealants in preventing caries progression. We searched electronic databases for comparative studies examining caries progression in sealed permanent teeth. We used a random-effects model to estimate percentage reduction in the probability of caries progression in sealed vs. unsealed carious teeth. Six studies, including 4 randomized-controlled trials (RCT) judged to be of fair quality, were included in the analysis (384 persons, 840 teeth, and 1090 surfaces). The median annual percentage of non-cavitated lesions progressing was 2.6% for sealed and 12.6% for unsealed carious teeth. The summary prevented fraction for RCT was 71.3% (95%CI: 52.8%-82.5, no heterogeneity) up to 5 years after placement. Despite variation among studies in design and conduct, sensitivity analysis found the effect to be consistent in size and direction. Sealing non-cavitated caries in permanent teeth is effective in reducing caries progression.
authors.affiliation: Centers for Disease Control and Prevention/Division of Oral Health/Surveillance, Investigations, and Research Branch, Chamblee, GA 30341, USA. sig1@cdc.gov
authors.forename: S O
authors.initials: SO
authors.lastname: Griffin
authors.forename: E
authors.initials: E
authors.lastname: Oong
authors.forename: W
authors.initials: W
authors.lastname: Kohn
authors.forename: B
authors.initials: B
authors.lastname: Vidakovic
authors.forename: B F
authors.initials: BF
authors.lastname: Gooch
authors.forename: J
authors.initials: J
authors.lastname: Bader
authors.forename: J
authors.initials: J
authors.lastname: Clarkson
authors.forename: M R
authors.initials: MR
authors.lastname: Fontana
authors.forename: D M
authors.initials: DM
authors.lastname: Meyer
authors.forename: R G
authors.initials: RG
authors.lastname: Rozier
authors.forename: J A
authors.initials: JA
authors.lastname: Weintraub
authors.forename: D T
authors.initials: DT
authors.lastname: Zero
mesh_terms: D015331:Cohort Studies; D003731:Dental Caries / Q000517:prevention & control*; D018450:Disease Progression; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000627:therapeutic use; D006801:Humans; D015233:Models, Statistical; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D011336:Probability; D016032:Randomized Controlled Trials as Topic; D019279:Resin Cements / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005899:Glass Ionomer Cements; D010895:Pit and Fissure Sealants; D019279:Resin Cements