Resin-modified glass-ionomer cements versus resin-based materials as fissure sealants: a meta-analysis of clinical trials.
OBJECTIVE
To appraise quantitatively current evidence regarding the caries-preventing effect of resin-modified glass-ionomer cement (RM-GIC) fissure sealants in comparison to that of resin-based fissure sealants.


METHODS
Systematic review with meta-analysis.


METHODS
8 Anglophone databases and 2 Lusophone databases were searched until 15 April 2009, using a pre-determined search strategy. Clinical trials were considered for inclusion if their titles/abstracts were relevant to the topic, published in English, Portuguese or Spanish and had a two-arm longitudinal study design. The outcome measure of the caries-preventive effect was caries absence on sealed teeth. Two reviewers independently extracted data from the accepted articles in order to complete a 2x2 table for meta-analysis. The unit of interest was the tooth, and the number of caries-free teeth (n) at the end of each time interval (6, 12 and 24 months) was compared against the total number of evaluated teeth (N).


METHODS
Datasets were assessed for their clinical and methodological heterogeneity, following Cochrane guidelines, and only homogeneous datasets were combined for meta-analysis, using a random effects model (RevMan 4.2). Differences in the caries-preventive effect were computed on the basis of the combined Relative Risk (RR) with 95% confidence interval (CI).


RESULTS
Of the 212 articles identified, only 6 trials were included. From these, 19 separate datasets were extracted. For the pooled data, equivalent caries-preventive effects were observed at 6 months (RR= 0.98, 95% CI 0.95- 1.00; p = 0.08); 12 months (RR=1.00, 95% CI 0.96-1.04, p = 0.99) and 24 months (RR=1.01, 95% CI 0.84-1.21, p = 0.91). The 36-month data (not pooled) favoured resin-based sealants (RR 0.93, 95% CI 0.88-0.97, p = 0.002).


CONCLUSIONS
This meta-analysis found no conclusive evidence that either material was superior to the other in preventing dental caries.
Yengopal
V
V
Division of Public Oral Health, University of the Witwatersrand, 7 York Rd., Parktown/Johannesburg, 2193, South Africa.
Mickenautsch
S
S
D002327:Cariostatic Agents / Q000737:chemistry; D002986:Clinical Trials as Topic; D003731:Dental Caries / Q000517:prevention & control; D005899:Glass Ionomer Cements; D006801:Humans; D010895:Pit and Fissure Sealants / Q000737:chemistry*; D019279:Resin Cements
D002327:Cariostatic Agents; D005899:Glass Ionomer Cements; D010895:Pit and Fissure Sealants; D019279:Resin Cements