title: European Fissure Sealant Guidelines: assessment using AGREE II.
abstract: BACKGROUND
  Pit and fissure sealants are effective in reducing the incidence of occlusal caries, and multiple clinical practice guidelines (CPGs) have been developed for recommending their proper use. The usefulness of CPGs depends on their quality and on the rigour of the guideline development process.
  
  
  OBJECTIVE
  A study was made to assess the quality of current European CPGs based on the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, which uses 23 key items rated on a 7-point scale to assess practice guideline development and the quality of reporting.
  
  
  METHODS
  A search was conducted for fissure sealant guidelines for preventing caries in children and adults at high and low risk published in the last 10 years. Calibration was carried out before scoring to assess agreement between the appraisers using the AGREE II instrument.
  
  
  RESULTS
  The searches identified 19 relevant guidelines, and following application of the inclusion/exclusion criteria, three guidelines were retained for evaluation. The proportion of observed agreement was calculated, expressed by the agreement separately for positive and negative ratings (PA = 0.89, NA = 0-91). The results of the guideline assessments revealed the highest score for the Irish guideline, a moderate score for the French guideline and the lowest score for the European guideline.
  
  
  CONCLUSIONS
  Based on the AGREE II instrument, the results obtained show significant variation in the quality assessment of the three European Fissure Sealant Guidelines. Future studies should be carried out both to develop quality dental CPGs and to investigate effective ways of adopting them.
authors.affiliation: School of Dentistry, University of Seville, Seville, Spain.
authors.forename: L
authors.initials: L
authors.lastname: San Martin-Galindo
authors.affiliation: School of Dentistry, School of Medicine, University of Murcia, Murcia, Spain.
authors.forename: F J
authors.initials: FJ
authors.lastname: Rodríguez-Lozano
authors.affiliation: School of Dentistry, University of Seville, Seville, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Abalos-Labruzzi
authors.affiliation: Department of Epidemiology and Health Promotion, Center for Evidence-Based Dentistry, College of Dentistry, New York University, New York, NY, USA.
authors.forename: R
authors.initials: R
authors.lastname: Niederman
mesh_terms: D000328:Adult; D002648:Child; D003731:Dental Caries / Q000517:prevention & control; D005060:Europe; D006801:Humans; D010895:Pit and Fissure Sealants / Q000592:standards* / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D010895:Pit and Fissure Sealants
keywords: Appraisal of Guidelines for Research and Evaluation II; European guidelines; fissure sealants