title: Are self-etch adhesive systems effective in the retention of occlusal sealants? A systematic review and meta-analysis.
abstract: BACKGROUND
  Occlusal sealants are an effective method for caries prevention, although the effectiveness of different application strategies has not been established yet.
  
  
  OBJECTIVE
  This systematic review compared the retention rate of sealants placed on occlusal surfaces following the use of self-etch adhesive systems and traditional acid etching, with or without the application of adhesive system.
  
  
  METHODS
  Literature searching was carried out until June 2015 in PubMed/MEDLINE, CENTRAL, and ClinicalTrials databases selecting randomized clinical trials that evaluated self-etch adhesive systems associated with pit and fissure sealants in primary or permanent molars comprising retention as outcome. From 683 potentially eligible studies, 10 were selected for full-text analysis and 5 were included in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the bias risk. Pooled-effect estimates were obtained by comparing the retention failure rate between groups (self-etch systems vs acid etching with or without adhesive systems).
  
  
  RESULTS
  Significant difference was found between groups, favoring the control group (prior acid etching) (P < 0.05), which showed lower failure rate in the retention of occlusal sealants. High heterogeneity was found on the meta-analysis. Most trials showed good evidence strength.
  
  
  CONCLUSIONS
  Occlusal sealants applied with self-etch systems show lower retention throughout time than sealants applied in the conventional approach, regardless of the use of adhesive systems.
authors.affiliation: Dental Science Graduate Program, Federal University of Santa Maria, Santa Maria, Brazil.
authors.forename: Graziela
authors.initials: G
authors.lastname: Botton
authors.affiliation: School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil.
authors.forename: Caroline Sonego
authors.initials: CS
authors.lastname: Morgental
authors.affiliation: School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil.
authors.forename: Maitê Munhoz
authors.initials: MM
authors.lastname: Scherer
authors.affiliation: Dental Science Graduate Program, Federal University of Santa Maria, Santa Maria, Brazil.
authors.forename: Tathiane Larissa
authors.initials: TL
authors.lastname: Lenzi
authors.affiliation: Dental Science Graduate Program, Federal University of Santa Maria, Santa Maria, Brazil.
authors.forename: Anelise Fernandes
authors.initials: AF
authors.lastname: Montagner
authors.affiliation: Departament of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil. rachelrocha@smail.ufsm.br.
authors.forename: Rachel de Oliveira
authors.initials: RO
authors.lastname: Rocha
mesh_terms: D000134:Acid Etching, Dental / Q000379:methods*; D002327:Cariostatic Agents / Q000737:chemistry*; D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D003738:Dental Cements / Q000737:chemistry*; D006801:Humans; D008963:Molar; D010895:Pit and Fissure Sealants / Q000737:chemistry*
chemical_list: D002327:Cariostatic Agents; D003738:Dental Cements; D010895:Pit and Fissure Sealants