Fissure sealant in a nutshell. Evidence-based meta-evaluation of sealants’ effectiveness in caries prevention and arrest

Abstract Objective This meta-evaluation aimed to summarize all available evidence regarding different fissure sealants on occlusal caries prevention, arrest, retention rate, adverse effect and cost-effectiveness; when compared with no intervention, other preventive or minimally-invasive procedures. Materials and methods The systematic reviews and meta-analyses were identified via four electronic databases and manual searching. Two independent reviewers performed study selection, data extraction, quality assessment with AMSTAR-2. Results Among the 366 records yielded, 38 systematic reviews were identified as eligible 24 of them included meta-analyses. Moderate evidence has supported the efficacies of resin-based sealants (RBS) in occlusal caries prevention, arrest and cost-effectiveness compared to no interventions. Low to very low certainty of evidence suggested similar effectiveness of glass-ionomer cements (GIS) in caries prevention with RBS and more superior performance of resin infiltration in arresting non-cavitated occlusal lesions. Conclusion This meta-evaluation supports the use of RBS on permanent molars to reduce occlusal caries occurrence, arrest lesion progression and alleviate oral health inequalities between individuals of different socioeconomic status. This meta-evaluation also advocates further research on GIS and resin infiltration with respect to their efficacies in caries prevention and arrest.