What do systematic reviews say?

Ormocer-based sealant vs Glass-ionomer cement-based fissure sealants

• Pit and fissure sealants for preventing dental decay in permanent teeth 2017 · Cochrane All outcomes

  24 months
  Guler 2013 (N=50) compared ormocer-based sealant versus low-viscosity glass ionomer; not separately meta-analysed
  1 study · 50 participants
  GRADE not reported

Glass ionomer sealant (with fluoride gel plus dentifrice) vs Fluoride gel plus fluoride toothpaste/dentifrice (non-invasive control)

Glass ionomer sealant (with fluoride gel plus dentifrice) showed no clear difference in caries (lesion) progression (radiographic) compared with fluoride gel plus fluoride toothpaste/dentifrice (non-invasive…; GRADE not reported.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Glass ionomer sealant
  OR 0.13 [0.01, 2.52]
  1 study
  GRADE not reported

Adhesive/polyurethane sealant patch vs No treatment (both arms received flossing plus fluoride toothpaste)

Adhesive/polyurethane sealant patch showed no clear difference in caries (lesion) progression (radiographic) compared with no treatment (both arms received flossing plus fluoride toothpaste); GRADE not reported.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Sealant patch
  OR 1.00 [0.14, 7.23]
  1 study
  GRADE not reported

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

Micro-invasive treatment (proximal sealing or resin infiltration):… probably leads to lower caries (lesion) progression measured by pairwise reading of… compared with non-invasive measures (e.g. fluoride varnish, flossing/oral hygiene… (moderate certainty).

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  18 to 36 months (radiographic follow-up)
  OR 0.31 [0.18, 0.53]
  4 studies
  Moderate
• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up)
  OR 0.24 [0.14, 0.41]
  7 studies · 365 participants
  Moderate
• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 18 months (radiographic follow-up)
  OR 0.18 [0.06, 0.50]
  3 studies
  Moderate

Resin sealant (one micro-invasive treatment) vs Resin infiltration alone

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  up to 3 years
  Only one study (Martignon 2012) directly compared resin sealant versus resin infiltration; the review could not determine which technique is more advantageous and reported no direct effect estimate for this comparison.
  1 study
  GRADE not reported

Resin sealant (with or without flossing advice) vs Flossing advice (non-invasive control)

Resin sealant (with or without flossing advice) led to lower caries (lesion) progression (radiographic) compared with flossing advice (non-invasive control); GRADE not reported.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Resin sealant
  OR 0.33 [0.18, 0.59]
  2 studies
  GRADE not reported

Resin infiltration vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Resin infiltration led to lower caries (lesion) progression (radiographic) compared with fluoride varnish, sham/placebo, or flossing advice (non-invasive…; GRADE not reported.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  12 to 36 months (radiographic follow-up) · Resin infiltration
  OR 0.19 [0.08, 0.46]
  2 studies
  GRADE not reported

Analogue (conventional) radiographs vs Cone beam computed tomography (CBCT) (direct within-person / paired comparison); reference standard: histology

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  Direct comparison analogue vs CBCT (within-person): 6 datasets from 3 studies (737 tooth sites or surfaces) provided data, but the results could not be pooled; only individual study results are shown (Figure 21). No…
  3 studies
  GRADE not reported

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Study setting (in vitro vs in vivo)
  Pre-specified in vitro versus in vivo comparison was not completed because 49 of the 60 histology studies were in vitro; a sensitivity analysis removing the in vivo studies confirmed a minimal change to summary…
  Studies not reported
  GRADE not reported

Transillumination/OCT device used as an adjunct to a conventional visual examination vs Reference standard: histology, or enhanced visual examination with or without radiographs (also operative excavation, tooth separation, or microcomputed tomography)

The review found no eligible studies for this question.

• Transillumination and optical coherence tomography for the detection and diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo; in vitro no limit if stored appropriately)
  No studies formally reported the use of the illumination devices as an adjunct to a conventional visual examination, and therefore it has not been possible to make an assessment.
  0 studies
  No studies found

Radiographic imaging methods (any: analogue radiographs, digital radiographs, or CBCT) vs Reference standard (histology, excavation, or enhanced visual examination)

The review found no eligible studies for this question.

• Imaging modalities to inform the detection and diagnosis of early caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Pit and fissure sealants
  Pre-specified heterogeneity investigation of surfaces with pit and fissure sealants: no study reported the inclusion of sealants that would allow evaluation of early caries lesions.
  0 studies
  No studies found

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

The review found no eligible studies for this question.

• Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries 2021 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies) · Pit and fissure sealants
  Pre-specified heterogeneity investigation of surfaces with previously applied pit and fissure sealants: no studies reported the inclusion of sealants.
  0 studies
  No studies found

Canary System (Quantum Dental Technologies; red fluorescence, scale 0-100) vs Reference standard: histology, enhanced visual examination with or without radiographs, or excavation

The review found no eligible studies for this question.

• Fluorescence devices for the detection of dental caries 2020 · Cochrane All outcomes

  Up to 3 months between index test and reference standard (in vivo studies)
  The Canary System was not used by any included study.
  0 studies
  No studies found

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  None of the studies reported on participant or operator perception
  0 studies
  No studies found

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  None of the studies reported on costs for micro-invasive treatment or non-invasive control
  0 studies
  No studies found

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  1 to 3 years
  The four studies that measured adverse events reported no adverse events after micro-invasive treatment (no events in either arm)
  4 studies
  GRADE not reported

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  No studies reported on caries measured as change in decayed, missing and filled (DMF/dmf) figures at surface, tooth or whole mouth level
  0 studies
  No studies found

Micro-invasive treatment (proximal sealing or resin infiltration) vs Conventional invasive treatment (restoration / drill and fill)

The review found no eligible studies for this question.

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes
  No studies compared micro-invasive treatments with invasive treatment (fillings)
  0 studies
  No studies found

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  3 years
  One study (Alkilzy 2011, sealant patch) reported material deficiency: 10% total and 23% partial loss of proximal sealants after three years; 53% maintained perfect margins and none had open margins. No studies reported…
  1 study
  GRADE not reported