Non-Cochrane · other · PM24194861
Validity of sealant retention as surrogate for caries prevention--a systematic review.
Mickenautsch Steffen, Yengopal Veerasamy · PloS one · 2013 · PubMed · doi:10.1371/journal.pone.0077103
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
10
current version
GRADE rated
0
No studies
0
Included studies
62
as reported
No studies 0 · 0%Ungraded 10 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients of any age, gender, or place of origin with resin- or GIC-sealed permanent molar teeth | 62 accepted trial reports (150 datasets); permanent molar teeth (17,377 resin and 3,768 GIC unique sealed teeth in main analysis) |
| Intervention | Resin-based and glass-ionomer cement (GIC)-based fissure sealants | Resin-based fissure sealants (115 datasets) |
| Comparison | Resin- versus GIC-based sealants (between-material); surrogate (retention loss) versus clinical endpoint (caries) within material | Glass-ionomer cement-based fissure sealants (35 datasets) |
| Outcomes | Ratio of risk of loss of complete retention to risk of caries occurrence (RCR); validity of retention as surrogate for caries (Prentice criterion) | Regression slope of ln(caries risk) on ln(retention-loss risk); difference in retention-to-caries risk ratio (RCR) between materials |
| Study designs | Clinical trials reporting retention and caries; systematic reviews/meta-analyses screened to identify trials | 18 controlled direct-comparison trials; 39 controlled trials versus other controls; 5 uncontrolled longitudinal studies (none appropriately randomized) |
| Timing | Minimum 24-month follow-up | At least 24 months (main); longest follow-up per trial (sensitivity) |
Search date: 21 October 2012. Databases: PubMed/Medline; Directory of Open Access Journals (DOAJ); IndMed; Scielo
Questions and results
Resin-based fissure sealants vs No comparator (within-material surrogate-validity regression)
Population: Patients with fissure-sealed permanent molar teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Association between loss of complete retention risk and caries occurrence risk At least 24 months · Main analysis Loss of complete sealant retention was directly associated with caries occurrence for resin-based sealants in the main analysis (regression slope 0.89, 95% CI 0.56 to 1.23; ungraded). Source: Table 3 (Mat 1 - main, 115 datasets); Results (Regression analysis) · same question in other reviews | Regression slope (ln caries risk on ln retention-loss risk) 0.89 [0.56, 1.23] | 54 studies · 17377 participants | Ungraded |
Association between loss of complete retention risk and caries occurrence risk Longest follow-up per trial · Sensitivity analysis In the sensitivity analysis, loss of complete retention was not directly associated with caries occurrence for resin-based sealants (regression slope 0.53, 95% CI -0.27 to 1.32; ungraded). Source: Table 3 (Mat 1 - sens, 18 datasets); Results (Sensitivity analysis) · same question in other reviews | Regression slope (ln caries risk on ln retention-loss risk) 0.53 [-0.27, 1.32] | 14 studies · 3154 participants | Ungraded |
Glass-ionomer cement-based fissure sealants vs No comparator (within-material surrogate-validity regression)
Population: Patients with fissure-sealed permanent molar teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Association between loss of complete retention risk and caries occurrence risk Longest follow-up per trial · Sensitivity analysis In the sensitivity analysis, loss of complete retention was directly associated with caries occurrence for glass-ionomer cement-based sealants (regression slope 1.44, 95% CI 0.71 to 2.18; ungraded). Source: Table 3 (Mat 2 - sens, 14 datasets); Results (Sensitivity analysis) · same question in other reviews | Regression slope (ln caries risk on ln retention-loss risk) 1.44 [0.71, 2.18] | 14 studies · 2307 participants | Ungraded |
Association between loss of complete retention risk and caries occurrence risk At least 24 months · Main analysis Loss of complete retention was not directly associated with caries occurrence for glass-ionomer cement-based sealants in the main analysis (regression slope 0.81, 95% CI -0.07 to 1.68; ungraded). Source: Table 3 (Mat 2 - main, 35 datasets); Results (Regression analysis) · same question in other reviews | Regression slope (ln caries risk on ln retention-loss risk) 0.81 [-0.07, 1.68] | 22 studies · 3768 participants | Ungraded |
Resin-based fissure sealants vs Glass-ionomer cement-based fissure sealants
Population: Patients with fissure-sealed permanent molar teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Retention-to-caries risk ratio (RCR) Longest follow-up per trial · Sensitivity analysis In the sensitivity analysis, the difference in retention-to-caries risk ratio between resin- and glass-ionomer cement-based sealants was not statistically significant (p = 0.069; ungraded). Source: Results (Sensitivity Analysis); 14 trials per sealant type · same question in other reviews | Mean RCR (retention-to-caries risk ratio); t-test of difference Resin vs GIC difference not statistically significant (p=0.069); sensitivity-analysis mean RCRs not reported | 14 studies | Ungraded |
Retention-to-caries risk ratio (RCR) At least 24 months · Main analysis The mean retention-to-caries risk ratio differed significantly between resin- and glass-ionomer cement-based sealants (9.64 vs 13.68; p = 0.017), indicating non-compliance with the Prentice criterion (ungraded). Source: Results (Null-hypothesis testing); Table 2 (62 trial reports) · same question in other reviews | Mean RCR (retention-to-caries risk ratio); t-test of difference Resin mean RCR 9.64 (SD 24.58) vs GIC 13.68 (SD 13.72); p=0.017 | 62 studies | Ungraded |
Comparison
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Risk of loss of complete retention Main analysis; GIC-based (Mat 2) | Mean risk (proportion of sealed teeth) 0.84 (SD 0.19) | 22 studies | Ungraded |
Risk of loss of complete retention Main analysis; resin-based (Mat 1) | Mean risk (proportion of sealed teeth) 0.36 (SD 0.23) | 54 studies | Ungraded |
Risk of caries occurrence Main analysis; resin-based (Mat 1) | Mean risk (proportion of sealed teeth) 0.12 (SD 0.14) | 54 studies | Ungraded |
Risk of caries occurrence Main analysis; GIC-based (Mat 2) | Mean risk (proportion of sealed teeth) 0.12 (SD 0.08) | 22 studies | Ungraded |