Non-Cochrane · intervention · PM36263239
Pit and Fissure Sealant versus Fluoride Varnish for the Prevention of Dental Caries in School Children: A Systematic Review and Meta-Analysis.
Rashed Tasneem, Alkhalefa Nura, Adam Alaa, et al. · International journal of clinical practice · 2022 · PubMed · doi:10.1155/2022/8635254
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
2
current version
GRADE rated
0
No studies
0
Included studies
7
linked below
No studies 0 · 0%Ungraded 2 · 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 | Schoolchildren aged 6-12 years with a sound occlusal surface in the first permanent molars | 1249 schoolchildren across 4 RCTs (included-trial ages 6-8, 6-7, and mean 9.1 years) |
| Intervention | Resin-based pit and fissure sealant (glass ionomer sealant/cement comparisons excluded) | Resin-based pit and fissure sealant (e.g., Delton visible-light sealant) |
| Comparison | Fluoride varnish | Fluoride varnish (e.g., Duraphat) |
| Outcomes | Incidence of dental caries on first permanent molar surfaces; change in DMFS (decayed, missing, filled surfaces) increment | Caries incidence in first permanent molars (3 trials, 2622 FPMs; RR 0.65, 95% CI 0.31-1.38); DMFS increment (2 trials; SMD -0.13, 95% CI -0.67 to 0.40) |
| Study designs | Randomized controlled trials with at least 24 months follow-up; split-mouth, quasi-randomized, non-randomized, and observational studies excluded | 4 RCTs (Table 1 labels 2 as RCT and 2 as randomized parallel), published 1996-2014 |
| Timing | At least 24 months follow-up | 24 months follow-up (all included trials) |
Search date: Databases searched for studies from January 1980 to May 2022 (Methods 2.6), implying a May 2022 search; the Abstract instead states 1990-2019. Databases: Embase; Google Scholar; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via Ovid; ClinicalTrials.gov (ongoing/unpublished RCTs); reference lists of identified articles (Abstract states 'five databases')
Questions and results
Resin-based pit and fissure sealant (PFS) vs Fluoride varnish (FV)
Population: Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
DMFS (decayed, missing, filled surfaces) increment, occlusal surfaces 24 months Pit and fissure sealant and fluoride varnish showed no statistically significant difference in DMFS increment at 24 months (SMD -0.13, 95% CI -0.67 to 0.40; I2=92%; not GRADE-rated). Source: Results 3.3 (Meta-Analysis); Figure 4 (forest plot, DMFS increment); Abstract · same question in other reviews | MD 0.09 [-0.03, 0.21] | 2 studies · 762 participants | Ungraded |
Caries incidence in first permanent molars 24 months Pit and fissure sealant and fluoride varnish showed no statistically significant difference in caries incidence of first permanent molars at 24 months (RR 0.65, 95% CI 0.31 to 1.38; I2=89%; not GRADE-rated). Source: Results 3.3 (Meta-Analysis); Figure 3 (forest plot, caries incidence of FPM); Abstract · same question in other reviews | RR 0.65 [0.31, 1.38] | 3 studies · 1263 participants | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | No | no |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 7
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Bravo et al. 1996 Effectiveness of visible light fissure sealant (Delton) versus fluoride varnish (Duraphat): 24‐month clinical trial DOI:10.1111/j.1600-0528.1996.tb00811.x | 1 other review | not stated | not extracted yet | not extracted yet |
| Bravo et al. 1997 A 24‐month Study Comparing Sealant and Fluoride Varnish in Caries Reduction on Different Permanent First Molar Surfaces DOI:10.1111/j.1752-7325.1997.tb02972.x | 1 other review | not stated | not extracted yet | not extracted yet |
| Liu et al. 2012 Randomized Trial on Fluorides and Sealants for Fissure Caries Prevention DOI:10.1177/0022034512452278 | 1 other review | not stated | not extracted yet | not extracted yet |
| Bravo et al. 1996 Effectiveness of visible light fissure sealant (Delton) versus fluoride varnish (Duraphat): 24-month clinical trial. PMID:8833514 | this review only | not stated | not extracted yet | not extracted yet |
| Bravo et al. 1997 A 24-month study comparing sealant and fluoride varnish in caries reduction on different permanent first molar surfaces. PMID:9383759 | this review only | not stated | not extracted yet | not extracted yet |
| Liu et al. 2012 Randomized trial on fluorides and sealants for fissure caries prevention. PMID:22736448 | this review only | not stated | not extracted yet | not extracted yet |
| Salem et al. 2014 Pit and Fissure Sealant Versus Fluoride Varnish In Prevention of Occlusal Caries DOI:10.18869/acadpub.3dj.3.1.46 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Comparison between Fissure Sealant and Fluoride Varnish on Caries Prevention for First Permanent Molars: a Systematic Review and… (2020) | 3 | 0.27 |