Retention Loss of Resin Based Fissure Sealants - a Valid Predictor for Clinical Outcome?

PURPOSE: The null-hypothesis that retention loss of resin fissure sealants predicts caries manifestation no more accurately than random values was tested. METHODS: Systematic reviews were checked and electronic databases searched for clinical trials. Trials reporting on the retention of resin sealants and caries occurrence in permanent molar teeth, with minimum 24-month follow-up period, were included. Extracted data: number of sealed teeth, number of teeth without completely retained sealants, number of sealed teeth with caries. The number of teeth with complete sealant retention and absence of carious lesions/cavities was calculated; the predictive outcomes: true/false positive; false/true negative were established. Random values were generated as control-data. Diagnostic Odds ratios (DOR) were computed and tested for statistical difference. Summary Receiver Operating Characteristic curves were plotted. RESULTS: 95 trials were found. Median DOR values were 1.21 and 0.28 for test- and control data, respectively. Wilcoxon test (z = 0.56; p = 0.58) and Sign test (z = 1.38; p = 0.17) results were statistically non-significant. The null-hypothesis was not rejected. CONCLUSIONS: Predictions based on the retention loss of resin sealants, regarding caries manifestation, was no more accurate than random guesses. Sealant retention loss appears not to be a valid predictor for clinical outcome.