Retention of pit and fissure sealants versus flowable composites in permanent teeth: A systematic review

OBJECTIVE: To summarize the available clinical evidence on the relative effectiveness of retention of resin-based pit and fissure sealants (PFS) with that of flowable composites on occlusal surfaces of permanent teeth when evaluated in clinical trials. SOURCES: Electronic searches were performed in PubMed and Cochrane Library for the identification of relevant studies, from their inception until February 2020 and an additional search was done with the reference lists of included articles. STUDY SELECTION: The review protocol followed the PRISMA guidelines and was registered in PROSPERO (CRD42018112805). The risk of bias of the studies was independently appraised using the revised Cochrane Risk of Bias tool (RoB 2.0). DATA: Ten articles were considered relevant for qualitative synthesis. The data extracted from two of the included articles showed statistically significant difference between the two materials based on their retention potential, of which one article favored superior retention of flowable composites and one article favored higher retention of PFS and the other eight studies showed no significant difference between the two materials. CONCLUSION: The current review has shown evidence suggesting the effective retention of resin-based pit-and-fissure sealants and flowable composites when applied to prevent occlusal caries in permanent molars, however, this evidence is of low quality. Carefully designed long-term clinical trials are required to support the results of this review. CLINICAL SIGNIFICANCE: This is an important topic that would be of significant interest in the field of preventive dentistry, where sealants are the primary recommended method to prevent caries. The clinical efficacy of sealants is directly linked to their potential to retain and this systematic review focuses on comparing the relative effectiveness of resin-based pit-and-fissure-sealants with flowable composites in permanent teeth.