Abstract
The high prevalence and heavy socio-economic burden for caries of first permanent molars (FPMs) make the prevention of this disease a major public health goal. Current guidelines recommend a preference of fissure sealant (FS) over fluoride varnish (FV) based on two recent systematic reviews. However, evidences of these two studies are weak because of scarce data and some limitations. Besides, an up-to-date large scale randomized controlled trial (RCT) reported commensurate effectiveness of these two techniques. Thus, in order to more accurately compare the clinical efficacy between FS and FV on caries prevention for FPMs, we carried out this systematic review and meta-analysis. A total of 8 RCTs involving 3289 participants and 6878 FPMs fulfilled the inclusion criteria. Our meta-analysis for the first time showed that there was no statistical difference on caries incidence or occlusal DMFS increment between sealant group and fluoride varnish group at 2~3 years’ follow-up. In that sense, biannual applications of FV or FS may be equally effective on caries prevention for FPMs. These results do not support routine recommendation of FS over FV, thus shedding light on current conceptions. Our findings endow clinicians with a window to reconsider the choice between these two techniques.
Highlights
First permanent molars (FPMs) are of great significance to caries prevention[6,7]
After selection according to the inclusion and exclusion criteria, 8 studies were included for quantitative synthesis, yet five of these 8 studies were not included in previous meta-analysis (Table 1)[13,14,15,16,17,18,19,20]
randomized controlled trial (RCT) included in present study dated from 1984 to 2017, which enrolled in 3289 participants and 6878 first permanent molars (FPMs)
Summary
First permanent molars (FPMs) are of great significance to caries prevention[6,7]. Two techniques, namely fluoride varnish (FV) and fissure sealant (FS), are introduced to prevent caries of FPMs, both proved effective[11,12]. It still cannot be concluded clearly which of these two skills is clinically superior. A large-scale, high-qualified RCT updated recently showed that there was no significant difference on prevention efficacy of FPMs caries between FV and FS13. Our study aimed to accurately evaluate the efficacy of FPMs caries management between FS and FV
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