ObjectiveThis meta-analysis investigates the clinical retention of pit and fissure sealants in relation to observation time and material type. Data, sources and study selectionA search in the MEDLINE, EMBASE and CENTRAL databases identified 2944 abstracts (published prior to 9/30/2011), of which 485 clinical publications were analyzed in detail. A total of 146 articles included information about sealant retention, with a minimum observation time of 2years. These publications were analyzed to determine the retention rates of the various materials studied (UV-light-, light- and auto-polymerizing resin-based sealants, fluoride-releasing materials, compomers, flowable composites and glass-ionomer-cement-based sealants). The meta-analysis used random effects models for longitudinal logistic regression and Bayesian statistics. ResultsAs part of the systematic review, 98 clinical reports and 12 field trial reports were identified. Auto-polymerizing sealants had the longest observation time (up to 20years) and were found to have a 5-year retention rate of 64.7% (95%CI=57.1–73.1%), which was estimated from the meta-analysis model. Resin-based light-polymerizing sealants and fluoride-releasing products showed similar 5-year retention rates (83.8%, 95%CI=54.9–94.7% and 69.9%, 95%CI=51.5–86.5%, respectively) for completely retained sealants. In contrast to these high retention rates, poor retention rates were documented for UV-light-polymerizing materials, compomers and glass-ionomer-cement-based sealants (5-year retention rates were <19.3%). Retention rates for UV-light-polymerizing materials, compomers and glass-ionomer-cement-based sealants were classified as inferior. Conclusions versus SignificanceThe results of this meta-analysis suggested that resin-based sealants can be recommended for clinical use. The faster and less error-prone clinical application of light-polymerizing materials, however, makes them the preferred choice for daily dental practice.