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Mejàre I, Lingström P et al. Acta Odontol Scand 2003; 61: 321–330

A wide-ranging search identified 113 studies of potential relevance. Two reviewers independently performed a detailed examination of these studies to include all randomized, split mouth or controlled trials which gave outcome as caries increment, specified the teeth under investigation, defined the diagnostic criteria, involved children <9 yrs for 1st molars and <15 yrs for 2nd molars, and had at least 2 yrs' follow-up. Eventually 13 studies involving 3897 children were identified.

No studies were graded as high value evidence, 2 were graded as moderate evidence, and 11 as limited evidence. Relative caries risk reduction varied from 4% to 54% for single, and 69% to 93% for repeated, applications. A pooled estimate of resin-based sealing of 1st permanent molars showed a relative risk reduction (RRR) of 33% for caries in sealed teeth, and for 2 glass ionomer (GI) studies, RRR was 56%.

The authors state that only one included study was a randomized controlled trial and consider there is a need for well-designed studies in this category. They consider there is only limited evidence of an effect with resin-based sealants, and incomplete evidence of any effect of GI sealants.