Sealants generally show equal performance regardless of tooth type and position.

Data sourcesMedline (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Virtual Health Library (including Bibliography Brazilian Dentistry and LILACS), Scopus, and ISI Web of Knowledge, Google Scholar, International Standard Registered Clinical/soCial sTudy Number registry, Directory of Open Access Journals, Digital Dissertations and metaRegister of Controlled Trials) and the reference lists of included trials.Study selectionRandomised clinical trials (RCT) on humans including at least one trial arm comparing clinical performance of pit and fissure sealants with any other active, control or placebo were considered.Data extraction and synthesisIndependently and in duplicate by two reviewers using piloted data extraction forms. Risk of bias was carried out by two reviewers using the Cochrane Risk of Bias tool. Paule-Mandel random-effects meta-analyses of Relative Risks (RRs) and their 95% confidence intervals (CIs) were calculated.ResultsSixteen trials were included with 2,778 participants (mean age 8.4 years). There was no significant difference in caries incidence or sealant retention rate for: mouth side; maxilla vs mandible; or tooth type for: 1st permanent molar vs 2nd permanent molar; 1st permanent molar vs 2nd primary molar or 1st primary molar vs 2nd primary molar (very low to low quality evidence). However, there was a difference between 1st permanent molars and premolars where sealed premolars were significantly less likely to develop caries or sealant loss (low to moderate evidence quality).ConclusionsFissure sealants seem to perform similarly for sealant retention and caries rate for different sides of mouth, arches and tooth types apart from between 1st permanent molars and premolars, where premolars have more favourable results. The quality of the evidence however, is very low to moderate and this should be borne in mind when interpreting the results.