Resin-based sealant effectiveness in high-caries risk children: a systematic review.

backgroundThere have been limited previous reviews on the use of sealants in high-caries-risk children that include multiple study designs. This systematic review aimed to evaluate the preventive effect of sealants on high-caries-risk children and compare the effectiveness of sealants between high-caries-risk children and lower-caries-risk children.

methodsAn initial protocol was developed following the PRISMA guidelines. A comprehensive literature search was performed across several electronic databases, including PubMed, the Cochrane Library, Embase and Google Scholar. Experimental or observational studies that examined resin-based sealants for preventing caries over at least 12 months in high-caries-risk children, identified by individual risk assessment, were included. Comparison groups were moderate- or low-risk children or no sealant; if unavailable, only intervention data were used. The risk of bias was assessed via the RoB2 tool and the Newcastle‒Ottawa Scale.

resultsA total of 1651 unique records were identified, 20 of which were included in this systematic review. Studies comparing only sealed teeth among different caries risk groups have indicated that high-caries-risk children have a greater risk of developing new carious lesions than low- or moderate-risk children do. In contrast, the effect of sealants was negligible in low-caries-risk children when compared between sealed and nonsealed teeth. Additionally, caries experience was the primary criterion used across all included studies.

conclusionResin-based sealants are still recommended for high-caries-risk children. However, generalizability and an appropriate threshold for risk assessment remain unclear owing to the limited number of studies from low- to middle-income countries and variability in risk assessment methods. SYSTEMATIC REVIEW REGISTRATION: PROSPERO Registration number CRD42023473013. CLINICAL TRIAL NUMBER: Not applicable.