Summary of findings 3. Glass ionomer‐based sealants versus (fluoride‐releasing) resin‐based sealants.
| Glass ionomer‐based sealants versus resin‐based sealants | ||||||
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Population: 'healthy' children, with caries‐free second primary molars, aged 3–5 years Settings: schools and kindergarten, India and China Intervention: glass ionomer‐based sealants Comparison: fluoride‐releasing or non‐fluoride‐releasing resin‐based sealants | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Risk with resin‐based sealants | Risk with glass ionomer‐based sealants | |||||
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Development of ≥ 1 new carious lesion (caries incidence) Follow‐up: 6–24 months |
N/A Insufficient quantitative information available |
N/A | 200 (2 studies) | ⊕⊝⊝⊝ Very lowa | Due to the methods of data collection, analysis and reporting we were unable to provide any quantitative estimates for this comparison. | |
| Progression of non‐cavitated enamel caries | No studies reported this outcome. | |||||
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Sealant retention Complete or partial retention of sealant Follow‐up: 24 monthsb |
70 per 1000 | 320 per 1000 (208 to 458) | BB OR 0.20 (0.11 to 0.36) | 100 children, 100 tooth pairs (1 RCT) | ⊕⊝⊝⊝ Very lowa | We were unable to re‐analyse the results from an additional split‐mouth study (several tooth pairs) that failed to consider the split‐mouth nature of the data and the multiple teeth treated. The authors reported that, "At 6 month after pit and fissure seal, detachment rate was lower in the glass ionomer group compared with resin group (P = 0). At 18 months, detachment rate was lower in the glass ionomer group compared with resin group (P = 0.113)." |
| Adverse events | — | — | — | 100 children (1 RCT) | ⊕⊝⊝⊝ Very lowa | 1 study reported adverse events as some discomfort such as nausea among some children. 1 child reported feeling uncomfortable and experienced a strong gag reflex following application of the glass ionomer‐based sealant while 8 children reported feeling uncomfortable after the fluoride resin‐based applications. |
| *The basis for the assumed risk is the control group risk. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). BB OR: Becker Balagtas odds ratio; CI: confidence interval; RCT: randomised controlled trial. | ||||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
aWe downgraded two levels for study limitations arising from lack of blinding and selective reporting, and one level for imprecision. bThe reported retention percentages for the resin group did not add up to 100% for the six‐ and 12‐month time points and so we were unable to use the reported data. For the 24‐month time point, 32% of sealants were completely or partially retained in the glass ionomer‐based sealant group, and 70% completely or partially retained in the resin‐based sealant group.