Introduction
Oral health is an important aspect for persons of all ages. Failure to care for one’s teeth and mouth can lead to a wide range of problems. Such problems include cavities, tooth loss, and decay, as well as gums infections (Felton et al, 2014). In most developed nations, such as the US, the majority of the citizens enjoy good oral health. In addition, most of these people maintain their natural teeth throughout their lives. Cases of dental problems are prevalent among low-income earning citizens. It is also prevalent among those who fail to make regular visits to the dentist.
There are several ways to maintain good oral hygiene. The practices include brushing teeth twice a day with fluoride toothpaste, as well as replacing toothbrushes regularly. Other means of oral care entail the use of sealants and cleaning between the teeth daily with inter-dental cleaner (Felton et al, 2014).
In this paper, the author will focus on the use of fissure sealants to care for one’s teeth. According to Chen et al (2012), fissure sealants are plastic coatings that are applied to the grooves of the molars and premolars. The sealants form protective layers that prevent bacteria and food from getting trapped in the grooves found on the teeth. There are various types of sealants used by dentists today. They include, among others, GIC and resin-based sealants. In this study, the author will evaluate whether or not GIC based sealants are more effective compared to resin-based sealants. The research will take the form of a literature review.
Methods
Database Search
Several databases were used to gather the relevant materials needed for the study. The articles used were those published between 2005 and 2015. Some of the catalogs from which the resources were accessed include Ovid MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, and EMBASE. Others are HealthSTAR and International Pharmaceuticals Abstracts.
Inclusion and Exclusion Criteria
Articles with clinical and systematic reviews were eligible for inclusion in the study. The search was limited to articles published in the English language. The works included in the systematic review were those published between 2005 and 2015. However, for an article to be used, the research must have been conducted credibly. In addition, the study published in the article should have a representative sample that is of a reasonable size. In addition, the study had to meet the psychometric evaluation criteria used. During the search, all the articles that reported the findings of studies that used small or non-representative samples were excluded. Other studies not included were those without detailed information on the kind of sealants used in oral healthcare.
Search Strategy
The key terms used were GIC and resin fissure sealants. The two terms were combined with other words, such as dental fissure, tooth decay, oral health, and dental caries. Other key phrases used were caries susceptibility and tooth surface. A total of 50 articles and their abstracts, including guideline editorials, were initially reviewed. Reference lists were analyzed to identify additional articles that may have had important information on sealants relevant to the study.
Search Results
From the initial search results, 50 articles were identified and 10 were chosen for review. Independent evaluation of the 10 editorials resulted in the exclusion of 3 systematic reviews (Chen et al, 2012; Felton et al, 2014; Lygidakis et al 2009). The 3 articles were excluded because they did not provide sufficient information on the effectiveness of GIC and resin-based sealants on patients.
However, out of the 6 editorials chosen, only 3 were prioritized for the study. The three were those by Niederman (2010), Tellez et al (2011), and Yengopal et al (2009). One of the reasons why the author focused on information from the three articles is because they had large sample sizes. In addition, the editorials had information that was highly relevant to GIC and resin fissure sealants. As a result, the 3 articles formed the basis for the evaluation of evidence regarding which fissure sealant is more effective.
Description of Included Studies
A total of 10 articles were included for the review. However, three were prioritized. All the articles provided evidence regarding the effectiveness of GIC and resin-based fissure sealants. However, some of the articles had less convincing or incomplete evidence related to the sealants on review. The results from the comparison between the tooth care products were conflicting. The studies by Chen et al (2012) and Lygidakis et al (2009), for example, were in favor of resin sealants. On their part, the research by Niederman (2010) reported that GIC produced better results after placement compared to resin-based sealants. In addition, other articles had differing results and the authors did not carry out meta-analyses. Out of these studies, none was graded as providing high-value evidence on the effectiveness of GIC and resin-based sealants.
The main outcomes reported by the studies were relative risk reduction or fraction prevention. The risk cutbacks ranged from between 4% to 95% for all the reviews evaluated (Chen et al, 2012). A meta-analysis report on caries preventive effect as stated in the studies showed that the use of both GIC and resin-based sealants significantly reduced the chances of tooth decay compared to the untreated control. The confidence levels were 95% CI: 0.55-0.80.
Quality of the Study
The overall quality of the study, based on the Newcastle Ottawa Scale, was found to be average. The reason for this is that the achieved scale was 5.5.
Discussion
Principal Findings
This review aimed to identify the effectiveness of GIC and resin-based fissure sealants. The main findings from the research were based on the 3 prioritized articles. Based on the results, there were no significant differences between the use of GIC and resin-based sealants. However, 2 editorials favored GIC, while 1 reported that resin was more effective. It was also noted that resin sealants worked better in non-moisture environments.
GIC vs. Resin-Based Sealants
The study by Niederman (2010) showed that resin-based sealants provided better retention in permanent molars compared to GIC. The results were obtained after six months and one year of re-examination. The author noted that GIC was linked to higher risks of retention loss. As a result, patients have greater chances of experiencing dental carries and microleakage.
The study carried out by Tellez et al (2011) found that both GIC and resin-based sealants presented satisfactory results related to retention. However, GIC was the best product for controlling tooth decay. The reason for this is that GIC produced a more positive result during the microleakage test when compared to resin fissure sealants. Microleakage was found to lead to bacterial buildup in the teeth. The accumulation forms carious tension and subsequent development of dental caries.
The other study that supported the use of GIC was the one conducted by Yengopal et al (2009). According to the results reported in this article, GIC is more effective compared to resin-based sealants. The reason is that it has high levels of fluoride ions. In addition, GIC did not lose all its protective effects once retention was lost.
Limitations of the Study
The review had several limitations. One of the restraints was the use of only three papers to determine the effectiveness of GIC sealants. Using only 3 articles did not provide enough results and comparison space to make the findings conclusive. Another limitation of the study was the possibility of bias in publications used for the meta-analysis. The presence of bias was noted by the use of the funnel plot asymmetry technique (Tellez et al, 2011). However, the preconception levels were moderate. As a result, the impact of the bias on conclusions made was minimal.
Conclusion
The use and effectiveness of fissure sealants as preventive measures for managing dental caries have been reported in several studies. Most researchers agree that both GIC and resin-based sealants produce good results. However, based on the 3 articles reviewed in this paper, GIC was found to be more effective. The review is of clinical significance. One of the primary applications entails helping clinicians to understand the limitations of polymers with biomaterial properties in both GIC and resin sealants. In addition, the study will help clinicians to figure out the right time to apply fissure sealants. In terms of future studies, researchers should focus on high-quality randomized control trials to provide conclusive information on the effectiveness of GIC and resin-based fissure sealants.
References
Chen X, Du M, Fan M, Mulder J, Huysmans M, Frencken J. Effectiveness of two new types of sealants: retention after 2 years. Clin Oral Investig 2012;16(5):1443-1450.
Felton A, Chapman A, Simon F. Basic Guide to Oral Health Education and Promotion (2nd ed). Chichester, West Sussex, UK: John Wiley & Sons 2014.
Lygidakis N, Dimou G, Stamataki E. Retention of fissure sealants using two different methods of application in teeth with hypomineralised molars (MIH): a 4 year clinical study. Eur Arch Paeditr Dent 2009;10(4):223-226.
Niederman R 2010. Glass ionomer and resin-based fissure sealants: equally effective?. Evid Based Dent 2010;11(1):10.
Tellez M, Gray S, Gray S, Lim S, Ismail A. Sealants and dental caries: dentists’ perspectives on evidence-based recommendations. JADA 2011;142(9):1033-1040.
Yengopal V, Mickenautsch S, Bezerra A, Leal S. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: a meta-analysis. Jour of Ora Sci 2009;51(3):373-382.