covid
Buscar en
Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral
Toda la web
Inicio Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral Uso de sellantes de fosas y fisuras para la prevención de caries en población ...
Información de la revista
Vol. 6. Núm. 1.
Páginas 14-19 (abril 2013)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 6. Núm. 1.
Páginas 14-19 (abril 2013)
Open Access
Uso de sellantes de fosas y fisuras para la prevención de caries en población infanto-juvenil: Revisión metodológica de ensayos clínicos
Use of pit and fissure sealants for preventing caries in child population: Methodological review of clinical trials
Visitas
9233
S. Faleiros Chioca1, I. Urzúa Araya2,
Autor para correspondencia
ivanurzua@yahoo.com

Correspondencia autor: Departamento Odontología Restauradora. Facultad de Odontología, Universidad de Chile. Sergio Livingstone P. 342, Independencia. Santiago, Chile
, G. Rodríguez Martínez2, R. Cabello Ibacache2
1 Doctorado en Salud Pública. Facultad de Odontología, Universidad de Chile. Chile
2 Magíster en Ciencias Odontológicas. Facultad de Odontología, Universidad de Chile. Chile
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
Resumen

La caries dental es uno de los problemas más relevantes dentro del ámbito odontológico y de la Salud Pública. En Chile existe una alta prevalencia de caries en la población infanto-juvenil, siendo esta una de las prioridades de salud del país. Se constata la necesidad de utilizar métodos complementarios para su control. Los sellantes de fosas y fisuras representan una de las intervenciones preventivas más efectivas en odontología, siendo considerados como un aporte a la Salud Pública. Sin embargo, no existen evidencias consistentes acerca de su verdadera efectividad e impacto en la prevención de caries. Las inconsistencias encontradas podrían deberse a la presencia de sesgos o a la heterogeneidad de los estudios disponibles en la literatura. Así, se propone realizar una revisión sistemática con el fin de evaluar la calidad metodológica de los ensayos clínicos controlados que utilizan sellantes de fosas y fisuras. Se condujo una búsqueda de ensayos realizados entre 1990 y 2007, encontrándose trece que cumplieron con los criterios de inclusión y exclusión. Los estudios incluidos fueron obtenidos y evaluados por un único revisor. Se concluye que la evidencia que avala la utilización de esta intervención es metodológicamente muy pobre. Estos hallazgos debieran estimular a los profesionales a esclarecer la verdad referente a la efectividad de los sellantes, antes de aplicarlos indiscriminadamente. Se recomienda la realización de nuevos ensayos clínicos ejecutados con un adecuado diseño metodológico y de análisis estadístico, cuyos resultados sirvan como evidencia confiable para la toma de decisiones que guíen las políticas de Salud Pública.

Palabras clave:
Epidemiología
caries dental
sellantes de fosas y fisuras
Abstract

Dental decay is one of the most important problems within the Public Oral Health. Chile has a high prevalence of decay among children and adolescents, being this issue one of the priorities of public health in the country. Taking into account this context, there is a necessity of using complementary methods for its control. Pit and fissures sealants represent one of the most effective preventive interventions in dentistry, being considered as a contribution to the public health interventions. Nevertheless, there are no consistent evidences about their true effectiveness and impact in the prevention of caries. These inconsistencies could be due to the presence of bias or the heterogeneity of the studies available in literature. Thus, we propose to make a review with the aim to evaluate the methodological quality of clinical trials using pit and fissure sealants. A search of studies between 1990 and 2012 was conducted and 18 clinical trials that fulfilled the inclusion and exclusion criteria were found. The studies included were obtained and evaluated by a single reviewer. This review concludes that the evidence that guarantees the use of this intervention is methodologically poor. These findings may stimulate the professionals to clarify the truth referring to the effectiveness of sealants, before applying it indiscriminately. The accomplishment of new clinical trials executed with an appropriate methodological design and statistical analysis is recommended, generating reliable results for the decision making that guides the Public Health Policies.

Key words:
Epidemiology
dental caries
pit and fissure sealants
El Texto completo está disponible en PDF
Referencias Bibliográficas
[1.]
World Health Organization. Oral Health. Consultado el 12 de Marzo 2012. Disponible en: http://www.who.int/mediacentre/factsheets/fs318/es/index.html.
[2.]
P. Arrow.
Cost minimilization analysis of two occlusal caries preventive programmes.
Community Dent Health, 17 (2000), pp. 85-91
[3.]
A. Sheiham.
Dietary effects on dental diseases.
Public Health Nutrition, 4 (2001), pp. 569-591
[4.]
T. Urbina, J.P. Caro, M. Vicent.
Caries dentaria y fluorosis en niños de 6 a 8 años y 12 años. Ministerio de Salud, Chile 1996-1999.
División Protección de Salud, (2012),
[5.]
L. Soto, R. Tapia, et al.
Diagnóstico Nacional de Salud Bucal de los niños de 6 años. Chile, 2007. Ministerio de Salud de Chile. División Protección de Salud. Departamento Odontológico.
Consultado el 04 de Abril, (2012),
[6.]
L.N. Baratieri, M.A.C. Andrada, S.M. Júnior, et al.
Operatoria dental.
Editora Quintessence, (1993), pp. 509
[7.]
J.C. Carvalho, A. Thylstrup, K.R. Ekstrand.
Dental plaque and caries on occlusal surfaces of first permanent molars in relation to stage of eruption.
J Dent Res, 68 (1989), pp. 773-779
[8.]
M. Barrancos.
Operatoria dental-integración clínica.
Editorial Médica Panamericana, cuarta edición, (2006), pp. 1603
[9.]
L. Skartveit, A.B. Tveit, B. Totdal, et al.
In vivo fluoride uptake in enamel and dentin from fluoride-containing materials.
ASDC J Dent Child, 57 (1990), pp. 97-100
[10.]
A. Ahovuo-Saloranta, A. Hiiri, A. Nordblad, H. Worthington, M. Makela.
Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents.
Cochrane Database Syst Rev, (2008),
[11.]
G. Karlzen-Reurving, J. Van Dijken.
A 3-years follow-up of glass ionomer cement and resin fissure sealant.
ASDC J Dent Child, 62 (1995), pp. 108-110
[12.]
H. Forss, E. Halme.
Retention of a glass ionomer cement and a resin-based fissure sealant and effect on carious outcome after 7 years.
Community Dent Oral Epidemiol, 26 (1998), pp. 21-25
[13.]
S. Poulsen, N. Beiruti, N. Sadat.
A comparison of retention and the effect on caries of fissure sealing with a glass-ionomer and a resin-based sealant.
Community Dent Oral Epidemiol, 29 (2001), pp. 298-301
[14.]
D. Moher, K. Schulz, D. Altman.
The CONSORT. statement: Revised recommendations for improving the quality of reports of parallel-group randomized trials.
JAMA, 285 (2001), pp. 1987-1991
[15.]
S. Straus, W. Richardson, P. Glasziou, et al.
Medicina basada en la evidencia. Tratamiento.
Editora Elsevier, tercera edición, (2006), pp. 313
[16.]
S. Hulley, S. Cummings, W. Browner, et al.
Designing clinical research.
Lippincott Williams & Wilkins. Segunda edición, (2001), pp. 336
[17.]
N. Beiruti, J. Frencken, M. Van’t Hof, D. Taifour, H. Van Paleinstein.
Cariespreventive effect of a one-time application of composite resin and glass ionomer sealants after 5 years.
Caries Res, 40 (2006), pp. 52-59
[18.]
S. Pousen, L. Lauberg, M. Vaeth, U. Jensen, D. Haubek.
A field trial of resin-based and glass-ionomer fissure sealants: Clinical and radiographic assessment of caries.
Community Dent Oral Epidemiol, 34 (2006), pp. 36-40
[19.]
V. Pardi, A. Pereira, F. Mialhe, et al.
A 5-year evaluation of two glass-ionomer cements used as fissure sealants.
Community Dent Oral Epidemiol, 31 (2003), pp. 386-391
[20.]
L. Villela, M. Fava, M. Vieira.
Avaliação clínica de vinte e quatro meses do fluoroshield e do vitremer utilizados como selante de fossas e fissuras.
Rev Odontologia Univ São Paulo, 12 (1998), pp. 383-387
[21.]
M. Mark, E. Descheper, J. Dean.
Using a resin-modified glass ionomer as an occlusal sealant: A one year clinical study.
Journal Am Dental Association, 127 (1996), pp. 1508-1510
[22.]
R. Silva, M. Araújo, M. Rego.
Avaliação clínica de selantes de fossas e fissuras: Efeito de materiais e tempo de análise.
Rev Odontologia UNESP São Paulo, 25 (1996), pp. 237-245
[23.]
P. Arrow, P. Riordan.
Retention and caries preventive effects of a GIC and a resin-based fissure sealant.
Community Dent Oral Epidemiol, 23 (1995), pp. 282-285
[24.]
Y. Songpaisan, D. Bratthall, P. Phantumvanit, Y. Somidhivej.
Effects of glass ionomer cement, resin-based pit and fissure sealant and HF applications on occlusal caries in a developing country field trial.
Community Dent Oral Epidemiol, 23 (1995), pp. 25-29
[25.]
A. Zuanon, V. Vertuan, M. Andrade.
Comparação de 5 selantes oclusais quanto à retenção e eficácia na prevenção de cáries.
Rev Odontologia UNESP, São Paulo, 24 (1995), pp. 79-86
[26.]
P. Nóbrega, V. Vertuan.
Eficácia e retenção de selantes oclusais fotopolimerizáveis.
Rev Odontología UNESP, 23 (1994), pp. 253-259
[27.]
H. Forrs, U. Saarni, L. Seppa.
Comparison of glass-ionomer and resin-based fissure sealants: A 2-year clinical trial.
Community Dent Oral Epidemiol, 22 (1994), pp. 21-24
[28.]
F. Barja-Fidalgo, S. Maroun, B.H. Oliveira.
Effectiveness of glass ionomer cement used as a pit and fissure sealant in recently erupted permanent first molars.
J Dent Child, 76 (2009), pp. 34-40
[29.]
S. Kervanto-Seppala, E. Lavonius, I. Pietila, et al.
Comparing the caries preventive effect of two fissure sealing modalities in public health care: A single application of glass ionomer and a routine resin based sealant program. A randomized split-mouth clinical trial.
Int J Paedriatic Dent, 18 (2008), pp. 56-61
[30.]
V. Dhar, R. Chen.
Evaluation of resin based and glass ionomer based sealants placed with or without tooth preparation - a two year clinical trial.
Pediatric Dentistry, 34 (2012), pp. 46-50
[31.]
S. Antonson, D. Antonson, S. Brener, et al.
Twenty-four month clinical evaluation of fissure sealants on partially erupted permanent first molars.
JADA, 143 (2012), pp. 115-121
[32.]
B.C.D. Borges, G.B.P. Campos, A.D.S. Silveira, et al.
Efficacy of a pit and fissure sealant in arresting dentin non-cavitated caries: A 1-year follow-up, randomized, single-blind, controlled clinical trial.
Am J Dent, 23 (2010), pp. 311-316
[33.]
M. Muller-Bolla, L. Lupi-Pégurier, C. Tardieu, et al.
Retention of resin based pit and fissure sealants: A systematic review.
Community Dent Oral Epidemiol, 34 (2006), pp. 321-336
[34.]
R. Feigal, K. Donly.
The use of pit and fisure sealants.
Pediatr Dent, 28 (2006), pp. 143-150
[35.]
D. Locker, A. Jokovic, E. Kay.
Prevention. Part 8. The use of pit fissure sealants in preventing caries in the permanent dentition of children.
Br Dent J., 195 (2003), pp. 375-378
[36.]
A. Ahovuo-Saloranta, A. Hiiri, A. Nordblad, H. Worthington, M. Makela.
Pit fissure sealants for preventing dental decay in the permanent teeth of children adolescents.
Cochrane Database Syst Rev, (2004),
[37.]
N. Beiruti, J. Frencken, M. Van't Hof, H. Van Paleinstein.
Caries-preventive effect of resin-based and glass ionomer sealants over time: A systematic review.
Community Dent Oral Epidemiol, 34 (2006), pp. 403-409
[38.]
R. Simonsen.
Glass Ionomer as fisure sealant - a critical review.
J Public Health Dent, 56 (1996), pp. 146-149
[39.]
I. Mejàre, P. Lingstron, L. Peterson, et al.
Caries-preventive effect of fissure sealants: A systematic review.
Acta Odontol Scand, 61 (2003), pp. 321-330
[40.]
B. Dawson, R. Trapp.
Bioestadística médica.
Manual Moderno, (2002), pp. 435
[41.]
A. Donner, N. Klar.
Design and analysis of cluster randomization trials in health research.
Hodder Arnold Publication, (2000), pp. 192
Copyright © 2013. Sociedad de Periodoncia de Chile, Sociedad de Implantología Oral de Chile y Sociedad de Prótesis y Rehabilitación Oral de Chile
Descargar PDF
Opciones de artículo