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JADA Continuing Education

Background. To date, no trials have been published that examine whether four-handed delivery of dental sealants increases their retention and effectiveness. In the absence of comparative studies, the authors used available data to explore the likelihood that four-handed delivery increased sealant retention.

Methods. The authors examined data regarding the retention of autopolymerized resin-based sealants from studies included in systematic reviews of sealant effectiveness. The explanatory variable of primary interest was the presence of a second operator. To examine the unique contribution of four-handed delivery to sealant retention, the authors used linear regression models.

Results. Eleven of the 36 studies from systematic reviews met explicit criteria and were included in this analysis. The high level of heterogeneity among studies suggested that multivariate analysis was the correct approach. According to the regression model, the presence of a second operator increased retention by 9 percentage points.

Conclusions. For this group of studies, four-handed delivery of autopolymerized sealants was associated with increased sealant retention.

Clinical Implications. Using four-handed delivery to place resin-based sealants may increase retention.

Key Words: Pit-and-fissure sealants; sealant retention; four-handed delivery

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