Comparative Evaluation of the Retention Rates of Composite Resin Pit and Fissure Sealants Placed on Permanent Molars Treated with Air Abrasion and Acid Etching: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Abstract

Aim and objectives: This systematic review and meta-analysis aimed to compare the retention rates of composite resin pit and fissure sealants placed on permanent molars prepared using air abrasion versus traditional acid etching methods.

Methods: A comprehensive search was conducted across multiple databases, including MEDLINE (via PubMed), Cochrane Library, Scopus, and Web of Science since inception to date, but only in English. Randomized controlled trials (RCTs) with at least a 1-year follow-up, involving permanent molars treated with either air abrasion or acid etching prior to sealant placement, were included. Data extraction and risk of bias assessments were performed independently by two reviewers using the Cochrane Risk of Bias 2 (RoB 2) tool. Meta-analysis was performed using RevMan 5.3 with log odds ratios (ORs) as effect size metrics.

Results: Four RCTs were included in the review. Meta-analysis revealed no statistically significant difference in sealant retention between air abrasion and acid etching. The combined log OR was -0.727 [95% confidence interval (CI): -2.055 to 0.602], indicating a slight, nonsignificant trend favoring acid etching. Heterogeneity was moderate across studies. The overall quality of evidence was rated as moderate using the grading of recommendations, assessment, development, and evaluations (GRADE) framework.

Conclusion: There is no clear advantage of air abrasion over acid etching regarding the retention of fissure sealants on permanent molars. While air abrasion presents a minimally invasive alternative, acid etching remains the more established and effective technique. Further high-quality RCTs with larger sample sizes and standardized methodologies are needed to confirm these findings and explore other clinically relevant outcomes.

How to cite this article: Raut V, Sharma D, Jain AK, et al. Comparative Evaluation of the Retention Rates of Composite Resin Pit and Fissure Sealants Placed on Permanent Molars Treated with Air Abrasion and Acid Etching: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Int J Clin Pediatr Dent 2026;19(2):271-277.