Eficácia do selante de superfície no desempenho clínico de restaurações de resina composta: revisão sistemática

Abstract

Surface sealants are low-viscosity resin materials developed to promote smoother surfaces, increase wear resistance, and improve marginal integrity of different types of composites. The aim of this study was to systematically review the literature on the efficacy of surface sealants on the clinical performance of composite resin restorations. The review followed the PRISMA recommendations and was registered on the PROSPERO platform (CRD42024540577). The literature search was performed in the Embase, PubMed, Scopus, and Web of Science databases, in addition to Google Scholar, and by reading the references of the included articles. For this purpose, the following terms and their synonyms were determined from the acronym PICOS and related to Boolean operators. The risk of bias of the selected articles was assessed using the RoB 2.0 tool. A total of 717 articles were found in the databases, four in the gray literature, and one in the manual search of references. According to the eligibility criteria, six randomized clinical trials were included. The studies presented low (n=2), some concern (n=3) and high (n=1) risk of bias. The clinical performance of the restorations was analyzed by the USPHS criteria in three articles and by the FDI in one, in addition to the Moffa-Lugassy scale, in two studies, to measure wear resistance and the visual analogue scale and numerical rating scale to analyze postoperative sensitivity. The sealant influenced the clinical performance of the restorations in four articles. A better marginal adaptation was identified in three of them, of which two also identified less marginal discoloration. Although less wear of the composite resin surface was observed in two studies, the use of the surface sealant did not interfere with the roughness, which also occurred in the postoperative sensitivity. Regarding the color match, while one study identified a significant worsening with the use of the sealant, another observed a higher percentage of match. Thus, surface sealant can positively interfere in the clinical performance of composite resin restorations, in relation to wear, adaptation and marginal staining, but more studies are needed to provide more solid results.