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Comparative evaluation of pit & fissure sealant retention using cotton roll & rubber dam isolation techniques – a systematic review & meta-analysis

Evidence-Based Dentistry volume 26, page 112 (2025)Cite this article

Subjects

Abstract

Background

Isolation with cotton rolls does not always provide as complete isolation as rubber dam, especially in procedures where absolute moisture control is critical. Therefore, this review aims to summarize and analyze previous studies evaluating the retention and marginal integrity of pit & fissure sealant using rubber dam and cotton roll isolation techniques during dental treatment in children.

Material and methods

In accordance with PRISMA guidelines, search yielded 1361 articles, with seven RCTs and one non-RCT design meeting the inclusion criteria. Data were extracted on study design, sample size, sealant type, follow-up duration, retention rates, and caries incidence.

Results

The comparison of retention rate between rubber dam and cotton roll at six months difference was non-significant (OR:1.15; p = 0.64) while there was significant difference at 12 month (OR:2.23; p < 0.001). The difference for the marginal integrity was statistically significant at six months (OR:2.00; p = 0.03) while non-significant difference observed (OR:1.74; p = 0.10) at 12 months.

Conclusion

The sealant placed using a rubber dam as an isolation technique showed higher retention than the cotton roll after 12 months. In terms of marginal integrity, the performance of the rubber dam and cotton roll was equivalent at the end of 12 months.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article and further inquiries can be directed to the corresponding author.

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Funding

The authors received no specific funding for this work.

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Authors and Affiliations

  1. Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

    Neha Shukla, Zainab Akram, P. G. Naveen Kumar, Mahesh R. Khairnar, Sachin Kumar Jadhav & Savitha Priyadarsini

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  1. Neha Shukla
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  2. Zainab Akram
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  3. P. G. Naveen Kumar
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  4. Mahesh R. Khairnar
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  5. Sachin Kumar Jadhav
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  6. Savitha Priyadarsini
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Contributions

Neha Shukla: Conceptualization, Data curation, Formal analysis, Methodology, Visualization, Writing – original draft. Mahesh Khairnar: Data curation, Formal analysis, Methodology, Writing – review & editing. P G Naveen Kumar: Data curation, Formal analysis, Writing – review & editing. Sachin Kumar Jadhav: Data curation, Methodology, Writing – review & editing. Zainab Akram: Conceptualization, Methodology, Visualization, Writing – review & editing. Savitha Priyadarsini: Data curation, Methodology, Writing – review & editing.

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Correspondence to Mahesh R. Khairnar.

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Shukla, N., Akram, Z., Kumar, P.G.N. et al. Comparative evaluation of pit & fissure sealant retention using cotton roll & rubber dam isolation techniques – a systematic review & meta-analysis. Evid Based Dent 26, 112 (2025). https://doi.org/10.1038/s41432-024-01092-6

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