Efficacy of Surface Sealant on Clinical Performance of Composite Resin Restorations: A Systematic Review

ABSTRACT Objective This systematic review evaluated the effect of surface sealant application on the clinical performance of composite resin restorations. Materials and Methods The review followed PRISMA 2020 guidelines and was registered in PROSPERO. Searches were conducted in Embase, PubMed, Scopus, Web of Science, and Google Scholar, supplemented by manual reference screening. Only randomized clinical trials were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Results Of 717 records identified, six trials met eligibility criteria. Two were low risk of bias, three had some concerns, and one was high risk. Clinical performance was evaluated using USPHS (three studies), FDI (one study), and Moffa–Lugassy (two studies) criteria, along with postoperative sensitivity scales. Surface sealant application improved clinical outcomes in four studies. Marginal adaptation improved in three trials, two of which also showed reduced marginal discoloration. Surface wear decreased in two studies, while no significant effects were observed for surface roughness or postoperative sensitivity. Findings regarding color matching were inconsistent across studies. Conclusions Surface sealants may enhance clinical performance of composite restorations, particularly regarding wear resistance, marginal integrity, and marginal staining. Evidence remains limited, and further well‐designed randomized trials with standardized outcomes are required to strengthen these findings. Clinical Significance Surface sealants can improve marginal adaptation, reduce wear, and help maintain color stability in composite restorations, contributing to their longevity and esthetic performance.