Biocompatibility, bioactivity, porosity, and sealer/dentin interface of bioceramic ready-to-use sealers using a dentin-tube model

This study evaluated the biocompatibility, bioactivity, porosity, and sealer/dentin interface of Sealer Plus BC (SP), Bio-C Sealer (BIOC), TotalFill BC Sealer (TF), and AH Plus (AHP). Dentin tubes filled with the sealers and empty tubes (control group) were implanted in the subcutaneous tissue of rats for different periods (n = 6 per group/period). Number of inflammatory cells (ICs), capsule thickness, von Kossa reaction, interleukin-6 (IL-6) and osteocalcin (OCN) were evaluated. Porosity and voids in the interface dentin/sealers were assessed by micro-computed tomography. The data were submitted to ANOVA/Tukey's tests (α = 0.05). Greater capsule thickness, ICs and IL-6 immunolabeling cells were observed in AHP. No significant difference in thickness of capsule, ICs, and IL-6- immunolabeling cells was detected between SP and TF, in all periods, and after 30 and 60 days between all groups. At 60 days all groups had reduction in capsule thickness, ICs and IL-6 immunolabeling cells. Von Kossa-positive and birefringent structures were observed in the capsules around the sealers. BIOC, SP, and TF exhibited OCN-immunolabeling cells. All sealers had porosity values below 5%, besides low and similar interface voids. BIOC, SP and TF are biocompatible, bioactive, and have low porosity and voids. The dentin-tube model used is an alternative for evaluating bioceramic materials.

Effect of erosive conditions on different sealant materials used in paediatric dentistry

To evaluate the effect of acidic challenge on erosion depth and topographic characteristics of different materials used as occlusal sealants. Two hundred specimens of five sealant materials (Fuji IX, Ketac Molar, Fuji II, Equia and Clinpro) and forty bovine teeth enamel samples (control) were prepared and exposed to acidic challenge. The specimens were immersed in four different solutions (orange juice, coke drink, citric acid or distilled water) under mildly shaken conditions for 3 days. The erosion depth profiles were measured using a profilometer and Scanning Electron Microscope (SEM). Two-way ANOVA with Tukey post-hoc test was performed to evaluate the interactions. Sealant material and acidic challenge had significant effects on erosion depth. Among the materials, Fuji II presented the highest mean of erosion depth after immersion in orange juice, coke drink, and citric acid. All materials groups presented higher erosion depth values after immersion in the citric acid solution, except Clinpro. Bovine enamel presented higher erosion depth values compared to all materials when submitted to erosive challenge. Sealant materials submitted to the acidic challenge presented different degrees of erosion and topographic modification; however, they are less susceptible to erosion than bovine teeth enamel.

Novel pit and fissure sealant with nano-CaF2 and antibacterial monomer: Fluoride recharge, microleakage, sealing ability and cytotoxicity

Conventional resin-based sealants release minimal fluoride ions (F) and lack antibacterial activity. The objectives of this study were to: (1) develop a novel bioactive sealant containing calcium fluoride nanoparticles (nCaF2) and antibacterial dimethylaminohexadecyl methacrylate (DMAHDM), and (2) investigate mechanical performance, F recharge and re-release, microleakage, sealing ability and cytotoxicity. Helioseal F served as commercial control. The initial F release from sealant containing 20% nCaF2 was 25-fold that of Helioseal F. After ion exhaustion and recharge, the F re-release from bioactive sealant did not decrease with increasing number of recharge and re-release cycles. Elastic modulus of new bioactive sealant was 44% higher than Helioseal F. The new sealant had excellent sealing, minimal microleakage, and good cytocompatibility. Hence, the nanostructured sealant had substantial and sustained F release and antibacterial activity, good sealing ability and biocompatibility. The novel bioactive nCaF2 sealant is promising to provide long-term F ions for caries prevention.

Effect of phytic acid and ethylenediaminetetraacetic acid on penetration depth of bioceramic and resin sealers

This study assessed influence of 1% phytic acid and 17% ethylenediaminetetraacetic acid (EDTA) on the dentinal tubules penetration of EndoSequence BC bioceramic-based and AH Plus resin-based sealers using confocal laser scanning microscopy (CLSM). Forty single-rooted mandibular premolars were divided randomly into four groups (n = 10). Group 1 received final irrigation with 1% phytic acid solution and canals sealed by AH Plus sealer, Group 2: 1% phytic acid solution and EndoSequence BC sealer, Group 3: 17% EDTA solution and AH Plus sealer and Group 4: 17% EDTA solution and EndoSequence BC sealer. Specimens were horizontally sectioned 2, 4 and 6 mm from the apex. Average maximum depth of sealer penetration was examined using CLSM. Group three showed the deepest sealer penetration at all three levels which was significantly higher than all other groups (P ˂ 0.05). Deep sealer penetration is achievable with AH Plus and EDTA. Phytic acid groups have moderate tubular penetration ability.

Ion release and recharge from a fissure sealant containing amorphous calcium phosphate

To assess- the release of calcium and phosphate ions from a fissure sealant containing amorphous calcium phosphate (ACP), and to determine the re-release capacity of these ions when charged with a solution containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). Nine blocks of ACP resin-based sealant were prepared and immersed in three solutions at different pH (4.0, 5.5, 7.0), and calcium and phosphate ion release was measured with ion chromatography at 1, 3, 5, 7, 14, 21 and 28 days after immersion. Sixty days after immersion, each block was charged with CPP-ACP solution in three 7-day cycles to investigate the re-release of these ions, which was measured on days 1, 3, and 7. No difference was observed in initial calcium ion release at pH 4.0 and pH 5.5. At both values, ion release was significantly higher than at pH 7.0 (p<0.001). Initial phosphate release was significantly different among the three pH values (p<0.001). After re-charging the specimens, calcium ion re-release was greater than phosphate ion release. Initial ion release from ACP resin-based sealant was greatest at the lowest pH. Ion release decreased with time. As the number of recharge cycles increased, ion re-release also improved. Phosphate ion re-release required more recharge cycles than calcium ion re-release.

Anti-biofilm activity of a novel pit and fissure self-adhesive sealant modified with metallic monomers

Dental plaque is a biofilm composed of a complex oral microbial community. The accumulation of plaque in the pit and fissures of dental elements often leads to the development of tooth decay (dental caries). Here, potent anti-biofilm materials were developed by incorporating zinc methacrylates or di-n-butyl-dimethacrylate-tin into the light-curable sealant and their physical, mechanical, and biological properties were evaluated. The data revealed that 5% di-n-butyl-dimethacrylate-tin (SnM 5%) incorporated sealant showed strong anti-biofilm efficacy against various single-species (Streptococcus mutans or Streptococcus oralis or Candida albicans) and S. mutans-C. albicans cross-kingdom dual-species biofilms without either impairing the mechanical properties of the sealant or causing cytotoxicities against mouse fibroblasts. The findings indicate that the incorporation of SnM 5% in the experimental pit and fissure self-adhesive sealant may have the potential to be part of current chemotherapeutic strategies to prevent the formation of cariogenic oral biofilms that cause dental caries.

Microcavitated (ICDAS 3) carious lesion arrest with resin or glass ionomer sealants in first permanent molars: A randomized controlled trial

OBJECTIVES

Although there is some consensus that carious lesions in early stages (non-cavitated) could be treated using sealants, neither the type of materials nor their use in lesions with localized enamel breakdown (microcavitated) has been reported To compare the efficacy of resin or glass ionomer (GI) sealants in arresting microcavitated carious lesions (ICDAS 3) in first permanent molars.

MATERIALS AND METHODS

A double-blinded randomized controlled clinical trial was conducted in 41 healthy 6 to 11-year-old children. At the baseline examination, each subject had at least one carious lesion classified as ICDAS 3 on the first permanent molar. One hundred fifty-one lesions were randomized into: Group 1: resin sealants (76 lesions) and Group 2: GI sealant (75 lesions). Carious lesion progression was assessed clinically and radiographically. Progression and retention failure were the outcomes used for group comparisons at p-value<0.05.

RESULTS

After a two-year follow-up, only one lesion progressed to ICDAS 5, without statistically significant differences between the groups (χ²(1) = 0.90, p = 0.53). Radiographically, 100 lesions (98%) were arrested and 2 (2%) showed radiographic progression, without differences between groups (χ²(1) = 0.93, p = 0.93). At 2 years, complete retention was observed in 77% of the resin-based and in 83% of the GI sealants, without statistical differences between type of sealant (χ²(1) = 0.71, p = 0.48). The multilevel mixed model demonstrated that location and type of sealant did not affect retention rates (χ²(1) = 24,98, p < 0.001).

CONCLUSION

Sealing ICDAS 3 carious lesions in permanent molars appears to be effective in arresting lesions after a two-year follow-up. Clinicaltrials.gov: RCTICDAS3/2015.

CLINICAL SIGNIFICANCE

Minimally invasive approaches for carious lesion management have been promoted. Using sealants for the treatment of microcavitated lesions (ICDAS 3) appears predictable in the routine practice, without predilection for resin or glass ionomer materials. In addition to preserving tooth structure, this strategy reduces chair-time, dental fear and costs, and increases coverage to dental care.

Dental Sealants Part 4: Bisphenol A: What dentists should know

Bisphenol A (BPA) is a synthetic chemical resin used worldwide to produce plastic products. It is also a component of the bisphenol A diglycidylether methacrylate (Bis-GMA), which is a monomer found in dental resin-based materials (including resin-based dental sealants, RBSs). The controversy about its possible toxicity begins around the early '30s. Even if the amount of BPA released by dental sealants is well below the limit proposed by the U.S. Environmental Protection Agency and the European Food Safety Authority, we can reduce the risk of exposure, particularly for children, following precautionary measures.

Effect of Cured Versus Uncured Adhesive Inclusion on the Microtensile Bond Strength of Sealants

PURPOSE

To determine the impact of light curing of bonding agents on the microtensile bond strength (MTBS) of sealants on extracted teeth.

METHODS

Flat enamel surfaces were created on 54 extracted, sound human molars by sequential grinding. Three different sealants- Clinpro (3M ESPE), Ultraseal XT Hydro (Ultradent), and Fluorshield VLC (Dentsply)- were placed after acid etching without a bonding agent (control) or with three different bonding agents - Adper Single Bond Plus (3M ESPE), Peak Universal Bond (Ultradent), and Prime&Bond Elect (Dentsply)- each in both light-cured and uncured form. The teeth were sectioned into bar specimens and the MTBS of each specimen was measured. The bond strength data were analyzed using two-way analysis of variance and Tukey's test (P=0.05).

RESULTS

There was no significant difference between the MTBS of sealants in the thermocycled and non-thermocycled groups. The uncured adhesive had the lowest bond strength in each group, except for Clinpro after thermocycling. Teeth with uncured adhesive exhibited significantly lower bond strength in the Ultraseal (no thermocycling) and Fluroshield (with thermocycling) groups (P=0.02 and P=0.001, respectively).

CONCLUSIONS

Adding bonding agents without curing before sealant placement weakened the microtensile bond strength. There was no significant difference in MTBS between the thermocycled and nonthermocycled groups.

Long-term release of fluoride from fissure sealants-In vitro study

The intensity of the cariostatic activity of fluoride ions can be attributed to their multidirectional influence on the caries process. They are an irreplaceable factor that helps sustain mineral balance of dental tissues, simultaneously demonstrating antibacterial properties. As a consequence, many manufacturers of fissure sealants include fluoride ions in their products. The aim of this in vitro study was to determine long-term fluoride release from four fissure sealants (Conseal F, Fissurit FX, Delton Fs+, Admira Seal). During a 14-week-long observation, all the materials showed a relatively constant level of F- release; however, it is crucial to mention that within the first 48h, the most significant increase in fluoride release was found for Fissurit and Delton sealants. Based on the overall assessment, the highest total amount of the released fluoride ions was observed for Delton, and the lowest level was reported for Admira Seal.

Ion release and in vitro enamel fluoride uptake associated with pit and fissure sealants containing microencapsulated remineralizing agents

PURPOSE

To determine if pit-and-fissure sealants with microencapsulated remineralizing agents with sustained release of fluoride, calcium and phosphate ions could promote enamel fluoride uptake by demineralized tooth structure.

METHODS

Sealants that contained 5 w/w% microcapsules with aqueous solutions of 5M Ca(NO3)2 or 0.8M NaF or 6.0M K2HPO4 or a mixture of all three were prepared. Ion release profiles were measured as a function of time. Enamel fluoride uptake by demineralized tooth structure was determined.

RESULTS

Sustained release of fluoride, calcium and phosphate ions from a sealant was demonstrated. Fluoride uptake by demineralized enamel was significantly increased compared to a control sealant manufactured without microcapsules (P< 0.01). Bovine enamel that contained 2.2±2.1 µg F/g of enamel prior to exposure to a sealant without microcapsules had 2.3±0.5 after 90 days. Enamel exposed to sealant with 5w/% NaF microcapsules went from 3.5±3.5 µg F/g of enamel prior to exposure to 148±76 after 90 days. Enamel exposed to sealant with 2 w/w% NaF, 2 w/w% Ca(NO3)2 and 1 w/w% K2HPO4 microcapsules went from 1.7±0.7 µg F/g of enamel prior to exposure to 190±137 after 90 days.

CLINICAL SIGNIFICANCE

Sealants with encapsulated remineralizing agents were capable of releasing biologically available fluoride, calcium, and phosphate ions. Incorporation of these microcapsules in pit and fissure sealants is a promising method for remineralization determined by enamel fluoride uptake measurements.

The Effect of Fluoride Varnish on Enamel Shear Bond Strength of Pit and Fissure Sealants

PURPOSE

The purpose of this study was to determine the effects of fluoride varnish on the enamel shear bond strength of pit and fissure sealants.

METHODS

Ninety-six teeth were divided into three duplicated test groups: sealant (S)/sealant thermocycle (ST) received Clinpro Sealant only; varnish sealant (VS)/varnish sealant thermocycle (VST) received five percent sodium fluoride (NaF) varnish plus sealant (VPS); and VPS/VPS thermocycle (VPST) received NaF, polish with Clinpro Prophy Paste, plus sealant. One set of each group (ST, VST, VPST) was thermocycled to represent aging, and one set (S, VS, PVS) was not. The shear bond strengths for the thermocycled groups and nonthermocycled groups were determined, and two-way analysis of variance tested the effects of thermocycling and varnish.

RESULTS

Thermocycling did not have a significant effect on the peak stresses of the groups (P=0.0552), so sets were combined. The peak stress for S/ST was significantly higher than for VS/VST (P<0.0001). The peak stress for VPS/VPST was significantly higher than for VS/VST (P<0.0001). The peak stress for S/ST was significantly higher than VPS/VPST (P=0.025).

CONCLUSION

Fluoride varnish applied immediately before pit and fissure sealant placement negatively affected the shear bond strength of the sealant. Mechanically cleaning a fluoride varnish-coated tooth with prophy paste did not provide pit and fissure sealant enamel shear bond strengths comparable to those of untreated enamel.

Penetration of Filled and Unfilled Resin Sealants on Different Enamel Substrates

PURPOSE

To evaluate the penetration ratio of filled and unfilled resin-based sealants on different enamel substrates and pit and fissure morphologies.

METHODS

Forty-eight occlusal enamel blocks obtained from impacted human third molars were randomly divided (n equals eight) according to enamel substrates (sound; caries-like lesion; caries-like lesion plus topical fluoride application) and sealant material (FluroShield; Helioseal Clear Chroma). Sealants were applied on the enamel surface. The specimens were stored in 100 percent humidity for 24 hours at 37 degrees Celsius, sectioned in a buccal-lingual direction (at approximately 50 μm), and examined to determine the sealant penetration ratio (b x 100/a; a equals total fissure length and b equals sealant penetration length) and pit and fissure morphology (V-, U-, or Y-shaped). Statistical analysis was performed using Friedman and Kruskal-Wallis tests (P<0.05).

RESULTS

Enamel substrate and sealant material did not affect the sealant penetration ratio, with no interactions between these factors. Moreover, the morphology significantly affected the sealant penetration, with the "Y"-shaped fissures presenting the lowest sealant penetration ratio compared to "U-"shaped (P=0.0001) and "V-" shaped fissures (P=0.0018).

CONCLUSIONS

Pit and fissure morphology was a critical factor on sealant's penetration capacity; however, enamel substrate and sealant type did not affect sealant's penetration ratio.

Synthetic phenolic antioxidants, including butylated hydroxytoluene (BHT), in resin-based dental sealants

Resin-based dental sealants (also referred to as pit-and-fissure sealants) have been studied for their contribution to bisphenol A (BPA) exposure in children. Nevertheless, little attention has been paid to the occurrence of other potentially toxic chemicals in dental sealants. In this study, the occurrence of six synthetic phenolic antioxidants (SPAs), including 2,6-di-tert-butyl-4-hydroxytoluene (BHT), 2,6-di-tert-butyl-4-(hydroxyethyl)phenol (BHT-OH), 3,5-di-tert-butyl-4-hydroxy-benzaldehyde (BHT-CHO), 2,6-di-tert-butylcyclohexa-2,5-diene-1,4-dione (BHT-Q), 3,5-di-tert-butyl-4-hydroxybenzoic acid (BHT-COOH) and 2-tert-butyl-4-methoxyphenol (BHA), was examined in 63 dental sealant products purchased from the U.S. market. BHT was found in all dental sealants at median and maximum concentrations of 56.8 and 1020µg/g, respectively. The metabolites of BHT and BHA were detected in 39-67% of samples, at concentration ranges of <LOQ to 242µg/g. BHT is likely used in sealants to inhibit oxidative reactions, remove free radicals, and inhibit potential polymerization, which would eventually prolong the shelf-life of the products. The estimated daily intake (EDI) of BHT, following sealant placement, based on a worst-case scenario (application on eight teeth at 8mg each tooth), was 930 and 6510ng/kg bw/d for adults and children, respectively. The EDI of BHT from dental sealants was several orders of magnitude lower than the current acceptable daily intake (ADI) proposed by the European Food Safety Authority (EFSA).

Pit and Fissure Sealant Retention Following Air Abrasion Preparation with Bioactive Glass and Aluminum Oxide Particles

PURPOSE

Alumina air abrasion is an alternative for acid-etch technique for tooth preparation before placement of a fissure sealant. The aim of this study was to compare the retention of sealants placed subsequent to air abrasion with alumina and bioactive glass (BAG) particles.

METHODS

Sixty-two 6-12 year old children were included in this study. Using a halfmouth design, the fissures were prepared using air abrasion with alumina particles on randomly assigned permanent mandibular or/and maxillary first molars on one side of the mouth (Group 1) and air abrasion with BAG on the contralateral side of the mouth (Group 2). Sealants were applied on 180 teeth, and were scored as missing, partially retained, and completely retained after three, six, nine and 12 months. Data were analyzed using Friedman and Wilcoxon tests (α=0.05).

RESULTS

Sealant retention rates in the alumina group were higher than those in the BAG group at all time periods (P<0.001).

CONCLUSIONS

Sealant retention after air abrasion with alumina particles was higher than BAG over 12 months.

Shear Bond Strength and Microleakage of a New Self-etching/Self-adhesive Pit and Fissure Sealant

PURPOSE

To evaluate shear bond strength and microleakage of a new self-etching/self-adhesive fissure sealant on prismless enamel compared with conventional fissure sealing.

MATERIALS AND METHODS

A total of 90 extracted third molars were assigned to 3 main groups: group 1: self-etching/self-adhesive sealant, without acid etching; group 2: self-etching/self-adhesive sealant, with prior acid etching; group 3: conventional fissure sealing (control group). After specimen preparation, each group was divided into 3 subgroups according to storage time (1-day water storage, 3-month water storage, and 1-day water storage followed by 5000x thermocycling). The shear bond strength was determined with a universal testing machine, according to ISO standard 29022. Afterwards, the failure mode was analyzed. An additional 24 third molars were used for microleakage assessment. The fissure pattern was sealed in strict accordance with the manufacturers' instructions. After thermocycling, the dye penetration was examined. Data were analyzed using the Mann-Whitney U-Test at a significance level of 0.05.

RESULTS

The shear bond strength of the self-etching/self-adhesive fissure sealant without prior acid etching was significantly lower (4.3 MPa) than that of the self-etching/self-adhesive fissure sealant with prior acid etching (17.1 MPa) and the conventional fissure sealing (19.1 MPa). Microleakage was significantly lower in the control group (1.1%) and in the group with the self-etching/self-adhesive sealant with prior acid etching (0.8%) compared to the group that used the self-etching/self-adhesive material alone (49.4%).

CONCLUSION

The self-etching/self-adhesive fissure sealant can be recommended for clinical use when enamel is etched with phosphoric acid. The self-etching/self-adhesive sealant without prior acid etching showed significantly inferior results.

The impact of Er:YAG laser enamel conditioning on the microleakage of a new hydrophilic sealant--UltraSeal XT hydro

UltraSeal XT® hydro™ is a new hydrophilic, light-cured, methacrylate-based pit and fissure sealant which has been developed by Ultradent Products, USA. The sealant is highly filled with a 53 wt.% mixture of inorganic particles which confer both thixotropy and radiopacity. The principal purpose of this study was to investigate the microleakage of UltraSeal XT® hydro™ as a function of different enamel etching techniques. The occlusal surfaces of sound, extracted human molars were either acid etched, Er:YAG laser irradiated or successively laser irradiated and acid etched. UltraSeal XT® hydro™ was applied to each group of teeth (n = 10) which were subjected to a thermocycling process consisting of 2500 cycles between 5 and 50 °C with a dwell time of 30 s. Microleakage assessments were then carried out using 0.5 % fuchsin dye and optical microscopy. The microleakage score data were analysed using the Kruskal-Wallis, Mann–Whitney U test with Bonferroni adjustment. No significant differences in microleakage were noted between the individually acid etched and laser-irradiated groups (p > 0.05); however, teeth treated with a combination of laser irradiation and acid etching demonstrated significantly lower microleakage scores (p < 0.001). Electron microscopy with energy-dispersive X-ray analysis revealed that the mineral filler component of UltraSeal XT® hydro™ essentially comprises micrometre-sized particles of inorganic silicon-, aluminium- and barium-bearing phases. Laser etching increases the roughness of the enamel surface which causes a concentrated zoning of the filler particles at the enamel-sealant interface.

Evaluation of shear bond strength, penetration ability, microleakage and remineralisation capacity of glass ionomer-based fissure sealants

AIM

The aim of this study was to evaluate the bond strength, penetration ability, microleakage, and remineralisation capacity of glass ionomer-based fissure sealant materials.

MATERIALS AND METHODS

In this study, three glass ionomer-based fissure sealants were evaluated (Fuji Triage, Fuji VII EP, and GCP Glass Seal). A dye-penetration test was performed to evaluate microleakage under a stereomicroscope. The materials were applied to occlusal tooth surfaces, and bucco-lingual sections (1 mm width) were assessed to evaluate the penetration ability. Shear bond strength of tested materials was assessed using a universal testing machine. Finally, the remineralisation capacities of the materials were evaluated with EDS.

RESULTS

The Fuji Triage exhibited the lowest microleakage and unfilled area proportion (p<0.05). The highest shear bond strength was calculated with Fuji VII EP (p<0.05). The fluoride content for all treatment groups was significantly different when remineralisation values were compared to demineralisation (p<0.05).

CONCLUSION

Both the Fuji Triage and Fuji VII EP yielded compatible and satisfactory results and all fissure sealants used in this study are sufficient as anti-caries agents.

Evaluation of Different Fissure Sealant Materials and Flowable Composites Used as Pit-and-fissure Sealants: A 24-Month Clinical Trial

PURPOSE

The effectiveness of resin-based pit-and-fissure sealants mainly depends on their retention and integrity over time. The purpose of this study was to evaluate retention rates of two different pit-and-fissure sealants compared with a flowable composite and a self-adhesive flowable composite over a 24 month period.

METHODS

A split-mouth study design was used for all four permanent first molars of each patient. They were subjected to different kinds of sealants--either flowable composites or with fissure sealants. The flowable composites used were: flowable composite with an adhesive system (Tetric EvoFlow); and a self-adhesive flowable composite (Vertise Flow). The fissure sealants used were: a highly filled pit-and-fissure sealant (Fissurit FX); and a highly filled nano-hybrid pit-and-fissure sealant (Grandio Seal). Evaluation of the sealants was carried out at three-, six-, 12-, 18-, and 24-month follow-up visits.

RESULTS

The complete retention rates were 95.7 percent for Tetric EvoFlow, 80.6 percent for Fissurit FX, 73.1 percent for Grandio Seal, and 62.9 percent for Vertise Flow. The retention rate of Tetric EvoFlow was significantly higher among all materials tested (P<0.05).

CONCLUSION

The flowable composite used with an adhesive system was found to be superior to other sealing materials.

Buffering or non-buffering; an action of pit-and-fissure sealants

OBJECTIVES

The aim of this study was to evaluate the buffering capacity of glass-ionomer material in vitro. The null hypothesis tested was that there is no effect of cured glass-ionomer pit-and-fissure sealant (PFS) pastes on the environmental acidity as well as the tooth substrate.

METHOD

For each material, a cured PFS disk and a section of human enamel were simultaneously soaked in lactic acid solution in a conical tube, and the pH of the solution was measured daily for one week. Subsequently, the total amount of calcium leached out in solution was also measured with ICP-AES.

RESULTS

The results showed that the acidity of the solutions changed over time. Significant differences of calcium ion concentration in solution were observed as a result of decalcification. As the PFS products tested did not include calcium, the concentration of calcium ion released indicated acidic erosion of the tooth enamel.

CONCLUSIONS

The glass-ionomer countered the acid of the solution rapidly and preserved the structure of human tooth enamel.

Retention of Moisture-tolerant and Conventional Resin-based Sealant in Six- to Nine-year-old Children

PURPOSE

The purpose of this study was to evaluate and compare the retention rates and development of caries in permanent molars in children sealed with moisture-tolerant, resin-based (Embrace WetBond), and conventional resin-based (Helioseal) sealant over a period of one year.

METHODS

This was a double blind, split-mouth, randomized controlled trial among six- to nine-year-olds. Sixty-eight permanent mandibular first molars in 34 children were randomly assigned to be sealed with Embrace WetBond or Helioseal sealant.

RESULTS

The final sample was 32 children with 64 teeth. At 12 months, 23 of 32 (72 percent) sealants were completely retained in Embrace WetBond, whereas only 16 of 32 (50 percent) were retained in the Helioseal group. There was a statistically significant difference in retention rates of Embrace WetBond and Helioseal sealants at 12 months (P<.05). At 12 months follow-up, only two teeth developed caries in Embrace WetBond; in the Helioseal group, five teeth developed caries (two initial and three enamel caries).

CONCLUSIONS

Embrace WetBond was superior to Helioseal sealant, as Embrace exhibited higher retention and lower caries scores. Embrace WetBond can be preferred over conventional resin-based sealants for community and outreach sealant programs where use of rubber dam for moisture control is difficult to practice.

Can Increasing the Manufacturer's Recommended Shortest Curing Time of High-intensity Light-emitting Diodes Adequately Cure Sealants?

PURPOSE

To investigate sealant depth of cure after increasing the curing times of high-intensity light-emitting diode units (LEDs).

METHODS

Three sealants (opaque-unfilled, opaque-filled, and clear-filled) were light cured in a covered-slot mold with: (a) three LEDs (VALO, SmartLite, Fusion) for six to 15 seconds; and (b) a quartz-tungsten halogen (QTH) light for 40 seconds as a control (N=10). Twenty-four hours after light curing, microhardness was measured at the sealant surface and through the depth at 0.5 mm increments. Results were analyzed via analysis of variance followed by the Student-Newman-Keuls test (significance level 0.05).

RESULTS

The opaque-filled and clear-filled sealants cured with VALO for six or nine seconds had hardness values that were statistically equivalent to or better than the QTH to a depth of 1.5 mm. Using Fusion for 10 seconds (exposure limit) did not adequately cure the three sealants beyond one mm. SmartLite at 15 seconds (maximum exposure period without overheating) did not adequately cure the sealants beyond 0.5 mm.

CONCLUSIONS

Among the tested high-intensity LEDs, only VALO at double or triple the manufacturers' shortest curing time (six or nine seconds) provided adequate curing of opaque-filled and clear-filled sealants at 1.5 mm depth compared to the 40-second QTH light.

Report on the clinical technique of thermo-curing glass-ionomer sealant

Controversy exists regarding the general safety of resin sealants and in particular their use in children, due to the possible leaching of non-polymerized monomers including bisphenol A. A thermally cured high-viscosity glass-ionomer cement (GIC) is suggested as a first-choice sealant material. An innovative approach of thermo-curing the GIC during placement is presented. The step-by-step clinical procedure and rationale for the biomimetic thermo-cured glass-ionomer fissure sealant are introduced and described. A thermally cured GIC sealant may provide long-term caries protection to fissures and pits without the need to maintain and reseal. GICs are both biocompatible and biomimetic resulting in formation of fluorapatite, the ultimate protection against dental caries.

Resin-based pit-and-fissure sealants: microleakage reduction and infiltration enhancement using a bonding agent

PURPOSE

To evaluate the marginal microleakage and the infiltration ability of pit-and-fissure sealants by applying the conventional sealing technique in comparison to using an additional bonding agent.

MATERIALS AND METHODS

Extracted non-carious permanent molars (n = 60) were first stored in sterile saline solution and then assigned to one of two groups: group C (control) was sealed (Helioseal F) by using the conventional technique, while in group BA (bonding agent), a bonding agent (OptiBond FL) was additionally applied prior to sealing. The teeth were thermocycled (1000 cycles, 5°C to 55°C, dwell time 30 s), then varnished and immersed in 5% methylene blue solution for 24 h. After embedding and sectioning each tooth into 6-12 slices, the presence of microleakage, unfilled areas, and air bubbles trapped in the sealant were assessed with a stereomicroscope.

RESULTS

A higher proportion of microleakage was found under sealants applied without the additional use of the bonding agent. A statistically significant difference in microleakage was noted between the groups (p = 0.045). Regarding the presence of unfilled areas, a statistically significant difference between the groups was observed (p < 0.001), especially since no unfilled areas were found at all in the samples of the group using the bonding agent. Regarding the amount of air bubbles trapped in the sealant, no statistically significant difference was observed between the two groups (p = 0.829).

CONCLUSION

Under these in vitro conditions, sealant procedures using an additional bonding agent applied beforehand significantly improved fissure infiltration and microleakage prevention significantly.

Bond strength of a sealant to enamel after a cariogenic challenge using three bonding protocols: an in vitro study

PURPOSE

The purpose of this study was to evaluate in vitro the tensile bond strength of a resin-based pit and fissure sealant to enamel after a cariogenic challenge using three bonding protocols.

METHODS

The demineralized tooth specimens were assigned to three groups of equal size: Group 1 (37 percent phosphoric acid gel), Group 2 (total-etch adhesive system), and Group 3 (one-step self-etch adhesive system). After the surface treatment, a resin-based sealant was applied and cured. The specimens were thermocycled and tensile bond strength was measured using a universal testing machine by an investigator who was blinded to the group distribution.

RESULTS

The mean tensile bond strength was highest with the total-etch adhesive system, which was statistically significant (P<.001). A post hoc test revealed a significant difference between Groups 1 and 2 (P<.001) and Groups 2 and 3 (P<.001), but none between Groups 1 and 3 (P=.44).

CONCLUSION

The total-etch bonding system resulted in significantly higher tensile bond strength with incipient enamel caries.