Wear of dental sealing materials using the replication technique

AIM

The aim of the present study was an in vivo evaluation of the wear of different sealing materials using the replication technique.

MATERIALS AND METHODS

Four different sealing materials were randomly applied on 2 out of 4 caries-free permanent first molars of each patient. Impressions were taken at T0: before the sealing material was applied; T1: right after the application; T2: 6 months after the application, and T3: 1 year after the application. The impressions were then processed for scanning electron microscopy analysis of the wear of the examined materials. Statistical analysis was used to evaluate differences among and within the 4 groups.

RESULTS

At T2, the average ratio of residual material in all the groups was 62.37% ± 1.21%, while at T3 it was 49.63% ± 1.11%. At both T2 and T3 there were no statistically significant differences among the 4 groups examined (p=0.76 and p=0.50 respectively). Comparison within the same group at T2 and T3 showed that statistically significant differences were only detected in group D (p=0.015).

CONCLUSION

Sealing materials do not undergo a complete loss after 1 year of application, thus indicating that they are suitable for caries prevention.

Degree of microleakage of a self-etch sealant

The purpose of this study was to compare the microleakage of a new self-etch sealant (Enamel Loc), with and without acid etching, to a traditional sealant (UltraSeal XT Plus) with acid etching in occlusal fissures. The self-etch sealant had significantly more microleakage than the traditional sealant or the self-etch sealant with acid-etching of the enamel.

In vitro sealing potential of a self-adhesive pit and fissure sealant

OBJECTIVE

To study the sealing ability of a self-adhesive sealant.

METHOD AND MATERIALS

Thirty-five extracted molars were assigned to seven groups: group 1, 35% phosphoric acid (PA) followed by Clinpro Sealant (CL) as the control group; group 2, Enamel Loc (EL), a self-adhesive sealant; group 3, PA followed by EL; group 4, Adper Prompt L-Pop (AP) followed by CL; group 5, AP followed by EL; group 6, PA followed by Adper Single Bond Plus (SB) and CL; and group 7, PA followed by SB and EL. Specimens were thermocycled and immersed in 50 wt% ammoniac silver nitrate. Silver leakage was measured in ranks from 0 to 4 and analyzed with Kruskal-Wallis and Mann-Whitney tests at P < .05. One additional tooth per group was used to study the enamel etching pattern. Specimens were observed under a field-emission SEM.

RESULTS

The least silver infiltration was measured for group 1 (control group), which was significantly different from all other six groups. Etching enamel prior to the application of EL resulted in significantly less leakage than all other groups, except for the control group. EL alone resulted in similar leakage to EL with either AP or SB. None of the groups resulted in perfectly sealed interfaces. Under SEM, EL was unable to etch enamel. The self-etch adhesive AP resulted in a less defined etching pattern than the etch-and-rinse adhesive SB.

CONCLUSION

Etching enamel with phosphoric acid is still essential for sealing the enamel-sealant interface. The self-adhesive sealant tested in this study may not be indicated for clinical use.

Does the amount of filler content in sealants used to prevent decalcification on smooth enamel surfaces really matter?

OBJECTIVE

To determine how filler content and an acidic environment affect the retention of sealants placed on smooth enamel surfaces.

MATERIALS AND METHODS

A sample of 120 teeth was randomly divided into six subsamples. Three experimental sealants with identical formulas, with the exception of the amount of filler content (18%, 30%, 50%), were applied according to manufacturers' recommendations. Half of the subsamples were exposed to an acid environment (pH of 2.5) for 96 hours. With the use of a tooth-brushing simulator, each tooth was exposed to 15,000 brushing strokes, while a slurry of 1 : 3 toothpaste/neutral sodium bicarbonate cycled through the machine. Initial and final photographs were analyzed subjectively and objectively. Scanning electron microscope photomicrographs were used to evaluate the tooth surface.

RESULTS

Subjective analyses showed significant (P < .05) filler effects, with the 18% filled sealant showing the least change, followed by the 30% sealant, then the 50% filled sealant, which showed the greatest loss. Objective analyses showed the same pattern of loss, but the differences between sealants were not statistically significant. Exposure to an acidic environment had no significant effect on sealant retention. SEMS showed a layer of sealant remaining on all of the sealed teeth evaluated.

CONCLUSIONS

Filler content of resin sealant material affects the retention of sealants on smooth enamel surfaces; exposure to an acid environment has no effect on sealant retention. Within the limits of this study, highly filled resin sealants once saturated have the ability to endure the oral environment and remain on a smooth enamel surface, regardless of the amount of filler content.

Effect of accelerated ageing and surface sealing on the permanent deformation of auto-polymerising soft linings

PURPOSE

To compare the effects of different ageing methods on the permanent deformation of two permanent soft liners.

MATERIALS AND METHODS

The materials selected were auto-polymerising acrylic resin and silicone-based reliners. Sealer coating was also evaluated. Sixty specimens of each reliner were manufactured (12.7 mm diameter and 19 mm length). Specimens were randomly distributed into 12 groups (n = 10) and submitted to one of the accelerated ageing processes. Permanent deformation tests were conducted with a mechanical device described within the American Dental Association specification number 18 with a compressive load of 750 gf applied for 30 s. All data were submitted for statistical analysis. Mann-Whitney test compared the effect of the surface sealer on each material and the permanent deformation of the materials in the same ageing group (p = 0.05). Kruskal-Wallis and Dunn tests compared all ageing groups of each material (p = 0.05).

RESULTS

The silicone-based reliner presented a lower permanent deformation than the acrylic resin-based reliner, regardless of the ageing procedure. The surface sealer coating was effective only for the thermocycled silicone group and the accelerated ageing processes affected only the permanent deformation of the acrylic resin-based material.

CONCLUSION

The silicone-based reliner presented superior elastic properties and the thermocycling was more effective in ageing the materials.

Bisphenol A blood and saliva levels prior to and after dental sealant placement in adults

PURPOSE

This study examined the effects of a widely used (Delton Pit & Fissure Sealant - Light Cure Opaque, DENTSPLY Professional, York, PA) pit and fissure sealant material on bisphenol A (BPA) levels in blood and saliva, among both low and high-dose groups over time.

METHODS

A convenience sample of 30 adults from the Old Dominion University population were randomly and evenly divided into 2 independent variable groups: a low-dose group (1 occlusal sealant application) and high-dose group (4 occlusal sealant applications). A 2 group, time series design was used to examine the presence and concentration of BPA in serum and saliva after sealant placement. Differences comparing low-dose and high-dose groups were examined 1 hour prior (baseline), 1 hour post, 3 hours post and 24 hours after sealant placement, as measured by a direct-competitive BPA Enzyme Linked ImmunoSorbent Assay (ELISA). Hypothesized outcomes were evaluated by applying a parametric, 2 way ANOVA for repeated measures technique to data on the 30 participants ranging in age from 18 to 40 years, and were of mixed gender and ethnicity.

RESULTS

BPA was detected in the saliva of all participants prior to sealant placement and ranged from 0.07 to 6.00 ng/ml at baseline. Salivary BPA concentration levels peaked over a 3 hour period following sealant placement and returned to baseline levels within 24 hours. BPA was significantly elevated at all post-sealant placement time periods for both the low-dose (1 occlusal sealant application) and high-dose (4 occlusal sealant applications) groups with peak levels of 3.98 ng/ml and 9.08 ng/ml, respectively. The blood serum did not contain BPA at any point in this investigation.

CONCLUSIONS

Exposure to BPA from sources other than dental resins contributes to salivary baseline concentration levels and indicates environmental exposure and use of products containing BPA. Use of specific molecular formulations of dental sealant material determines the release of BPA, therefore, dental sealant materials should be reviewed independently when questioning the release of BPA from dental sealants. In addition, dosage amounts of the dental sealant material used in this study do not influence the serum concentration levels of BPA. Further research is needed to examine the cumulative estrogenic effects of BPA from dental sealants.

Effect of surface sealant and repolishing procedures on the color of composite resin exposed to cigarette smoke

This study evaluated the effect of cigarette smoke on the color of composite resins, with and without the application of a surface sealant and before and after the restorative material was repolished. Twenty composite resin specimens were divided into two groups (n = 10); one of which received a surface sealant. Both groups were exposed daily to the smoke of 20 cigarettes. Color analyses were performed using a spectrophotometer at different intervals: prior to cigarette smoke exposure (baseline), 21 days after cigarette smoke exposure, and after the specimens were repolished using aluminum oxide discs. Cigarette smoke caused a decrease in lightness (L*), especially in samples that received the sealant (p = 0.014). At 21 days, there was an increase in yellow pigment for both groups, with higher values (p = 0.00001) and predominant red pigmentation in the samples that received sealant. An increase in lightness and a decrease in yellow pigments (p < 0.05) were reported in both groups after repolishing. Cigarette smoke significantly altered the color of the composite resin (DeltaE > or = 10.34), especially in the specimens that received the sealant. In this study, the sealant tested intensified cigarette staining, and although repolishing decreased surface pigmentation, it was unable to restore the original color of the composite resin.

Differences in pediatric dental services under general anesthesia for Medicaid and military dependent children

PURPOSE

This study's purpose was to compare pediatric dental services provided for Medicaid and military dependent children to determine if differences in dental treatment choices exist based on site and payment method.

METHODS

Subjects included 120 Medicaid patients at the University of Texas Health Science Center at San Antonio and 120 military dependents at Lackland Air Force Base, Texas. Demographic data and treatment information were abstracted for children younger than 6 years old receiving dental treatment under general anesthesia between 2002 and 2006. Data was analyzed using Wilcoxon rank sum, Kruskal-Wallis, and Fisher's exact tests.

RESULTS

The Medicaid recipients were younger (40.2 vs 49.8 months, P<.001) and more likely to be Hispanic (78% vs 30%, P<.001). The means of decayed teeth, fillings, and stainless steel crowns did not differ between sites. Medicaid children received more composite fillings (P<.001), fewer amalgam fillings (P<.001), fewer pulp therapies (P<.001), more extractions (P=.01), and fewer sealants (P<.001). Age and gender did not affect decay rates, but those of Hispanic ethnicity did experience more decay than non-Hispanics (9.5 vs 8.6, P=.02).

CONCLUSION

This study found no difference in the number of less conservative, albeit more costly, procedures performed with Medicaid children at a university compared to military dependents at a military base.

Resin-modified glass-ionomer cements versus resin-based materials as fissure sealants: a meta-analysis of clinical trials

AIM

To appraise quantitatively current evidence regarding the caries-preventing effect of resin-modified glass-ionomer cement (RM-GIC) fissure sealants in comparison to that of resin-based fissure sealants.

STUDY DESIGN

Systematic review with meta-analysis.

METHODS

8 Anglophone databases and 2 Lusophone databases were searched until 15 April 2009, using a pre-determined search strategy. Clinical trials were considered for inclusion if their titles/abstracts were relevant to the topic, published in English, Portuguese or Spanish and had a two-arm longitudinal study design. The outcome measure of the caries-preventive effect was caries absence on sealed teeth. Two reviewers independently extracted data from the accepted articles in order to complete a 2x2 table for meta-analysis. The unit of interest was the tooth, and the number of caries-free teeth (n) at the end of each time interval (6, 12 and 24 months) was compared against the total number of evaluated teeth (N).

STATISTICS

Datasets were assessed for their clinical and methodological heterogeneity, following Cochrane guidelines, and only homogeneous datasets were combined for meta-analysis, using a random effects model (RevMan 4.2). Differences in the caries-preventive effect were computed on the basis of the combined Relative Risk (RR) with 95% confidence interval (CI).

RESULTS

Of the 212 articles identified, only 6 trials were included. From these, 19 separate datasets were extracted. For the pooled data, equivalent caries-preventive effects were observed at 6 months (RR= 0.98, 95% CI 0.95- 1.00; p = 0.08); 12 months (RR=1.00, 95% CI 0.96-1.04, p = 0.99) and 24 months (RR=1.01, 95% CI 0.84-1.21, p = 0.91). The 36-month data (not pooled) favoured resin-based sealants (RR 0.93, 95% CI 0.88-0.97, p = 0.002).

CONCLUSIONS

This meta-analysis found no conclusive evidence that either material was superior to the other in preventing dental caries.

In vitro comparison of three materials as apical sealants of equine premolar and molar teeth

REASONS FOR PERFORMING STUDY

Surgical endodontic therapy is a conservative dental technique used in horses with some degree of clinical success. Failure of this procedure can partially be explained by inadequate sealing of the root apices with resultant microleakage in the periapical area.

OBJECTIVES

To assess and compare in vitro sealing ability of 3 different dental restorative materials used as apical sealants during equine surgical endodontics.

METHODS

Thirty extracted equine cheek teeth were divided randomly into 3 groups and subjected to apicoectomy and apical sealing using 3 materials: reinforced zinc oxide-eugenol cement; intermediate restorative material (IRM); a resin-modified glass ionomer; and amalgam. After apical sealing, the teeth were submerged in a solution of Procion Brilliant Cresyl Blue stain for a period of 7 days. The teeth were then washed, embedded in resin, sectioned and assessed microscopically for dye leakage around the apical restorations.

RESULTS

Although the materials proved effective as apical sealants, some dye leakage was encountered in all 3 groups with no statistical difference (P = 0.114).

CONCLUSIONS AND POTENTIAL RELEVANCE

IRM, a resin-modified glass ionomer and amalgam all showed comparative features as apical sealants when used in vitro in equine teeth. IRM is currently regarded as the superior material in clinical situations due to its ease of handling and lesser sensitivity to environmental moisture during placement compared to the other 2 materials.

Caries-preventive efficacy and retention of a resin-modified glass ionomer cement and a resin-based fissure sealant: a 3-year split-mouth randomised clinical trial

PURPOSE

This prospective clinical trial compared the retention rate and caries-preventive efficacy of two types of sealant modalities over a 3-year period.

MATERIALS AND METHODS

Using a split-mouth randomised design, 1280 sealants were randomly applied on sound permanent second molars of 320 young patients aged between 12 and 16 years. Half of the teeth (n = 640) were sealed with a resin-modified glass ionomer cement (RMGIC) (Vitremer™, 3M ESPE) and the other half (n = 640) with a conventional light-cure, resin-based fissure sealant (LCRB) (Fluoroshield®, Dentsply Caulk). Teeth were evaluated at baseline, 6-, 12-, 18-, 24-, 30- and 36-month intervals with regard to retention and new caries development.

RESULTS

On the sealed occlusal surfaces after 3 years, 5.10% of RMGIC and 91.08% of LCRB sealants were totally intact and 6.37% of RMGIC and 7.65% of LCRB sealants were partially intact. New caries lesions were found in 20.06% of RMGIC sealed occlusal surfaces, compared to 8.91% for LCRB sealants.

CONCLUSIONS

The findings of the present clinical study suggest that RMGIC should be used only as a transitional sealant that can be applied to newly erupting teeth throughout the eruptive process, whereas LCRB sealants are used to successfully prevent occlusal caries lesions once an effective rubber dam can be achieved. It can be concluded that there are differences between the RMGIC and LCRB sealants over a 3-year period in terms of the retention rate and caries-preventive efficacy. RMGIC can serve as a simple and economic sealing solution, however provisional. Due to its poor retention rate, periodic recalls are necessary, even after 6 months, to eventually replace the lost sealant.

Effect of adhesive agent and fissure morphology on the in vitro microleakage and penetrability of pit and fissure sealants

OBJECTIVE

To evaluate the effect of adhesive agents and fissure morphology on the microleakage and penetrability of pit and fissure sealants.

METHOD AND MATERIALS

Sealants used in this study included Aegis (Bosworth), conseal f (Southern Dental Industries), and Admira Seal (Voco). Adhesive agents included Optibond Solo Plus (sds/Kerr) and Clearfil S3Bond (Kuraray). Ninety extracted permanent molars were randomly assigned to 9 groups combining sealant and adhesive agent materials. A sealant and control group (phosphoric acid etch only) was also included. Dye penetration (microleakage), penetrability, and fissure morphology assessment was performed for the treatment groups through microscopic evaluation.

RESULTS

Significant (P = .003) differences in microleakage were exhibited, with the Aegis + control and Aegis + Optibond Solo Plus groups displaying less leakage, while significant (P = .03) differences were also noted between groups regarding penetrability. Fissure morphology was not a significant (P = .82) factor affecting microleakage; however, fissure type did significantly (P < .001) impact penetrability. No correlation was found between the extent of microleakage and penetrability.

CONCLUSION

Application of sealants using phosphoric acid as a conditioning agent revealed superior results, while the use of adhesives was found to be unnecessary.

Optimal use of silver nitrate and marginal leakage at the sealant-enamel interface using micro-CT

PURPOSE

To investigate the optimal silver nitrate concentration and tooth immersion period for assessing marginal leakage at the sealant-enamel interface, using micro-CT.

METHODS

Two experiments were conducted, using eight teeth sealed with a resin composite without etching, in dried but not desiccated, pits and fissures. Five teeth were immersed in 50% silver nitrate for 0, 1, 2, 3, and 4 hours and scanned, using micro-CT, and two evaluators using a newly developed index assessed marginal leakage at the sealant-enamel interface (Experiment A). Experiment B was carried out in the same way as Experiment A, with the difference that teeth were immersed in 50% and 60% silver nitrate for 2 and 3 hours. Reliability of scores was estimated, using weighted kappa coefficient. ANOVA and t-test were applied to test for period and concentration effects.

RESULTS

Reliability of collected data was substantial. A statistically significant difference was observed between 50% silver nitrate penetration scores at 0-1 and 2-4 hours of immersion (P < 0.0001) but not between 50% silver nitrate penetration scores at 2-, 3-, and 4-hours of immersion (P > 0.05) (experiment A). Analysis in experiment B showed a period effect (P = 0.03) but no concentration (P = 0.07) and interaction effect (P = 0.64). Combining all data from 50% silver nitrate immersion, analysis showed no statistically significant difference in penetration scores between 2, 3 and 4 hours of immersion (P = 0.33). The newly developed index showed substantial reliability.

Bond strength of a sealant to permanent enamel: evaluation of 3 application protocols

PURPOSE

The purpose of this study was to compare sealant-enamel bond strengths of 3 application protocols.

METHODS

Sixty extracted third molars were randomly distributed into 3 groups according to the sealant's application protocol. The enamel was conditioned with: phosphoric acid in group 1; phosphoric acid and a single-bottle dentin bonding agent in group 2; and a self-etching adhesive in group 3. The specimens were thermocycled and tested in a shear mode at a cross-head speed of 1 mm/minute until fracture. Groups were compared using Kruskall-Wallis one-way analysis of variance and Mann-Whitney U tests.

RESULTS

No statistically significant difference was observed between groups 2 and 3 (P=.96), but both groups showed significantly higher bond strength than group 1. Group 3 appeared to be the most reproducible application protocol as shown by its coefficient of variation (27).

CONCLUSIONS

Self-etch adhesives are potentially attractive because of the easier clinical protocol required, provided that they have similar bond strengths compared to other products. The bond strength tests used in this study suggest that self-etch adhesives are equivalent to those using a separate bonding agent. Long-term clinical trials should be performed to assess performance of self-etch adhesives before definitive conclusions can be drawn.

Enamel bond strength of self-etch sealant with and without prior acid etching

Our study was undertaken to evaluate the bond strength (BS) of a self-etch sealant to enamel and to determine the effect of prior enamel conditioning with phosphoric acid. Lingual surfaces of permanent human molars were mounted in copper rings and assigned to five groups: Group 1, Clinpro (control); Group 2, Enamel Loc; Groups 3, 4, 5, Enamel Loc with prior phosphoric acid etching of enamel for 5, 10, 15 seconds, respectively. Sealants were applied and BS measured. Clinpro showed significantly higher BS than Enamel Loc. Prior enamel etching for 10 and 15 seconds improved BS of Enamel Loc.

Microleakage of an adhesive system used as a fissure sealant

AIM

The aim of this study was to investigate the microleakage of pit and fissure sealants in primary teeth and to determine if multi-step methods should produce better results in terms of microleakage prevention.

METHODS AND MATERIALS

A total of 40 intact primary molars were randomly assigned to one of four sealant groups: resin based sealant Ultraseal XT (US - Ultradent) (Group 1, n=10); adhesive system Scotchbond Multi Purpose Plus (SBMP - 3M/ESPE) used as a sealant (Group 2, n=10); primer (SBMP) and US (Group 3, n=10); and primer, bond (SBMP) and US (Group 4, n=10). After thermocycling (x700, 5-55 degrees C) all teeth surfaces were made impermeable with the exception of the occlusal surface. Samples were immersed in 50% silver nitrate for 8 hours, sectioned longitudinally with two cuts in the central fissure pit, and then immersed in photo development solution followed by 16 hours in fluorescent light. Pictures were obtained by light microscope (x40) and the degree of microleakage was evaluated by three blinded evaluators. The data were analyzed using the Kruskal Wallis test.

RESULTS

Significant statistical differences (p<.05) were observed between Groups 1-3, Groups 2-3, Groups 2-4, and Groups 3-4. Group 3 showed higher microleakage scores.

CONCLUSION

The adhesive system and the resin based sealant demonstrated similar microleakage properties, suggesting the possibility that adhesives can be used in a clinical setting. Additionally, the increase in the number of clinical steps required by common application of resin based sealant, including use of primer or primer and bond, did not lead to better results in preventing microleakage.

CLINICAL SIGNIFICANCE

The adhesive system can be used as a sealant without increasing the microleakage. Thus, the use of the adhesive system before the application of the sealant is not necessary to reduce the microleakage, although further research is warranted to support this conclusion.

The influence of Healozone on microleakage and fissure penetration of different sealing materials

The preventive effect of sealing materials depends on ability to penetrate into the fissures, and microleakage absence, resulting with better clinical success. The aim of present study was to investigate the influence of ozone on microleakage and penetration of nanoparticle fissure sealing resin and flowable composite, and quantitative and qualitative analysis of microleakage. Forty extracted non carious third molars were randomly divided in 4 groups. Group A: KaVo Healozone and Grandio Seal; Group B: Kavo Healozone and X-Flow; Group C: Grandio Seal; Group D: X-Flow. The teeth were thermocycled, immersed in 5% methylene dye for 24 hours, and sectioned with precision saw. The total of 149 slices were analysed with stereomicroscope for microleakage and sealant penetration. According to qualitative scores, there is a significant difference between groups C and D, group C showing better results. According to quantitative scores, there are no statistical differences between the groups. The treatment of the enamel with KaVo HealOzone after etching does not affect either microleakage or penetration proportion of flowable composite or sealing resin. There is no statistically significant difference in a degree of penetration between different groups of sealing materials. Groups of materials with flowable composite in combination with an adhesive system show a good degree of penetration into the fissure and low microleakage meaning that they can be used as a fissure sealing materials.

Effect of LED curing on marginal integrity of an ormocer-based sealant

PURPOSE

The purpose of this study was to investigate the microleakage of a light cured, ormocer-based fissure sealant when photopolymerized with 2 different light emitting diode (LED) curing units and a conventional quartz-tungsten halogen (QTH) light-curing unit.

METHODS

Thirty freshly extracted, unerupted human third molars from 9 adolescent were randomly assigned into 3 groups (N=10/group). Pits and fissures were acid etched for 30 seconds, rinsed for 15 seconds with an air-water spray, and air-dried. An ormocer-based fissure sealant material (Admira Seal) was applied to all fissures. In group 1, the sealant was photopolymerized with a Smart Light LED curing unit (Dentsply) for 10 seconds. Another LED curing unit (Elipar II) and a conventional QTH curing unit (Hilux) were used in groups 2 and 3 for 10 and 30 seconds, respectively. Specimens were immersed in 0.5% basic fuchsin for 24 hours, sectioned and examined under a stereomicroscope, and scored for marginal microleakage.

RESULTS

Statistical analysis of microleakage scores revealed no significant difference among the groups tested (P>.05, Kruskal-Wallis test).

CONCLUSION

The tested LED curing units may provide reduction in total application time without comprising marginal integrity of the ormocer-based sealant.

Marginal adaptation of pit and fissure sealants after thermal and chemical stress. A SEM study

PURPOSE

To evaluate the in vitro marginal adaptation (gap formation) in the fissure of different sealer materials (resin sealant, glass-ionomer cement, resin-modified glass-ionomer cement, and adhesive system) submitted to thermal and chemical stress, using scanning electron microscopy evaluation (SEM).

METHODS

80 impacted human third molars were randomly assigned to the following experimental groups (n = 10): FluroShield (F), Helioseal Clear Chroma (H), Vitremer (V), Fuji II-LC (FII), Ketac-Molar (KM), Fuji IX (FIX), Single Bond (SB), and Clearfil Protect Bond (CF). All groups were subjected to thermocycling and 14 days of pH cycling. A blinded and calibrated examiner performed SEM analysis. Gap formation was scored according to: 0 = no sealant marginal gaps; 1 = sealant marginal gaps present or total sealant loss. The score 0 was considered a success, while score 1 represented failure. Data were analyzed by Kruskal-Wallis and Bonferroni tests (P < 0.05).

RESULTS

The success rates of SB (100%) and V (90%) were similar, but statistically superior to F (30%), H (20%), FIX (20%), and CF (0%) (P < 0.05). A tendency for similar behaviors of FII and KM to SB and V was observed and for similar behaviors of F, FIX and H to CF. The worst results were obtained for CF.

Quantitative microleakage evaluation of fissure sealants applied with or without a bonding agent: results after four-year water storage in vitro

PURPOSE

To evaluate the effect of long-term water storage on the microleakage of a fissure sealant applied with or without different bonding agents.

MATERIALS AND METHODS

Extracted human third molars were randomly assigned into 8 groups (n = 24/each). The occlusal surfaces were sealed with a fluoride fissure sealant material (Helioseal F) after one of the following pretreatments: (1) phosphoric acid etching only; (2) phosphoric acid etching + Single Bond; (3) phosphoric acid etching + Prime & Bond NT; (4) Clearfil SE Bond; (5) FL Bond; (6) One Up Bond F; (7) Prompt L-Pop; (8) Mac Bond II. All specimens were thermocycled (1000X), after which half of them (n=96) were stored in distilled water for 48 h (group A), and the remaining half (n=96) for 48 months (group B). The specimens were immersed in 0.5% basic fuchsin solution, sectioned, and digitally photographed. Microleakage was evaluated quantitatively using an open-source image analysis toolkit (ImageJ), and the data were analyzed statistically.

RESULTS

Four-year water storage significantly increased the amount of leakage in all test groups (p < 0.001). In both the absence and presence of water aging, the etch-and-rinse adhesives yielded the lowest microleakage scores (p < 0.001). In the 48-h group, the following ranking was achieved in terms microleakage values: phosphoric acid + Prime & Bond NT = phosphoric acid + Single Bond < Prompt L-Pop = phosphoric acid etching only < FL Bond < Clearfil SE Bond < Mac Bond II = One Up Bond F. In the 48-month group, the ranking changed as follows: phosphoric acid + Prime & Bond NT = phosphoric acid + Single Bond < Prompt L-Pop = FL Bond < Clearfil SE Bond = Mac Bond II = One Up Bond F < phosphoric acid etching only.

CONCLUSION

Long-term water storage significantly increased the microleakage of Helioseal F applied alone and with a bonding agent. Regardless of the storage term, the use of etch-and-rinse adhesives resulted in significantly less microleakage compared to that achieved with self-etching adhesives or acid etching alone. The sealants placed without a prior bonding agent showed the greatest amount of leakage after four years.

Marginal seal evaluation of different resin sealants used in pits and fissures. An in vitro study

ATM: Oral health is important for everyone, but specially for children and people requiring special care owing to impaired manual ability. Primary prevention, with correct oral hygiene, proper diet, use of fluoride and pit and fissure sealants, can reduce caries risk thereby improving patients' quality of life. The first aim of this paper was to assess the marginal microleakage of different pit and fissure sealants after immersion in a cariogenic solution. The second aim was to evaluate the ability of the materials to penetrate into the bottom of the fissure.

METHODS

32 posterior teeth were divided into four groups based on the type of sealant tested: Concise, Clinpro, Fissurit, Fissurit F. Samples were immersed and stored in a lactic acid solution (pH 4.4, 0.1 M) at 37 degrees C for different periods: 1 day; 3 days; 7 days; 10 days. Then each sample was stored in erythrosine solution for 24 hours at 37 degrees C. Each sample was sectioned in a mesio-distal direction and evaluated at the stereomicroscope and subsequently at SEM.

RESULTS

SEM analysis showed that Clinpro and Concise obtained a good penetration inside the fissure and a good adaptation to the enamel wall, while Fissurit and Fissurit F showed gaps at the sealant-enamel interface and voids.

CONCLUSION

Sealant application is an important means for caries prevention but, for a lasting effect, it must be associated with good oral hygiene and regular dental check-ups.

Length of resin tags in pit-and-fissure sealants: all-in-one self-etching adhesive vs phosphoric acid etching

PURPOSE

To investigate the penetration (tags) of adhesive materials into enamel etched with phosphoric acid or treated with a self-etching adhesive, before application of a pit-and-fissure sealant.

MATERIALS AND METHODS

The sample comprised six study groups with six specimens each. Before pit-and-fissure sealing with the materials Clinpro SealantTM (Groups I and II), Vitro Seal ALPHA (Groups III and IV) and Fuji II LC (Groups V and VI), the teeth in Groups I, III, and V were etched with 35% phosphoric acid for 30 seconds. Teeth in Groups II, IV, and VI received application of the self-etching adhesive Adper Prompt L-Pop. The treated teeth were sectioned buccolingually, ground to 100-microm thickness, decalcified, and analyzed by conventional light microscopy at 400x magnification.

RESULTS

The teeth etched with phosphoric acid exhibited significantly greater penetration than specimens treated with self-etching adhesive.

CLINICAL SIGNIFICANCE

When compared with enamel treated with a self-etching adhesive, the penetration (tags) of adhesive materials into enamel was greater when applied on enamel etched with phosphoric acid.

Is there a risk of harm or toxicity in the placement of pit and fissure sealant materials? A systematic review

BACKGROUND

Recently, there has been increased interest in the in vivo release of dental sealant components, such as bisphenol A (BPA), which has the potential to bind the estrogen receptors of relevant cells at subtoxic concentrations in vitro, impairing the development, health and reproductive systems of wildlife. The purpose of this systematic review was to investigate whether the placement of pit and fissure sealant materials causes toxicity, and thus harms patients.

METHODS

The literature search (from the earliest record up to March 2007) for relevant articles was done with Ovid MEDLINE, CINAHL and other bibliographic databases.

RESULTS

A total of 377 articles were identified by the literature search; relevance was determined by examining the title and abstract of the articles. Eleven original studies met the inclusion criteria. These articles were read in full and scored independently by 2 reviewers.

RECOMMENDATIONS

The evidence suggests that patients are not at risk for exposure to BPA from the use of dental sealants. To reduce the potential, if any, for BPA toxicity from sealants, dental providers should use a mild abrasive, such as pumice, either on a cotton applicator or in a prophy cup; have older children and adolescents gargle with tepid water for 30 seconds; or wash the sealant surface for 30 seconds with an air-water syringe while suctioning fluids and debris from a child"s mouth.