Evaluation of two resin based fissure sealants: a comparative clinical study

Micro-tensile bond strength of two pit and fissure sealants to intact enamel

Background

Sealing dental pits and fissures with resin-based sealants effectively prevents occlusal dental caries. The effectiveness of resin-based pit and fissure sealants relies on maintaining a strong bond between the sealant and the enamel.

Objective

This in-vitro study compared the micro-tensile bond strength (μTBS) of a conventional resin-based sealant (Clinpro™) and a hydrophilic resin-based sealant (Embrace™ WetBond™) when applied to intact, aprismatic human enamel.

Methods

Forty extracted permanent premolar and molar teeth were divided into two groups and paired by tightly approximating two buccal surfaces to create an artificial enamel groove (fissure). Fissure sealants (Clinpro™ and Embrace™ WetBond™) were applied to the artificial enamel 'grooves' in each group. The specimens were then cut into beams with a cross-sectional area of 1 mm2 and tested for the micro-tensile bond strength (μTBS). Fractured surfaces of samples were examined under a conventional microscope to identify the failure modes. Two specimens from each group were prepared and observed under a scanning electron microscope (SEM). Mann-Whitney U and Fischer-Freeman-Holton exact tests were used to test the statistical differences between the fissure sealants.

Results

The μTBS mean ± SD for Clinpro™ was 16.43 ± 7.08, and 10.57 ± 6.64 for Embrace™ WetBond™. There was a statistically significant difference in μTBS between Embrace™ WetBond™ and Clinpro™ (p < 0.001). There was no association between fissure sealant and failure modes (p = 0.922).

Conclusion

Clinpro™ showed higher μTBS to enamel than Embrace™ WetBond™. Further studies are needed to conclude the clinical effectiveness of these sealants.

A concise review of dental sealants in caries management

This concise review provides an update of the use of dental sealants. Dental sealants protect a tooth from caries development by providing a physical barrier to microorganism colonisation and creating a favorable environment for patients to clean. Some sealants release fluoride ions to promote remineralization. Dental sealants can be applied on pits and fissures of primary and permanent teeth to prevent and arrest early enamel caries. They are effective in caries prevention. The preventive fraction of resin sealant is up to 61% after 5 years. Dental sealants can be classified as resin, glass ionomer and hybrid (compomer or giomer) according to the material. Recent studies from 2012 to 2022 showed resin sealant has a high retention rate of up to 80% after 2 years, whereas glass ionomer sealants is 44%. Chemical etching with 37% phosphoric acid is the standard of care, whereas laser or air-abrasion cannot does not increase the sealant retention rate. Moist control is critical and studies found the use of rubber dam and cotton rolls had similar success for sealant retention. The longevity of dental sealant is also associated with clinical operative factors, including approaches of moisture control, enamel pretreatment, selection of dental adhesive, and time of acid etching.

A Comparative Evaluation of Shear Bond Strength of Embrace WetbondTM Pit and Fissure Sealant with or without the Use of a Universal Dental Adhesive System [ScotchbondTM Universal Adhesive] Using Different Bonding Protocols: A Multiparametric In Vitro Study

Aim

To evaluate and compare the shear bond strength (SBS) of Embrace WetBondTM (EWS) Pit and Fissure Sealant (PF sealants) with or without the use of a universal dental adhesive system ScotchbondTM Universal Adhesive (SBU) using different bonding and curing protocols and to assess and compare the mode of failure as determined by visualization of the fractured surfaces of the test specimens after shear testing under an optical microscope at a magnification of 20×.

Materials and methods

A total of 85 samples were prepared for testing SBS on enamel on caries-free, extracted permanent human molars. The specimens were randomly divided into five groups based on different bonding and curing protocols. A knife-edge blade in a universal testing machine was used to perform the SBS test with a crosshead speed of 1 mm/minute. Then the mode of failure was assessed.

Statistical analysis

Results were analyzed using a one-way analysis of variance with Tukey's post hoc test and Chi-squared test. A probability value 0.05 (p ≤ 0.01) was regarded as significant.

Results

ScotchbondTM Universal Adhesive (SBU) in total-etch (TE) mode/etch-and-rinse (ER) mode with individual light curing of the sealant and adhesive showed the highest SBS to enamel (5.40 ± 2.51 MPa). A predominance of cohesive mode of failure was observed for all the test groups.

Conclusion

Embrace WetBondTM (EWS) PF sealants with SBU in the ER mode of application, with either curing mode, can be used as an alternative to a conventional technique for sealant placement for improving interfacial bond strength to enhance sealant retention and efficacy.

Clinical significance

Embrace WetBondTM (EWS) PF sealants with SBU in the ER mode of application can be used as an alternative to a conventional technique for sealant placement for improving interfacial bond strength.

How to cite this article

Swathy SR, Naidu J. A Comparative Evaluation of Shear Bond Strength of Embrace WetbondTM Pit and Fissure Sealant with or without the Use of a Universal Dental Adhesive System [ScotchbondTM Universal Adhesive] Using Different Bonding Protocols: A Multiparametric In Vitro Study. Int J Clin Pediatr Dent 2023;16(1):48-53.

Moisture Tolerant Pit and Fissure Sealant: A Literature Review

Even in the 21st century, dental caries are considered a global burden, severely upsetting the health and quality of life of those affected. Apart from the fluoride use and regular oral hygiene, one of the most important prophylactic approaches against caries occurrence is the sealing of pits and fissures. Pit and fissure sealants are a core part of the preventive program in pediatric dentistry and should be considered as a key component of minimally invasive dentistry due to their broad patient benefit. The primary sealant efficacy measure is retention. If the sealant remains bonded to the tooth and offers a good seal, then it is right to expect the occurrence of caries to be diminished. Traditional pit and fissure sealants are hydrophobic. These materials are based on bisphenol A-glycidyl methacrylate (bis-GMA) and other monomers requiring a dry field which is hard to achieve in an oral environment, especially for children. This review highlights the literature on the effectiveness of moisture tolerant pit and fissure sealant, which are the hydrophilic pit and fissure sealant, and a general overview of the pit and fissure sealant materials used for sealing occlusal surfaces, its classification as well as indications and possible side effects. How to cite this article: Priscilla S, GS P, Mohandoss S. Moisture Tolerant Pit and Fissure Sealant: A Literature Review. Int J Clin Pediatr Dent 2022;15(2):233-239.

Evaluation of Embrace WetBond and Helioseal-F sealant retention with and without a Self-etch adhesive: A 12 month follow-up

BACKGROUND

Pit and fissures on the young permanent tooth are ideal in harbouring dental plaque and calculus. Hence it is important to provide a preventive agent to protect against dental caries. Aim: To evaluate the retention of two different pit and fissure sealants with and without a self-etch adhesive in the first permanent molars for a period of one year.

MATERIAL AND METHODS

280 molars were included among 70 healthy children. According to randomisation, the groups were divided into Group IA - Embrace without Adhse One F bonding agent and Group IB - Embrace with Adhse One F bonding agent, Group IIA - Helioseal F without Adhse One F bonding agent and Group IIB - Helioseal F with Adhse One F bonding agent. The sealants were assessed clinically at 3,6,9, and 12 months using the modified Colour, Coverage, Caries (CCC) sealant evaluation system.

RESULTS

At the end of 12 months, the retention rates of Group IB showed statistically significant results, followed by Group IIB, Group IA and Group IIA.

CONCLUSIONS

At twelve months follow-up Embrase WetBond and Helioseal-F were better retentive when used with a Adhese One F bonding agent which was statistically significant. Key words:Retention, Bonding agent, Embrace WetBond, Helioseal-F.

Clinical success of fluoride-releasing fissure sealant in permanent first molars: 5-year retrospective atudy

Background/Aim: It is important to prevent caries on permanent first molars. Fissure sealants are very effective in protecting fissures from caries. The study aimed to determine the clinical success of fluoride-releasing fissure sealants in permanent first molars in the long term. Material and Methods: 64 children with 256 healthy erupted first permanent molars and followed for 5 years, comprised the study. Children who received a fluoride-releasing fissure sealant and came regularly to controls throughout 5 years were evaluated by retention rate and development of new caries and compared with a control group. Results: The complete retention rate of fluoride-releasing fissure sealants was 48.5% and 10.7 % of the sealed teeth had caries after 5 years. 25% of the teeth without fissure sealant were decayed after five years. There was no significant difference between the rate of retention of fissure sealants and the frequency of tooth brushing after 1 year. There was no significant difference between the rate of retention of fissure sealants and oral hygiene status of children after 1 year. Conclusions: The fluoride-releasing fissure sealants were effective for the prevention of caries on pit and fissures of permanent molars and long-term clinical success was satisfying.

Clinical success of fluoride-releasing fissure sealant in permanent first molars: 5-year retrospective study

Background/Aim: It is important to prevent caries on permanent first molars. Fissure sealants are very effective in protecting fissures from caries. The study aimed to determine the clinical success of fluoride-releasing fissure sealants in permanent first molars in the long term. Material and Methods: 64 children with 256 healthy erupted first permanent molars and followed for 5 years, comprised the study. Children who received a fluoride-releasing fissure sealant and came regularly to controls throughout 5 years were evaluated by retention rate and development of new caries and compared with a control group. Results: The complete retention rate of fluoride-releasing fissure sealants was 48.5% and 10.7 % of the sealed teeth had caries after 5 years. 25% of the teeth without fissure sealant were decayed after five years. There was no significant difference between the rate of retention of fissure sealants and the frequency of tooth brushing after 1 year. There was no significant difference between the rate of retention of fissure sealants and oral hygiene status of children after 1 year. Conclusions: The fluoride-releasing fissure sealants were effective for the prevention of caries on pit and fissures of permanent molars and long-term clinical success was satisfying.

Efficacy of hydrophilic resin-based sealant: A systematic review and meta-analysis

OBJECTIVES

This meta-analysis review aims to answer two questions: 1) What is the effectiveness of hydrophilic resin-based sealant (RBS) in preventing/arresting pits and fissures caries in permanent teeth, and 2) What is the retention rate of a hydrophilic RBS as compared to alternative treatments.

DATA

Randomized control trials investigating the efficacy of hydrophilic RBS compared to any other (placebo) treatment for permanent teeth. Outcomes were retention rate and caries prevention/arresting.

SOURCES

A systematic search for eligible studies was conducted on six electronic databases (Scopus, Ovid MEDLINE, Ovid Embase, Cochrane; Web of Science, PubMed) from inception to March 2021. The Cochrane guidelines were used to classify the risk of bias.

STUDY SELECTION/RESULTS

A systematic literature search resulted in 290 studies. Thirteen articles met our inclusion criteria and were included in the systematic review. Six articles were identified as good or fair quality and were included in the quantitative analysis. Meta-analysis results indicated that there is no significant difference in retention (RR 1.01, 95% CI:0.96-1.07, P-value 0.66), (RR 1.03, 95% CI: 0.89-1.19, P-value 0.0009) at six and twelve months, respectively. Likewise, for caries prevention there is no significant difference (RR 0.97, 95% CI: 0.91-1.03, P-value 0.19), (RR 0.30, 95% CI: 0.91-1.03, P-value 0.30) at six and twelve months.

CONCLUSIONS

This meta-analysis showed no statistically significant difference between the hydrophilic RBS and alternative treatment options (such as conventional resin or glass ionomer) regarding retention or caries prevention at six- and twelve-month follow-up. Future studies are required to investigate longer-term outcomes.

The effect of the Er: YAG laser on the clinical success of hydrophilic fissure sealant: a randomized clinical trial

Purpose:

The aim of this study was to assess the effect of the Er:YAG laser on the clinical success of a hydrophilic fissure sealant over 12 months.

Subject and methods:

This study was conducted on 132 permanent first molars from 44 (19 girls and 25 boys) patients aged 7-11 years. The teeth were divided into three groups. The first group (Group A-control) of teeth were etched with phosphoric acid, the second group of teeth (Group L) were etched with an Er:YAG laser, and the third group of teeth (Group A+L) were etched with both the Er:YAG laser and phosphoric acid. Clinical evaluations were performed at baseline and at 3-, 6-, 9- and 12-month follow-up visits. The data were analyzed with Pearson chi-square tests, Cochran Q tests and Kaplan-Meier analysis.

Results:

At the end of the 12 months, total retention rates were 72.7%, 59.1%, and 65.9% in the acid group, the laser group and the laser and acid group, respectively. Although there was no statistically significant difference between group retention rates (p>0.05), the lowest retention rate was found in the laser group at the end of the 12-month follow-up period. No new caries were observed in any group during the study period.

Conclusion:

Etching with the Er:YAG laser, phosphoric acid or a combination of both methods provided similar results for the clinical success of hydrophilic based fissure sealant.

One-year Clinical Evaluation of Retention Ability and Anticaries Effect of a Glass Ionomer-based and a Resin-based Fissure Sealant on Permanent First Molars: An In Vivo Study

Aim

To evaluate and compare the retention ability, anticaries effect and marginal discoloration when sealed with a glass ionomer-based sealant (Fusion i-seal) and a resin-based fissure sealant (Helioseal-F) on permanent first molars.

Materials and methods

Caries free, fully erupted permanent first molars of 50 children between 6 years and 8 years were sealed with pit and fissure sealants under rubber dam isolation. Glass ionomer-based sealant was applied on a permanent first molar and the contralateral molar with resin-based sealant. The sealants were evaluated at regular intervals for a period of 1 year. Statistical analysis was done by Chi-square test.

Results

Higher retention rates were noted for resin-based sealant (88%) compared to glass ionomer-based sealant (78%). None of the teeth sealed with resin sealant developed caries whereas 2% of teeth sealed with glass ionomer sealant developed caries. Marginal discoloration was not noted in teeth sealed with glass ionomer sealant whereas slight marginal discoloration was noted for 6% of teeth sealed with resin sealant.

Conclusion

Clinically a difference was noted in the retention rate, anticaries effect and marginal discoloration whereas statistically no significant difference was noted for the two sealants after 1 year.

Clinical significance

Pit and fissure sealants are highly effective and economical in preventing occlusal caries in young permanent tooth with low failure rate.

How to cite this article

Mathew SR, Narayanan RK, Vadekkepurayil K, et al. One-year Clinical Evaluation of Retention Ability and Anticaries Effect of a Glass Ionomer-based and a Resin-based Fissure Sealant on Permanent First Molars: An In Vivo Study. Int J Clin Pediatr Dent 2019;12(6):553–559.

Dawn of a New Age Fissure Sealant? A Study Evaluating the Clinical Performance of Embrace WetBond and ART Sealants: Results from a Randomized Controlled Clinical Trial

OBJECTIVES

 The main purpose of this article is to evaluate the clinical performance of atraumatic restorative treatment (ART) sealant versus Embrace WetBond sealant in terms of retention and fissure caries prevention among a section of school children in the southern Indian state of Karnataka (ClinicalTrials.gov NCT02716558).

MATERIALS AND METHODS

 After obtaining consent from the parents and screening the children against the inclusion cum exclusion criteria, 90 school children whose mandibular first molars were caries free and with a well-defined pit and fissure system were recruited for this spilt mouth trial. The respective molars were allocated either to the ART sealant or the embrace group after the randomization process. The sealants were applied according to the manufacturer's instructions and followed up at the end of 3rd, 6th, and 12th month, respectively. The outcome measures assessed were the retention and the caries preventive effects of the materials.

RESULTS

 At the end of the 6th month, about one-fourth of the sealants in either group remained totally intact, without evidence of caries. No significant differences were seen between the sealants either in terms of retention or caries preventive benefits at the end of 12 months.

STATISTICAL ANALYSIS

 The chi-squared test was used to check differences in proportions. The significance value was set at <0.05. Kappa test was performed to assess the intraexaminer reproducibility with respect to retention and caries status.

CONCLUSION

 The moisture-tolerant resin sealant could not replicate the physical properties usually associated with conventional resin sealants. The usage of ART sealants was deemed to be less cumbersome in an outreach setting as observed in this trial.

Retention of pit and fissure sealant versus flowable composite: An in vivo one-year comparative evaluation

INTRODUCTION

Pits and fissures are extremely vulnerable to the development of caries. Resin-based materials for sealing pits and fissures (pit and fissure sealants and flowable composites) are helpful in caries control by physical barrier formation, which prevents metabolic exchange between fissure microorganisms and oral environment. Retention is one of the most important prerequisites for pit and fissure sealants. Debris and pellicle might not be removed by conventional prophylaxis and etching; therefore, air abrasion (AB) for fissure preparation has been advocated for sealant retention. This in vivo study was aimed to compare the retention of resin-based pit and fissure sealant to flowable resin composition occlusal pits and fissures of all first permanent molars with and without air-abrasion over a 12-month follow-up.

MATERIALS AND METHODS

A randomized controlled clinical trial was done after obtaining ethical committee approval and informed and written consent. Thirty children with the age of 6-9 years, with all four caries-free first permanent molars without any hypoplasia/fracture but with pits and fissures prone to caries were included in this study. The four first molars were divided into the following four groups: Group A (tooth 16; sealant + AB), B (tooth 46; composite + AB), C (tooth 36; sealant), and D (tooth 26; composite). Assessments were made at 3, 6, 9, and 12 months for partial or total loss of sealant and caries according to Modified Simonsen's Criteria.

RESULTS AND CONCLUSIONS

Flowable composite was relatively better retained than sealant at 12 months' follow-up although results were statistically insignificant. AB followed by acid etching brought superior retention than acid etching. Mandibular teeth have shown relatively superior retention. Future studies should aim at investigating better techniques and materials for sealing pit and fissures.

A Two-Year Clinical Evaluation of Fluoride and Non-Fluoride Resin-Based Pit-and-Fissure Sealants

The aim of this study was to evaluate and compare for 24 months, the retention and surface characteristics of two pit-and-fissure sealants: Helioseal Clear and Helioseal F (Ivoclar Vivadent). The correlation between the different stages of eruption and sealant retention was also verified. Fifty children aged 6 to 8 years participated in the study, totalizing 153 teeth divided into two groups: HC (Helioseal Clear) and HF (Helioseal F). After 6, 12, 18 and 24 months, a clinical examination was performed by previously calibrated examiners. The surface characteristics and the retention of the sealants (modified RYGE & SNYDER criteria) were assessed. Analyzing the occlusal surface, HC exhibited a statistically significant higher retention at 12 (p=0.0345) and 24 months (p=0.0076). Concerning the surface characteristics, only the superficial discoloration of HC was smaller than HF, during the entire studied period. For all the other characteristics, the results of the Mann-Whitney test were highly significant at different periods (p=0.0000 to 0.0421). The frequency of air bubbles within the sealant surfaces, determined by Chi-square test, was significantly higher in HF (p=0.000:12 and 18 months to p=0.002: 6 and 24 months). HC sealant material exhibited the best performance regarding the retention and surface characteristics on the occlusal surface.