Effect of surface sealant on surface roughness and bacterial adhesion of bulk-fill composites

Surface sealants are reported to ensure surface smoothness and improve the surface quality of composite restorations. These sealants should also reduce the bacterial adhesion on composite surfaces however, there is not much information regarding their performance on bulk-fill composite materials. The aim of this study was to evaluate the effect of surface sealant application on surface roughness and bacterial adhesion of various restorative materials. Disc-shaped samples were prepared from a compomer, a conventional composite and three bulk-fill composites. Specimens of each group were divided into two groups (n = 9): with/without surface sealant (Biscover LV, [BLV]). Surface roughness values were examined by profilometry and two samples of each group were examined for bacterial adhesion on a confocal laser scanning microscope (CLSM). Bacterial counts were calculated by both broth cultivation and microscopic images. Results were analyzed with one-way ANOVA and Bonferroni/Dunn tests. Following the BLV application, there was a decrease in the surface roughness values of all groups however, only Tetric N-Ceram Bulk and Beautifil-Bulk groups showed significantly smoother surfaces (p < 0.001). There were no significant differences among material groups without BLV application. Evaluating bacterial adhesion after BLV application, conventional composite had the lowest values among all followed by the compomer group. Beautifil-Bulk had significantly the highest bacterial adhesion (p < 0.05), followed by Tetric N-Ceram Bulk group. Without BLV application, there was no significant difference among bacterial adhesion values of groups (p > 0.05). CLSM images showed cell viability in groups. Bulk-fill composites showed higher bacterial adhesion than conventional composite and compomer materials. The surface sealant was found to be highly effective in lowering bacterial adhesion, but not so superior in smoothing the surfaces of restorative materials. So, surface sealants could be used on the restorations of patients with high caries risk.

Abrasion of Pro Seal® and Opal® Seal™ by professional tooth cleaning protocols: results from an in vitro study and a randomized controlled trial

Summary Background The integrity of orthodontic surface sealants after professional tooth cleaning (PTC) has previously only been evaluated in vitro. Recently, we have shown that optical coherence tomography (OCT) can successfully be used for the longitudinal assessments of sealant thickness in vitro and in vivo. Objectives Thus, the aim of the present study was to assess the sealant thickness after PTC in vitro and in vivo by OCT. Trial design Single-centre four-arm parallel-group randomized controlled trial. Methods Ninety-six extracted human teeth were randomly assigned to the surface sealants Pro Seal® (PS) and Opal® Seal™ (OS) and to PTC protocols: (1) polishing with brush and prophy paste (Cleanic®) or (2) erythritol air-polishing. Sealant thickness was assessed by OCT immediately after application (baseline), after thermocycling and after polishing for totals of 5, 10, 15, 30, 60, 90, and 120 seconds. Additionally, a clinical trial was conducted. Therefore, using a split-mouth design, quadrants of 20 patients and PTC protocols were randomized by an external randomization centre using computer generated tables to assign the surface sealants and PTC protocols. Sealant thicknesses were analysed at baseline, before and after PTC. Due to the optical properties of sealants, a complete blinding was not feasible. Results In vitro both sealants revealed significant layer thickness losses after both PTC protocols. PS lost 0.77 µm/s [95% CI (confidence interval): 0.67, 0.87] from air-polishing and 0.43 µm/s (95% CI: 0.37, 0.49) from polishing with brush while OS lost 0.44 µm/s (95% CI: 0.32, 0.55) from air-polishing and 0.79 µm/s (95% CI: 0.68, 0.89) from polishing with brush of layer thickness. Sealant thickness loss of was significantly higher after erythritol air-polishing for PS and after polishing with brush for OS. The results of a concurrent randomized controlled trial (RCT) were comparable to those achieved in the in vitro part of this study. Limitations Long-term surface sealant abrasion should be validated by additional RCTs. Conclusions For PTC on surface sealant treated teeth, low abrasive protocols should be used. Air-polishing should be avoided on PS protected teeth and polishing with brush on OS treated teeth. Trial registration ClinicalTrials.gov NCT03753256.