Comparative Evaluation of GIC Based Sealant with Nano-Filled Resin Coating versus Filled Resin Sealant: A Randomized Clinical Trial

Objective: To evaluate and compare the retention of GIC based sealant with nano-filled resin coating and filled resin sealant at specified time intervals. Study Design: It was a split mouth design in which 248 mandibular first permanent molars were divided into two groups i.e. Group 1 (124): treated with glass ionomer sealant followed by light cured nano-filled resin coating and Group 2 (124): treated with acid etching followed by resin filled sealant. Clinical evaluation was done at 1,3,6,9 and 12 months as per modified categorization by Weiwei Z et al. Data was analyzed using Pearson’s chi-square test to evaluate the success of both treatment procedures (p<0.05). Results: At 12 months, overall retention rate of glass ionomer sealant with nano-filled resin coating was found to be superior (84.7%) as compared to filled resin sealant (74.3%); but no significant difference was noted (p>0.05). Conclusions: Nano-filled resin coating application over glass ionomer sealant provides enhanced longevity and cariostatic benefits; hence, can be used as a viable alternative in place of resin sealants.

In Vitro Evaluation of Different Protocols for Preventing Microleakage of Fissure Sealants Placed Following Saliva Contamination

Purpose: To evaluate the effect of different enamel conditioning protocols and their re-application on the microleakage of fissure sealants placed following saliva contamination. Study design: The study included 156 human third molars in 16 subgroups (2×4×2) under two main groups (sealant type): Group A- hydrophobic resin sealant, 3M Clinpro™ Sealant; Group B- hydrophilic resin sealant, Ultraseal XT Hydro. Each group was then divided according to the type of surface conditioning; 1- Er,Cr:YSSG laser etching, 2- acid-etching, 3- acid-etching+etch-and-rinse adhesive (Prime&Bond® One Select) and 4- self-etching adhesive (Clearfil™ SE Bond). After contaminating the conditioned occlusal enamel surfaces with artificial saliva, fissure sealant was applied in half of the specimens (a), whereas in the other half, (b) the respective surface conditioning was repeated and then fissure sealant was placed. Following thermocycling, the samples were immersed in basic fuchsin, sectioned, and dye penetration was quantitatively assessed with ImageJ. Two-way ANOVA and Bonferroni post-hoc tests were used for statistical analyses (p<0.05). Results: The least microleakage was observed in A3b and A3a, whereas B4b and B4a were the subgroups with the highest microleakage. Following saliva contamination, when surface conditioning was not re-applied, the effects of fissure sealant types and surface conditioning were significant (p=0.005 and p<0.001, respectively). However, their interaction was insignificant (p=0.173). When surface conditioning was re-applied after saliva contamination, the effects of type of fissure sealant and surface conditioning (p=0.000, for both) and their interaction (p=0.004) were significant. Conclusions: 3M Clinpro™ Sealant was superior to Ultraseal XT Hydro. Re-application of Er,Cr:YSSG laser and the self-etching adhesive did not affect the microleakage of both fissure sealants. Without re-application, acid-etching+etch-and-rinse adhesive was superior to acid-etching only. However, both of them were similarly successful when they were re-applied following saliva contamination.

Clinical Evaluation of the Retention of Resin and Glass Ionomer Sealants Applied as a Part of School-Based Caries Prevention Program

BACKGROUND: Using of sealant on pits and fissures is likely one of the most generally well-known strategies by the new cavity-prevention systems. AIM: The purpose of this research is to measure the retentiveness of sealants of resin-modified ionomer glass cement (GIC) and resin pits and fissures, on the first permanent molars of special patients as a part of caries prevention program in schools. METHODS: The sample was comprised by 60 molars. Resin-based sealants on one side and glass-ionomer sealant on the contralateral side of the mouth. The molars were examined in three and six months after application for retention with three standards: TR: Totally Retained; PR: Partially Retained; and CL: Completely Lost. RESULTS: by the end of the study 60% of resin sealant was present. While 55% of GIC were retentive after 6 months. CONCLUSION: Resin sealants are more retentive than glass ionomer sealants in school-based carries prevention program.

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.

Can surface protection prevent damage in margins of composite resin restorations after simulated endogenous erosion?

Aim: The study investigated the effect of using surface protection agents in the adaptation of external and internal margins of restorations subjected to simulated erosion. Methods: Cavities with margins in dentin were prepared in bovine incisors (n=120). Adhesive restorations were placed using a three-step etch&rinse adhesive system and nanofilled composite resin. The specimens were divided into four groups, according to the surface protection: negative control, topical application of fluoride (TAF), resin sealant and resin-modified glass ionomer varnish (RMGI varnish). Afterwards, they were divided into three sub-groups, according to the exposure to a simulated solution of gastric acid (DES) (5% HCl, pH=2,2) and subsequent remineralization (RE): negative control, 9 and 18 cycles of DES-RE. The evaluation of the tooth-restoration interface was performed on the internal and frontal images with the aid of a stereoscopic microscope (15x), and the percentage of continuous margins without adhesive failures was quantified. Results: In the external margins, only those groups with surface protection using sealants (resin and glass-ionomer) did not exhibit a significant decrease in the percentage of continuous margins after the erosive challenges. After 18 cycles of DES-RE, the use of resin-modified glass ionomer varnish resulted in the highest percentage of continuous margins. Conclusion: It was concluded that physically covering the surfaces with a sealing agent preserved the marginal adaptation of composite resin restorations exposed to endogenous erosive challenges.