Suharni , Puteh (2018) An in vitro evaluation of the effects of pre treatment protocols on fissure sealant microleakage / Suharni Puteh. Masters thesis, University of Malaya.
Abstract
Background: The use of pit and fissure sealants has been shown to be an effective preventive measure in reducing the incidence of occlusal caries. Optimal marginal-sealing ability is highly dependent on pre-treatment protocols, the use of adhesives, and the sealant material used. Various studies on enamel surface preparation and placement methods prior to the application of fissure sealants have produced mixed results. Objective: To evaluate and compare in vitro the effects of applying different enamel pre-treatments with conventional acid-etch, etch-and-rinse adhesive, and self-etch adhesive on microleakage around fissure-sealant margins in primary and permanent molar teeth. Materials and methods: 30 extracted human permanent third molars and 30 extracted primary second molars were randomly assigned to three groups of ten teeth each. Their pits and fissure surfaces were sealed with a resin-based fissure sealant (Clinpro, 3M) after undergoing one of these pre-treatment protocols: 1) Phosphoric acid etching; 2) Acid etching + Prime & Bond NT (etch-and-rinse adhesive); and 3) Single Bond Universal (self-etch adhesive). The teeth were then stored in water for 30 days following which they underwent thermocycling and then immersed in 0.5% basic fuchsin solution. Each tooth was sectioned into four slices. A total of 180 surfaces were identified and examined under a stereomicroscope by two calibrated examiners. Inter-examiner reliability revealed very good agreement (0.925). A microleakage scoring method was applied based on the following: score 0, no dye penetration; score 1, up to one-half or less of sealant depth penetrated; score 2, more than one-half penetrated; and score 3, penetration to the sealant base. Statistical analysis was done using SPSS version 23.0 and the Kruskal-Wallis test was used for comparison between the three pre-treatment protocols. Results: This study showed that there was significant difference (p < 0.05) between the permanent and primary teeth groups with all showing some degree of microleakage. In the permanent teeth, the acid etching technique showed the highest score of 0 or no leakage (at 96.7%) followed by the self-etch and etch-and-rinse adhesive at 76.7% and 46.7%, respectively. This was replicated in the primary teeth where the acid etching technique had the highest group score of 0 or no leakage (93.3%) followed by the self-etch (73.3%), and the etch-and-rinse adhesive (63.3%). Conclusion: Within the limitations of this study, it can be concluded that fissure sealants applied with conventional acid etching technique showed the least microleakage followed by the self-etch and the etch-and-rinse adhesive technique for both permanent and primary teeth.
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