Fissure penetration and microleakage of a conventional pit and fissure sealant and a flowable composite: a comparative study using three different bonding systems

Abstract

The concepts of using a pit and fissure sealant material to prevent dental caries have been well established in dental research. Effectiveness of a pit and fissure sealant material is limited to its ability to remain bonded to the occlusal surfaces. Adding a dentin-bonding agent between the etched enamel and the sealant material has been demonstrated as a way of optimizing bond strength in the face of moisture and salivary contamination. The purpose of this study was to examine if there was a difference in fissure penetration or microleakage between a conventional pit and fissure sealant or a flowable composite when used as a pit and fissure sealant, while using three different adhesive systems. Delton Direct Delivery System (Dentsply), an opaque, light cured pit and fissure sealant and the commercially available flowable composite, Revolution Formula 2 (Kerr) was selected for this study. Three clinically used adhesive systems selected for this study were: conventional phosphoric acid etching; Opti-bond Solo Plus(Kerr), a single bottle system; and Prompt L-Pop (3M ESPE), an all-in-one primer adhesive. One hundred fifty extracted caries-free third molars, selected for well-defined occlusal pits, were randomly divided into six treatment groups. Fissure penetration and microleakage was examined after immersion of the treated teeth in 5.0-percent methylene blue solution for 18 hours; the teeth were removed and thoroughly cleaned. Mesial and distal flat-ground sections were obtained and examined at X20; microleakage was recorded as either present or absent, and penetration was recorded as either complete or incomplete. The interaction between the material and the adhesive system was non-significant based on the logistic regression model for the penetration and the microleakage, so that only the main effects of material and adhesive system were included in the final model. Enamel conditioning with the total-etch and single-bottle adhesive system provided consistently microleakage resistance when compared with the use of the all-in-one bonding system. The all-in-one adhesive system demonstrated the most microleakage regardless of the material used for the pit and fissure sealant. The hypothesis of this thesis was that there would be no significant difference in fissure penetration or microleakage between the conventional pit and fissure sealant or the flowable composite, regardless of the adhesive system used. The results of this study support the hypothesis that there was no significant difference in fissure penetration between the materials. The result did demonstrate that there was significant difference in microleakage between the three different adhesive systems used.