Marginal integrity of pit and fissure sealants. Qualitative and quantitative evaluation of the marginal adaptation before and after in vitro thermal and mechanical stressing

Abstract

This research quantitatively evaluated the marginal adaptation of pit and fissure sealants. The occlusal surfaces of 48 intact, caries-free human molars were cleaned with an air-abrasion unit. The teeth were then randomly divided into eight groups of six teeth each according to the type of enamel conditioning, sealant material applied and curing unit used. After applying either 40% phosphoric acid gel (K-etch, Kuraray Co) or a self-etching primer adhesive system (Clearfil SE Bond, Kuraray Co), sealant materials of two viscosities were applied (Teethmate F-1 and Protect-Liner-F, Kuraray Co) and cured with halogen (Optilux 500, Demetron) or plasma arc (Apollo-95E, Dental & Medical Diagnostic Systems, Ltd) curing units. The marginal adaptation of the pit and fissure sealant restorations was evaluated by using a computer-assisted quantitative margin analysis in a scanning electron microscope (SEM) on epoxy replicas before and after thermal and mechanical stressing of the teeth. The results were statistically analyzed with one-way analysis of variance (ANOVA) at a confidence level of 95% (p=0.05). A post-hoc Tukey HSD-test was used for multiple pairwise comparisons between groups. The null hypothesis was that there was no statistically significant difference between the groups that were tested in this study. The statistically significant differences between groups were more pronounced after loading. In most cases, the self-etching adhesive system (SE Bond) proved as effective as phosphoric acid etching (K-etch). The low viscosity sealant material (Teethmate F-1), in most cases, exhibited better marginal adaptation than the high viscosity material (Protect-Liner F). The high viscosity material performed equally well only when used in combination with the self-etching primer adhesive system as an intermediate layer. The halogen curing unit (Optilux 500) led to better marginal adaptation than the plasma arc curing unit (Apollo 95E), especially after thermal and mechanical stressing.