Variables contributing to the quality of fissure sealants used by general dental practitioners

Abstract

This study investigated the factors that could influence microleakage, penetration ability and the formation of resin tags of different sealants used in routine oral health care. One hundred and two caries-free extracted molars were divided into 34 groups of three teeth each. A questionnaire and three teeth were submitted to 34 dentists participating in the study. They completed the questionnaire anonymously based on their own clinical procedures. The teeth were then treated, corresponding to the questionnaires. The types of sealants were categorized into three groups: classical sealant, flowable composite and flowable compomer. The molars were thermocycled in water (5,000 cycles between 5 degrees C and 55 degrees C), then stained with 5% methylene blue for 24 hours. Each tooth was then sectioned longitudinally at three sites. Fissure type, microleakage and penetration ability of the sealants was evaluated with a computer-linked light microscope (25x magnification). Formation of resin tags at the enamel-sealant interfaces was examined using SEM. Variables thought to influence performance of the sealants were analyzed by multiple regression analyses. Classical sealants showed significantly lower microleakage than flowable composites and flowable compomers. Conventional etching with phosphoric acid was critical for sealant success. Agitating the etchant could improve the quality of sealing by decreasing microleakage significantly. In addition, the fissure types had a significant effect on the penetration ability of sealants.