Microleakage at Sealant/Enamel Interface of Primary Teeth: Effect of Er:YAG Laser Ablation of Pits and Fissures

Department of Pediatric Dentistry
Lutheran Medical Center
Date: 02/27/2009
Article title: Microleakage at Sealant/Enamel Interface of Primary Teeth: Effect of Er:YAG Laser Ablation of Pits and Fissures
Author(s): Borsatto MC, et al
Journal: Journal of Dentistry for Children
Volume (number): 71:2
Month, Year: 2004
Major topic: Sealant enamel microleakage
Minor topics: etch technique and laser ablation
Type of Article: clinical study
Main Purpose: To compare microleakage of sealants using 3 etching techniques
Overview of method of research: Primary molars were split into 3 groups to have sealant placed on the occlusal surfaces. The 1st group was etched with 37% phosphoric acid, group 2 acid etch and laser preparation, and group 3 laser preparation alone.
The molars were placed in a dye solution after a round of thermal-cycling. The teeth were then sectioned and polished into .25mm strips and looked at under a microscope and analyzed with computer software for degree of dye penetration.
Findings:
Group 1 and 2 had equal levels of microleakage. Group 3, however, had almost twice the degree of microleakage.

Key points/Summary :
Sealants success depends on its ability to:
fill pits, fissures and anatomical defects
remain bonded to enamel and not allow microleakage and consequent development of caries.
Lasers have been shown to alter enamel surface anatomy--microscopically--similar to etching in both permanent and primary teeth.
It has been speculated that laser ablation could produce a similar effect to etching
All preparations experienced some degree of microleakage.
The laser and etch technique had slightly less microleakage, but it was not statistically significant.
The authors thought that although the laser “etched” the tooth surface, it was probably irregular, which might explain the leakage.
Assessment of article: Good article. I like lasers (laser-cats) and it’s good to have some articles to ground the promoters of the product.