Marginal Microleakage of a Sealant Applied to Permanent Enamel: Evaluation of 3 Application Protocols

Department of Pediatric Dentistry
Lutheran Medical Center

Resident’s Name: Craig Elice Date: 3/13/2009
Article title: Marginal Microleakage of a Sealant Applied to Permanent Enamel: Evaluation of 3 Application Protocols
Author(s): Asselin ME, Fortin D, Sitbon Y, Rompre PH.
Journal: Pediatric Dentisty
Volume (number): 30:29-33
Date: Jan/Feb 2008
Major topic: Compare microleakage of sealant after acid etch, etch and bond, and self etch adhesive
Type of Article: Research article
Main Purpose: This in vitro study compared the microleakage of a sealant on unground enamel using three different protocols 1) acid etch with 38% phosphoric acid 2) Phosphoric acid followed by single bottle dentin bonding agent, or 3) self etching adhesive.
Materials and Methods: 60 extracted third molars were pumiced using fluoride free pumice slurry and rinsed and dried. They were divided into 3 equal groups consisting of group 1: ClinPro sealant following 38 % phosphoric acid etch, group 2; ClinPro sealant following phosphoric acid etch and Adper Single Bond adhesive and group 3: ClinPro sealant following Adper Prompt L-Pop. All teeth were thermocycled to simulate normal thermal conditions in the mouth and placed in methylene blue for 24 hours. The teeth were sectioned and analyzed microscopically and classified on a 0-4 scale with 0 representing no leakage, and 4 penetration of dye all around sealant.
Findings: In group 1, no dye penetration was seen in 25% of the samples (median 1.75). In group 2, no dye penetration was seen in 59% of samples (median .25), and in group 3, 40% had no dye penetration (median 1). Groups 1 and 2 were significantly different. However groups 1 and 3 as well as groups 2 and 3 were not significantly different.. The author discusses the advantages (i.e. better adhesion and less microleakage) and disadvantages of bonding after etchant. The disadvantages include increased time in a young patient to apply a sealant and thus increase the possibility of contamination. Prompt L-Pop seems effective and more expedient but it is not equally compatible with all sealants
Key points/Summary : Adhesive prior to sealant application showed the least microleakage in vitro. Self etching adhesives offer some advantages and my be appropriate for certain clinical situations. This study is limited because it occurs in vitro.
Assessment of article: Good article. Further clinical studies and testing with other sealant materials is a good next step.