Effect of a NONrinse Conditioner on the Durability of a Polyacid-modified Resin Composite Fissure Sealant

Resident: Adam J. Bottrill
Date: 27AUG10
Region: Providence
Article title: Effect of a NONrinse Conditioner on the Durability of a Polyacid-modified Resin Composite Fissure Sealant
Author(s): Lampa, Ewa DDS et al
Journal: Journal of Dentistry for Children
Page #s: 152-157
Year: 71:2, 2004
Major topic: Conditioners and Sealants
Minor topic(s): NA
Type of Article: Comparative Study
Main Purpose: The aim of the study was to evaluate the effects of the simplified conditioning on durability of poly-acid-modified resin composite (PMRC) fissure sealants. The effectiveness of a non-rinsing conditioner (NRC) on retention of PMRC sealants was studied in a split-mouth design.

Key points in the article discussion:

I. Methods:

A. 92 teeth treated in Sweden.
1. Split-mouth study design.
2. First Side: NRC+PMRC (prime&bond NT)
3. Second Side: Acid etch+Sealant
B. An additional 49 treated with etch and PMRC
C. Performed by TWO SEPARATE PRACTITIONERS
1. ...but both were "experienced" so they must have the EXACT same technique... right?
D. Teeth evaluated at baseline, 3, 6, 12 and 24 months.
1. given a score based on presence, fracture, caries etc...

II. Results:

A. The argument used in favor of NRC+PMRC is: sensitive steps are eliminated from the procedure leading to a more efficient chair-side experience.
B. HOWEVER... SIGNIFICANTLY higher loss rate was found for the NRC+PMRC method when compaired to the acid etch+sealant method. Even the etch+PMRC showed better sucess than the NRC method.
C. The article concludes... "Conditioning with NRC prior to sealant application cannot be recommended."
D. Bottom line?.... NRC=Shenanigans

Assessment of article: Nice to know, but we don't use it at St Joseph. Closest thing to it might be the L-POP self etching adhesive... but even that is only used at the ED in emergent situations.

Effectiveness of Primer and Bond in Sealant Retention and Caries Prevention

Department of Pediatric Dentistry
Resident’s Name: Murphy Program: Lutheran Medical Center - Providence

Article title: Effectiveness of Primer and Bond in Sealant Retention and Caries Prevention
Author(s): Mascarenhas BDS PhD, Ana Karina. Huda Nazar, BDS. Sabiha Al-Mutawa, BDS MSD. Et al.
Journal: AAPD Journal
Year. Volume (number). Page #’s: 2008. Vol 6(1). 25-29
Major topic: Sealants effectiveness of preventing caries and retention w/ either bond or no bond

Overview of method of research: The purpose of this study was to test the use of a primer and bonding agent to increase the retention of a fissuresealant in a group of Kuwati children. 78 6-9 yo children were used for the study. 2 first molars in opposite arches were sealed either w. primer and bonding agent, and the other 2 w/o. The teeth were
1. Isolated with RDI
2. Pumiced with a rubber cup and rinsed
3. Etched for 15 seconds and rinsed thoroughly for 15 seconds
4. Dried.
One examiner, who was blind in the study was used to gather the data 2 years post sealant placement.

Findings:
Success with sealants is extremely technique sensitive. Factors affecting sealant retention are the eruption status of the tooth, isolation, tooth surface, and which arch the tooth is in. Previous studies and various articles have stated that the use of a primer/bonding agent can help sealant retention, and thus help prevent caries.
In this study, the following was found.
Teeth filled w/ Primer and bond
64% completely retained
23% partially lost
13% completely lost

Teeth sealed w/o Primer and bond
68% completely retained
20% partially lost
12% completely lost
There was no overall difference in sealant retention (p=.22), or in caries (p=.56).

Key points/Summary: When proper technique is used, primer and bonding agent does not enhance the retention of the sealant

Assessment of Article: Good article for us to review for our clinical treatment of patients. Limitations of the study include small sample size, and the fact that they only used one type of sealant(3m Plus).

SEM and Microleakage Evaluation of 3 Flowable Composites as Sealants Without using Bonding Agents

Resident: Roberts

Date: 8/27/10

Title: SEM and Microleakage Evaluation of 3 Flowable Composites as Sealants Without using Bonding Agents

Author: Kwon, Ho et al.

Journal: Pediatric Dentistry

Volume: 26: 5

Year: 2005

Purpose: The purpose of this study was to determine if flowable composites can be used as pit and fissure sealants without bonding agents.

Methods: Three flowable composites (Filtek Flow, Tetric Flow, Charmfil Flow) and a filled sealant (Ultraseal XT Plus) were used. The patterns of resin tag formation in the 4 sealant materials were compared using scanning electron microscopy. For the microleakage assessment, 54 extracted human premolar teeth were randomly divided into 3 groups. In each group, a conventional fille sealant and 1 of the 3 flowable composites were applied to occlussal fissures. The teeth were thermocycled and immersed in a 1% methylene blue solution for 48 hours. Each tooth was sectioned and examined to determine the extent of dye penetration.

Results. Three flowable composites and a filled sealant showed a similar resin tag formation pattern. The 3 flowable composites showed significantly more microleakage in each group than the filled sealant. The level of microleakage was similar in the 3 flowable composites.

Conclusions: Concerning the microleakage data, use of the filled sealant is more effective in sealing mechanically prepared occlusal fissures in comparison to the flowable composites.