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Abstract
INTRODUCTION
Recent studies have shown improved results when an intermediate bonding layer is applied between enamel and sealant after etched enamel comes into contact with saliva: the use of a bonding agent under sealants on contaminated enamel increases bond strength, reduces microleakage, and enhances the flow of resins into fissures.2-6 A recently introduced seventh generation bonding agent, iBond, performs etching, disinfecting, priming, and bonding in a single step. The benefits of this procedure are that it increases patient comfort, reduces chairside time, decreases contamination, and increases efficacy—which would be promising in preventing pit-and-fissure caries in pediatric patients. This article reports data from a clinical study of sealant retention with and without bonding agents.
METHOD AND MATERIALS
Occlusal sealants were placed on first mandibulars using a split-mouth design. The mandibular right first molar (tooth No. 46) was treated with a conventional method of acid-etching and sealed. The mandibular left first molar (tooth No. 36) was treated with bonding agent and sealed. Application procedures followed accepted protocols. Caries-detecting dye was applied and rinsed off after 5 seconds. The tooth was polished using a slow-speed dry brush and isolated using a rubber dam. On tooth No. 46, 37% phosphoric acid gel was applied for 15 seconds, rinsed for 12 to 20 seconds, and dried. Pit-and-fissure sealant (Fissurit F) was applied and cured (Figure 1A View Figure). On tooth No. 36, iBond was applied and cured and then Fissurit F was applied and cured (Figure 1B View Figure).
Scoring
RESULTS
For tooth No. 36 (sealant without bonding agent), the MI rates were 94% at 3 and 6 months, and 91% at 9 and 12 months. The MD rates were 100% at all four intervals. The AF of the sealants was 94% at 3 and 6 months, and 91% at 9 and 12 months. The clinically acceptable MI rates for tooth No. 46 (sealants with a bonding agent) were 83% at the end of 3, 6, 9, and 12 months. The rates for no color change in sealants with a bonding agent after 3 months were 83%. The AF of the sealants after the teeth sealed with a bonding agent at 3 months was 83%; subsequently after 6, 9, and 12 months the AF reported percentage was 83%. The results of the study are similar to the results obtained by Pinar et al.7 The authors observed that these results were statistically significant (P < .05) in all cases. Also, the scores of each individual for MI/MD/AF for different time periods were analyzed using ANOVA, and these results also revealed a significance value (P < .05), by which the authors conclude that the seal on tooth No. 46 is better than that on No. 36.
DISCUSSION
The present trend of using self-etching adhesives seems overstated in terms of its enormous benefit if applied to pit-and-fissure sealants. Literature shows conflicting findings concerning the need of a bonding agent prior to application of pit-and-fissure sealants.1 Based on the results observed in this study, the use of a seventh generation bonding agent was not significantly effective in the retention of pit-and-fissure sealants, when compared to the conventional phosphoric acid-etching technique.
ACKNOWLEDGMENT
REFERENCES
2. Hitt JC, Feigal RJ. Use of a bonding agent to reduce sealant sensitivity to moisture contamination: an in vitro study. Pediatr Dent. 1992;14(1):41-46. 3. Dukic W, Glavina D. Clinical evaluation of three fissure sealants: 24 month follow-up. Eur Arch Paediatr Dent. 2007;8(3): 163-170. 4. Burbridge L, Nugent Z, Deery C. A randomized controlled trial of the effectiveness of a one-step conditioning agent in fissure sealant placement: 12 month results. Eur Arch Paediatr Dent. 2007;8(1):49-54. 5. Burbridge L, Nugent Z, Deery C. A randomized controlled trial of the effectiveness of a one-step conditioning agent in fissure sealant placement: 6-month results. Int J Paediatr Dent. 2006;16(6):424-430. 6. Borem LM., Feigal RJ. Reducing microleakage of sealants under salivary contamination: digital image analysis evaluation. Quintessence Int. 1994;25(4):283-289. 7. Pinar A, Sepet E, Aren G, Bölükbas¸i N, Ulukapi H, Turan N. Clinical performance of sealants with and without bonding agent. Quintessence Int. 2005;36(5):355-360. 8. Feigal RJ, Musherure P, Gillespie B, Levy-Polack M, Quelhas I, Hebling J. Improved sealant retention with bonding agents: a clinical study of two-bottle and single-bottle systems. J Dent Res. 2000;79(11):1850-1856. 9. Hebling J, Feigal RJ. Use of one-bottle adhesive as an intermediate bonding layer to reduce sealant microleakage on saliva-contaminated enamel. Am J Dent. 2000;13(4):187-191.
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