Laser tooth preparation for pit and fissure sealing

Abstract

Background Considerable evidence shows that sealing dental pits and fissures contributes to caries prevention in children and adolescents. Various approaches are available for pit and fissure sealing. Sealants can be inserted with or without mechanical preparation; etching can be applied, with or without bonding. Lasers can be used as an alternative for mechanical preparation. In this study, we systematically evaluated the retention and micro-leakage of pit and fissure sealants, comparing mechanical preparation and Er:Yag laser enamel preparation. For each of these preparations we compared sealants without etching to those with etching, with and without bonding.Methods Sixty extracted sound third molars were classified into 6 groups: A. bur mechanical preparation and sealant application; B. bur mechanical preparation, etching and sealant; C. bur mechanical preparation, etching, bonding and sealant; D. laser mechanical preparation and sealant; E. laser mechanical preparation, etching and sealant application; F. laser mechanical preparation, etching, bonding and sealant. Pit and fissure sealing were evaluated by assessing the retention and micro-leakage of the sealant.Results All the groups showed dye micro-leakage beneath the sealants. Less micro-leakage was observed for the groups that used bur (groups A, B, C) than laser (groups D, E, F): 41 versus 44 specimens. The number of specimens without micro-leakage decreased as follows: group E (24), group A (18), groups B and F (17), group C (14) and group D (5). The difference in penetration between group D and the other groups was statistically significant, p<0.001, chi square.Conclusion Mechanical preparation is important and increases the retention of sealants, especially when using etching material; bonding can help the retention. We recommend preparing sealant with laser, without etching and bonding before its application.

Marginal Adaptation of Resin-based Pit and Fissure Sealant Pretreated with Er, Cr: YSSG Laser

“…The teeth were free from cracks or developmental defects, and their occlusal surface have deep and fissures. The teeth with macroscopic attrition or fracture were excluded [7,12] . Also, the teeth with previous restoration or sealant were not included in this study [13] .…”

“…Pits and fissures of each premolar were dried with air-water spray for 15 s and treated with 37% phosphoric acid gel (Scotch bond TM, 3M ESPE, USA). Acid was rinsed with an air-water spray for 15 s, and the tooth surface was let dry for another 15 s until a chalky white appearance was obtained [7,8] .…”

“…Fluoride releasing resin-based pit and fissure sealant (Clinpro TM Sealant, 3M ESPE, USA) was applied as a small drop in deep part with scrubbing motion then another drop was applied to the final shape of the fissure. Sealant was polymerized using the LED light cure (Woodpecker, Guilin Woodpecker Medical Instrument, China) for 20 s [1,7] . After curing, sealant was tested with an explorer for complete coverage and retention.…”

“…Several surface treatment techniques have previously been used for sealant application, mainly mechanical preparation, air abrasion, and acid etching [5][6][7] . Acid etching is a generally accepted and standard method for pretreating the enamel surface to allow the adhesion of restorative materials [5,6] .…”

“…Acid etch is an admitted and standard technique for pretreatment of enamel surface for adhesion of restorative materials, however in case of sealant placement, residual remnants and pellicle could not be removed from the deepest layer of fissure by conventional etching procedure, thus other methods have been suggested for surface treatment of fissure for sealants [8,9] . Lasers have been used on hard tooth tissue where previous research has shown the ability of the Erbium: yttrium-aluminum-garnet (Er: YAG) laser to ablate or cut tooth structure, remove carious lesions, cavities preparation, and dentin and enamel surfaces modifications to increase bond strength [7,10] .…”