Celiberti Paula, Lussi Adrian
Department of Operative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland.
J Dent. 2007 Jan;35(1):59-67. doi: 10.1016/j.jdent.2006.04.007. Epub 2006 Jun 14.
This study investigated the sealing ability of a current available unfilled fissure sealant applied over sound (n=80), artificially created (n=80) and naturally carious fissures (n=80) under different humidity conditions (90+/-2 and 45+/-2% relative humidity) and etching times (40 and 60s). All samples were submitted to 5000 thermal cycles and examined by light microscopy after sectioning. Microleakage, penetration ability, fissure type, fissure entrance angle, sealant occlusal length, caries location and caries depth were assessed.
The significantly longer sealant occlusal length and larger entrance angle exhibited by shallow fissures, contributed to their higher microleakage and smaller amounts of unfilled areas compared to deep fissures. Sealant microleakage was significantly influenced by the condition of the enamel (sound, artificial and natural caries) and the caries location in the fissures, but not by enamel caries depth (D1 and D2), etching time, or humidity condition. Natural caries exhibited significantly higher microleakage than sound or artificially created carious fissures.
Based on the results of this study, it can be concluded that location of caries in the fissure rather than its depth should be taken into account when applying a fissure sealant. When the borders of the fissure sealant are on carious enamel, a significantly higher microleakage must be expected. The artificial caries model was not a suitable method to assess the behavior of natural fissure caries.
本研究调查了一种市售未填充窝沟封闭剂在不同湿度条件(相对湿度90±2%和45±2%)和酸蚀时间(40秒和60秒)下,应用于健康(n = 80)、人工制备(n = 80)和自然龋坏窝沟(n = 80)的封闭能力。所有样本均经过5000次热循环,切片后通过光学显微镜检查。评估微渗漏、渗透能力、窝沟类型、窝沟入口角度、封闭剂咬合面长度、龋损位置和龋损深度。
与深窝沟相比,浅窝沟显著更长的封闭剂咬合面长度和更大的入口角度,导致其微渗漏更高,未填充区域更少。封闭剂微渗漏受牙釉质状况(健康、人工龋和自然龋)和窝沟内龋损位置的显著影响,但不受牙釉质龋损深度(D1和D2)、酸蚀时间或湿度条件的影响。自然龋的微渗漏显著高于健康或人工制备的龋坏窝沟。
基于本研究结果,可以得出结论,应用窝沟封闭剂时应考虑龋损在窝沟中的位置而非深度。当窝沟封闭剂边界位于龋坏牙釉质上时,必然会出现显著更高的微渗漏。人工龋模型不是评估自然窝沟龋行为的合适方法。