Francescut Paola, Lussi Adrian
Department of Pediatric Dentistry and Histology, School of Dental Medicine, University of Bern, Switzerland.
Oper Dent. 2006 Sep-Oct;31(5):543-50. doi: 10.2341/05-91.
Three different fissure preparation procedures were tested and compared to the non-invasive approach using a conventional unfilled sealant and a flowable composite. Eighty permanent molars were selected and divided into 4 groups of 20 teeth each. All the teeth were split into 2 halves, and the exposed fissures were photographed under a microscope (35x) before and after being prepared using the following methods: (I) Er:YAG laser (KEY Laser, KaVo) 600 mJ pulse energy, 6 Hz; (II) diamond bur; (III) Er: YAG laser (KEY Laser, KaVo) 200 mJ pulse energy, 4 Hz; (IV) Control group: Powder jet cleaner (Prophyflex, KaVo, Germany). The pre-and postimages were superimposed in order to evaluate the amount of hard tissue removed. Ten teeth in each group were then acid etched and sealed with an unfilled sealant (Delton opaque, Dentsply), while the remaining 10 teeth were acid etched, primed and bonded (Prime & Bond NT, Dentsply) and sealed with a flowable composite (X-flow, DeTrey, Dentsply). Material penetration and microleakage were evaluated after thermocycling (5000 cycles) and staining with methylene blue 5%. ANOVA and Mann-Whitney tests were applied for statistical analysis. The laser 600 mJ and bur eliminated the greatest amount of hard tissue. The control teeth presented the least microleakage when sealed with Delton or X-flow. A correlation between material penetration and microleakage could not be statistically confirmed. Mechanical preparation prior to fissure sealing did not enhance the final performance of the sealant.
测试了三种不同的窝沟预备程序，并将其与使用传统未填充封闭剂和流动复合树脂的非侵入性方法进行比较。选取80颗恒牙，分为4组，每组20颗牙。将所有牙齿均分成两半，使用以下方法预备前后，在显微镜（35倍）下拍摄暴露的窝沟：（I）铒钇铝石榴石激光（KaVo公司的KEY Laser），脉冲能量600 mJ，频率6 Hz；（II）金刚砂车针；（III）铒钇铝石榴石激光（KaVo公司的KEY Laser），脉冲能量200 mJ，频率4 Hz；（IV）对照组：喷粉清洁器（德国KaVo公司的Prophyflex）。将预备前后的图像叠加，以评估去除的硬组织量。然后，每组10颗牙进行酸蚀，并用未填充封闭剂（登士柏公司的Delton opaque）封闭，而其余10颗牙进行酸蚀、涂底漆并粘结（登士柏公司的Prime & Bond NT），并用流动复合树脂（迪特里公司的X-flow，登士柏）封闭。在热循环（5000次循环）并用5%亚甲蓝染色后，评估材料渗透和微渗漏情况。采用方差分析和曼-惠特尼检验进行统计分析。600 mJ激光和车针去除的硬组织量最大。用Delton或X-flow封闭时，对照牙的微渗漏最少。材料渗透与微渗漏之间的相关性未得到统计学证实。窝沟封闭前的机械预备并未提高封闭剂的最终性能。
