Salar David V, García-Godoy Franklin, Flaitz Catherine M, Hicks M John
College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, USA.
J Am Dent Assoc. 2007 Apr;138(4):502-6. doi: 10.14219/jada.archive.2007.0203.
The incorporation of fluoride into sealants has been viewed as a viable way to prevent pit-and-fissure caries by potential inhibition of demineralization through the release of fluoride to enamel. The authors conducted a study to examine the effect of a recently introduced fluoride-releasing sealant (ProSeal, Reliance Orthodontic Products, Itasca, Ill.) on enamel demineralization in an in vitro artificial caries system.
The authors randomly assigned 45 extracted human third molars to three treatment groups receiving either conventional sealant without fluoride (Group 1), fluoride-releasing sealant (Group 2) or glass ionomer sealant with high fluoride release (Group 3). They placed cavity preparations on the buccal surfaces of the molars and filled them with the assigned material. They placed acid-resistant varnish on the specimens' enamel surfaces to within 1 millimeter of the sealant, leaving a 1-mm rim of sound enamel available for in vitro enamel caries formation. They thermocycled the teeth (500 cycles) in artificial saliva. They subjected the teeth to an in vitro artificial caries challenge for six weeks to produce caries-like lesions in enamel adjacent to the sealant materials. The authors took longitudinal sections from each tooth, immersed them in water and examined them via polarized light microscopy to determine wall lesion frequencies.
The mean (+/- standard deviation) lesion depths were 232 +/- 17 micrometers for Group 1, 144 +/- 21 mum for Group 2 and 128 +/- 15 mum for Group 3. The wall lesion frequency was 12 percent for Group 1 and 7 percent for both Groups 2 and 3. There was a significant difference (P < .05) among the fluoride-releasing materials versus the nonfluoride-releasing material. This study indicates that the new fluoride-releasing sealant substantially reduces the amount of enamel demineralization adjacent to the material.
ProSeal provided increased demineralization inhibition compared with a conventional sealant containing no fluoride, but less than that shown by a glass ionomer sealant.
ProSeal's physical properties and cariostatic effects may allow for applications beyond traditional sealant use.
将氟化物加入窝沟封闭剂中，被视为一种可行的预防窝沟龋的方法，通过向牙釉质释放氟化物，有可能抑制脱矿。作者进行了一项研究，以检验一种新推出的含氟释放窝沟封闭剂（ProSeal，Reliance Orthodontic Products，伊利诺伊州伊塔斯卡）在体外人工龋系统中对牙釉质脱矿的影响。
作者将45颗拔除的人类第三磨牙随机分为三个治疗组，分别接受不含氟的传统窝沟封闭剂（第1组）、含氟释放窝沟封闭剂（第2组）或高氟释放玻璃离子窝沟封闭剂（第3组）。他们在磨牙的颊面制备窝洞，并用指定的材料填充。他们在标本的牙釉质表面涂上耐酸清漆，使其距离窝沟封闭剂1毫米以内，留下1毫米宽的完好牙釉质边缘用于体外牙釉质龋形成。他们将牙齿在人工唾液中进行热循环（500次循环）。他们让牙齿接受为期六周的体外人工龋挑战，以在窝沟封闭剂材料附近的牙釉质中产生类似龋的病变。作者从每颗牙齿上取纵向切片，将其浸入水中，并通过偏光显微镜检查，以确定壁部病变频率。
第1组的平均（±标准差）病变深度为232±17微米，第2组为144±21微米，第3组为128±15微米。第1组的壁部病变频率为12%，第2组和第3组均为7%。含氟释放材料与不含氟释放材料之间存在显著差异（P<.05）。这项研究表明，新的含氟释放窝沟封闭剂能显著减少材料附近牙釉质的脱矿量。
与不含氟的传统窝沟封闭剂相比，ProSeal提供了更强的脱矿抑制作用，但低于玻璃离子窝沟封闭剂。
ProSeal的物理性能和防龋效果可能使其应用范围超出传统窝沟封闭剂的使用。
