Symons A L, Chu C Y, Meyers I A
Department of Dentistry, University of Queensland, Brisbane, Australia.
J Oral Rehabil. 1996 Dec;23(12):791-8. doi: 10.1046/j.1365-2842.1996.d01-202.x.
Fissure sealants have been used successfully as a means of preventing fissure caries. This effectiveness is directly related to sealant retention and retention is dependent upon a meticulous method of application. The aims of this study were to determine if sealant adhesion and penetration were affected by the variation in preparation of the enamel surface, or by pretreatment of the enamel surface with dentine adhesive systems, in fissures of varying morphology. Non-carious posterior teeth were visually examined and sorted according to fissure type, classified as shallow, deep or intermediate. Occlusal fissures were sealed using one of six methods, thermocycled for 200 cycles between 5 and 55 degrees C, in artificial saliva, then placed in a 1.5% procion orange dye for 3 min. Teeth were sectioned bucco-lingually and examined with a light microscope for (i) penetration of the sealant into the fissure pattern and (ii) adhesion of the sealant. All sealant techniques employed in this study adapted well to the enamel surface as the 1.5% procion Reactive orange dye failed to penetrate any of the sealed tooth sections. Shallow fissures were well obturated in both lateral and vertical dimensions. Sealants adapted well to the vertical walls at the orifice of deep fissures but generally failed to penetrate into the deeper aspects. Reducing the etching period with 37% phosphoric acid resulted in increased voids between the sealant and enamel surface and poorer adaptation to the vertical walls. The addition of dentine adhesive systems, Scotchbond Multi-Purpose and All-Bond 2, enhanced the vertical penetration of the sealant, particularly in deep fissures. It is proposed that the dentine adhesive systems may improve the retention rate of sealants in deep fissures particularly if the fissure is not completely dry prior to resin placement.
窝沟封闭剂已成功用于预防窝沟龋。其有效性直接与封闭剂的保留有关，而保留又取决于细致的应用方法。本研究的目的是确定在不同形态的窝沟中，窝沟封闭剂的黏附与渗透是否受牙釉质表面制备方法的变化或牙本质黏结系统对牙釉质表面预处理的影响。对无龋的后牙进行视觉检查，并根据窝沟类型进行分类，分为浅、深或中等深度。采用六种方法之一对咬合面窝沟进行封闭，在人工唾液中于5至55摄氏度之间进行200次热循环，然后置于1.5%的活性橙染料中3分钟。沿颊舌向将牙齿切片，用光学显微镜检查（i）封闭剂向窝沟形态内的渗透情况以及（ii）封闭剂的黏附情况。本研究中采用的所有封闭剂技术都能很好地适应牙釉质表面，因为1.5%的活性橙染料未能渗透到任何一个封闭的牙齿切片中。浅窝沟在横向和纵向维度上均得到良好充填。封闭剂能很好地适应深窝沟开口处的垂直壁，但通常无法渗透到更深的部位。用37%磷酸缩短酸蚀时间会导致封闭剂与牙釉质表面之间的空隙增加，对垂直壁的适应性变差。添加牙本质黏结系统Scotchbond多功能黏结剂和全功能黏结剂2增强了封闭剂的垂直渗透，尤其是在深窝沟中。有人提出，牙本质黏结系统可能会提高深窝沟中封闭剂的保留率，特别是在放置树脂前窝沟未完全干燥的情况下。
