Michael Buonocore and the Eastman Dental Center: A Historic Perspective on Sealants

Abstract

Dr. Michael Buonocore is known for his innovative research on the preparation of the enamel surface with a weak acid to enhance adhesion of an organic plastic chemical sealant and the polymerization in situ of a sealant with ultraviolet light. His co-workers at Eastman Dental Center aided and extended his research findings. The purpose of his original research was the development of a sealant to prevent occlusal caries on posterior teeth. However, the major impact of his work has been the development of adhesive restorative techniques. Although it has been demonstrated that (i) bacteria tend to die out and caries does not progress if early caries lesions are inadvertently sealed, (ii) sealant retention rates are favorable, and (iii) sealants are cost-effective, the use of sealants by the profession is still far short of early expectations.

Cervical Sclerotic Dentin: Resin Bonding

“…This suggests that the inability of the adhesive to form resin tags in tubule lumina which are blocked by mineral deposits is an important parameter that leads to the reduction in bond strength. If the above hypothesis is correct, then grinding of the surface hypermineralized layer of these cervical wedge-shaped defects prior to bonding (Handelman and Shey 1996 ) should not result in an increase in bond strength, since the underlying sclerotic dentin still contains dentinal tubules which are blocked by whitlockite crystallites. Application of stronger phosphoric acid to these defects could have resulted in partial dissolution of the sclerotic casts and/or complete removal of the surrounding peritubular dentin, allowing resin infi ltration into the dentinal tubules.…”

“…While it is possible to produce hybrid layers in sclerotic dentin with thin diffusion barriers, these hybrid layers become erratic or even nonexistent in the presence of thick barriers. As clinicians have no way of discerning these differences at a clinical level, removal of the surface layer of sclerotic dentin prior to bonding should be adopted (Kwong et al 2002 ;Handelman and Shey 1996 ). Although such a recommendation may not result in an increase in bond strength to sclerotic dentin, it does remove one potential source of inconsistency that leads to bond failure.…”

“…While one may remove bacteria overgrowths from the surface hypermineralized layer, it is not possible to remove bacteria entirely from dentinal tubules. This is analogous to the application of fi ssure sealants to stained enamel fi ssures (Handelman and Shey 1996 ;Simonsen 2002 ) or the bonding of resins to the inner layer of carious dentin (Yoshiyama et al 2002(Yoshiyama et al , 2003. The use of bactericidal solutions (i.e., chlorhexidine) or adhesive resins with antibacterial activity (Imazato et al 1998(Imazato et al , 2003 would be helpful.…”

Resin bonding to cervical sclerotic dentin: A review

“…45,124 While one may remove bacteria overgrowths from the surface hypermineralised layer, it is not possible to remove bacteria entirely from dentinal tubules. This is analogous to the application of fissure sealants to stained enamel fissures, 125,126 or the bonding of resins to the inner layer of carious dentine. 127,128 The use of bactericidal solutions (i.e.…”

From prevention to therapy: Minimal intervention with sealants and resin restorative materials

“…7 The first paper published on the subject of pit and fissure sealant was by Cueto and Buonocore in 1965. 8 Gwinnett and Buonocore followed with a paper also in 1965 9 and Cueto and Buonocore followed with an additional report in 1967.…”