Resin infiltration of deproteinised natural occlusal subsurface lesions improves initial quality of fissure sealing

Kielbassa, Andrej M.; Ulrich, Ina; Schmidl, Rita; Schüller, Christoph; Frank, Wilhelm; Werth, Vanessa D.

doi:10.1038/ijos.2017.15

Cited by 28 publications

(25 citation statements)

References 62 publications

(95 reference statements)

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“…The subsequent penetration of the infiltrant deeply into etched enamel might enhance the retention rather than superficial sealing procedure. These results are in accordance with the results obtained by Kielbassa et al [18] who described, that infiltrant and conventional resin combination improved the quality of fissure sealing compared with the use of a conventional fissure sealant alone and recommended its clinical use; particularly with initial carious lesions.…”

Section: Discussionsupporting

confidence: 92%

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The efficacy of different sealant modalities for prevention of pits and fissures caries: A randomized clinical trial

Elkwatehy¹,

Bukhari²

2019

J Int Soc Prevent Communit Dent

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Objectives: This clinical trial evaluates the efficacy of different pit and fissure sealant modalities as a caries prevention tool. Materials and Methods: Forty-four children aged 6–8 years with completely erupted first permanent molars participated in sealant placement randomized clinical trial. Split-mouth technique used and each child received four treatment modalities (ICON, Seal It, GCP glass seal, ICON/Seal It combination). Caries progression and sealant retention monitored over a period of 24 months. Results: Seal It and combination modalities had the highest efficacy in the prevention of pits and fissures caries, whereas the ICON had the lowest efficacy. Regarding retention, there were no significant differences among the four modalities during the 1, 3, and 6 months follow-up intervals. However, at 12, 18, and 24 months, the retention of Seal It and combination modalities were better than ICON and better than GCP, but the differences were not statistically significant. In addition, the retention of combination modality was better than Seal It, but the difference was not significant. At the end of the trial, the caries incidence was the highest in ICON group (20 lesions) followed by GCP group (13 lesions), Seal It group (3 lesions) and the lowest observed in combination group (2 lesions). Conclusions: Both Seal It and combination modalities are highly effective in the prevention of pits and fissures caries, GCP has acceptable effect while the use of ICON alone was not effective. The Seal It and ICON combination improves their clinical efficacy in caries prevention.

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Section: Discussionsupporting

confidence: 92%

“…Kielbassa et al [18] assessed the infiltration capability and the rate of microleakage of a low-viscous resin infiltrant combined with a flowable CR (RI/CR) when used with deproteinized and etched occlusal subsurface lesions. This combined treatment procedure has compared with the exclusive use of flowable CR for fissure sealing.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of different sealant modalities for prevention of pits and fissures caries: A randomized clinical trial

Elkwatehy¹,

Bukhari²

2019

J Int Soc Prevent Communit Dent

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“…At the surface layer, the water pore volume in NEC was lower than in artificial subsurface enamel caries induced by an acid gel [Barbosa de Sousa et al, 2013]. This is consistent with the deeper infiltration of resin infiltrants into artificial enamel caries lesions compared to NEC lesions [Meyer-Lueckel and Paris, 2008], and with the improved caries infiltrantion [Kielbassa et al, 2017] and remineralization [Robinson et al, 1990] in NEC after surface treatment with organic solvents. Due to the inclusion of NEC lesions of unknown age [Barbosa de Sousa et al, 2013], it is not known whether the difference in water pore volume was a result of different amounts of organic matter in the external environment or in the caries induction time.…”

supporting

confidence: 63%

High Amount of Organic Matter during Caries Formation Reduces Remineralization and Resin Infiltration of Enamel Caries

et al. 2018

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The amount of organic material in the cariogenic environment correlates with the amount of organic material incorporated in carious enamel. The incorporated organic material may be expected to reduce the pore volumes available for remineralization and resin infiltration, but these expected outcomes have not yet been quantified. We tested the effect of the amount of organic content in the cariogenic agent on remineralization and the resin-occluded pore volume in artificial subsurface enamel caries. An acid gel (organic-rich; G1) and an aqueous solution (organic-poor; G2) were used to induce subsurface lesions in human enamel. Undemineralized histological sections were prepared, microradiographed, and then submitted to resin infiltration in vitro. The enamel component volumes (mineral, organic, remineralizable [total water volume], loosely and firmly bound water volumes, and resin-occluded volume) were measured (by microradiography and polarizing microscopy) at histological sites (n = 38, G1; n = 34, G2). The main outcomes were the differences between the experimental and the predicted volumes (Δremineralizable and Δresin-occluded volumes). Resin infiltration was confirmed by confocal scanning laser microscopy. Compared to G2, G1 presented more incorporated organic volume and lower Δremineralizable volume (p = 0.003; Hedges g = 0.66; power = 0.87), a lower increase in loosely bound water volume (p = 0.0013; Hedges g = 0.74; power = 0.93), a lower remineralization volume in the surface layer (p = 0.017; Hedges g = 0.68; power = 0.8), and a lower Δresin-occluded volume (p = 0.0015; Hedges g = 0.73; power = 0.92). In conclusion, the higher amount of organic matter in the cariogenic gel negatively affected remineralization and the resin-occluded volume in subsurface lesions.

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“…Despite minimally invasive treatment approaches, caries excavation in daily routine commonly does not only include softened and infected dentin, but also demineralized enamel, and is often extended to sound enamel margins [4,5]. Especially in extensive areas of demineralized enamel margins, this concept may lead to a high and potentially disproportional loss of dental hard tissue [6]. Therefore, the question arises, whether minimally invasive caries excavation needs to be extended to sound enamel margins in order to obtain optimum margin integrity of the restorations, and thus to guarantee an optimum sealing ability.…”

Section: Introductionmentioning

confidence: 99%

Demineralized enamel reduces margin integrity of self-etch, but not of etch-and-rinse bonded composite restorations

et al. 2018

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The aim of this study was to investigate margin integrity of Class V composite restorations in demineralized and sound enamel after bonding with different etch-and-rinse and self-etch adhesive systems. Out of a total of 60 specimens from bovine incisors, 30 specimens were demineralized (21 days, acid buffer, pH 4.95) to create artificial enamel lesions. Circular Class V cavities were prepared in all 60 specimens and treated with either an unfilled etch-and-rinse adhesive (Syntac Classic; Ivoclar Vivadent), a filled etch-and-rinse adhesive (Optibond FL; Kerr), or a self-etch adhesive (iBond Self Etch; Heraeus) (n = 10 per group). The cavities were restored with a nanofilled resin composite and thermocycled (5000×, 5-55°C). Scanning electron microscopy was used to evaluate margin integrity of the composite restorations, and the percentage of continuous margin was statistically analyzed (= 0.05). Demineralized enamel led to a significantly lower margin integrity when the self-etch adhesive iBond Self Etch was applied, but did not affect margin integrity when the etch-and-rinse adhesives Optibond FL (filled) or Syntac Classic (unfilled) were used. No significant differences in margin integrity in sound and demineralized enamel were observed between the different adhesives. Demineralized enamel reduces margin integrity of composite restorations when bonded with a self-etch adhesive, but does not affect margin integrity when an etch-and-rinse approach is used.

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Resin infiltration of deproteinised natural occlusal subsurface lesions improves initial quality of fissure sealing

Cited by 28 publications

References 62 publications

The efficacy of different sealant modalities for prevention of pits and fissures caries: A randomized clinical trial

The efficacy of different sealant modalities for prevention of pits and fissures caries: A randomized clinical trial

High Amount of Organic Matter during Caries Formation Reduces Remineralization and Resin Infiltration of Enamel Caries

Demineralized enamel reduces margin integrity of self-etch, but not of etch-and-rinse bonded composite restorations

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