TYPES OF PIT AND FISSURE SEALANTS. INDICATIONS AND CONTRAINDICATIONS FOR SILANIZATION. REVIEW

Background: Dental sealants have been used to reduce the incidence and severity of dental caries in the pits and fissures of teeth for over 40 years. Since that time, numerous scientific discoveries have led to the development of multiple generations of new sealant materials. Aim: The aim of this paper is to summarize the findings of reviews regarding the types of pit and fissure sealants, indications and contraindications for their use. Methods and materials: Previous systematic reviews on this topic were used as the basis for the current review. Cochrane, MEDLINE, Embase, and a few other bibliographic databases were searched for English and Bulgarian-language articles. The year of publication of the searched articles was limited from 2000 to 2020. Only articles in English and Bulgarian languages were read in full. Results: A total of 114 articles were identified by the literature search, the title and abstract of the articles were examined. Twenty-four original research studies met the inclusion criteria. They were read in full, and evidence was extracted for types of pit and fissure sealants, as well as indications and contraindications for their use. Conclusion: Evidence derived from the literature led to the conclusion that sealants are effective in preventing pit and fissure occlusal carious. The selection of the material used for silanization is made depending on a few factors that should be considered, such as patient's and tooth age, child's behavior and ability to isolate the surfaces which are going to be sealed. Regular examinations are required to be able to determine the need for reapplication of sealants and to maximize the effectiveness and results of the treatment.

Toothbrush-Dentifrice Abrasion of Dental Sealants: An In Vitro Study

Objective This study sought to investigate the toothbrush-dentifrice abrasion of dental sealants. Materials and Methods Weight loss (∆W) and depth loss (∆D) were used as abrasion indicators. Sealant samples from nine products were soaked in dentifrice slurry and abraded by using a toothbrushing machine with a brushing force of 300 g. The mean percentages of ∆W and mean values of ∆D after 24,000 and 48,000 strokes of brushing were compared by using paired t-test. A comparison of these mean values among sealant products was performed by using one-way ANOVA and multiple comparison analysis (Scheffe's test). Results Abrasive wear was observed in all sealants. Teethmate F-1 (Kuraray Noritake, Tokyo, Japan)—a fluoride-releasing unfilled sealant—exhibited the maximum abrasive wear, with ∆W and ∆D values of 1.14% ± 0.37% and 12.84 ± 4.28 µm, respectively. Delton (Dentsply Sirona, Charlotte, North Carolina, United States), a light-cured unfilled sealant, showed the minimum abrasive wear, with ∆W and ∆D values of 0.41% ± 0.09% and 2.93 ± 1.23 µm, respectively. No statistical differences were observed among unfilled sealants except when compared with Teethmate F-1. Similarly, no differences were observed when comparing among filled sealants and flowable composite. Conclusion Abrasive wear occurred in all sealants after brushing with dentifrice. Almost all unfilled sealants showed less wear compared with both filled sealants and flowable composite. However, the low abrasive values of all sealants after brushing with dentifrice implied that there is no clinical significance to this finding.

The Effect of Resin-Based Dental Sealant Containing Vanillin on Biofilm Formation of Candida albicans

Early childhood caries (ECC), or baby bottle tooth decay is one of the most common chronic diseases that affect young children at 6 years of age or younger. The disease is resulted from complex interactions between tooth structures and cariogenic microorganisms in dental biofilm after exposure to fermentable carbohydrates through improper feeding practices. This leads to a rapid development of demineralization of teeth shortly after they erupt in the oral cavity. Candida albicans have been reported recently to be associated with the pathogenesis of ECC. One of the general approaches currently used for the prevention of ECC is the application of dental sealant to occlusal (chewing surface) pits and fissures of caries-susceptible teeth. Many types of dental sealants have been extensively used and various antimicrobial agents were introduced to dental sealants to increase their caries preventive effect. The aim of the present study was to evaluate the antimicrobial effect of vanillin incorporated resin-based dental sealant on C. albicans biofilm. Resin-based dental sealants (Clinpro; 3M ESPE, USA) containing different concentrations of vanillin (0%, 0.5%, 1% and 5% w/v) were prepared in 96-well plate. The suspension (107 colony forming unit/mL) of each strain of Candida albicans (ATCC 10231, ATCC 18804 and 2 clinical isolates) was added to saliva-coated sealant resin samples and incubated at 37°C in 5% CO2 atmosphere for 24 h to allow the Candida biofilm formation. The quantity of vital biofilm was determined by WST Microbial Cell Counting Kit (Dojindo Molecular Technologies, USA) at 460 nm. All tests were done in triplicate and repeated three times. Kruskal-Wallis test followed by Dunn’s method were used to account for multiple comparisons. Statistical significance was set at p-value less than 0.05. The results showed that 0.5-5% vanillin-incorporated dental sealant resins showed a significant suppressive effect against all strains of Candida. No significant differences of anti-biofilm effects were found among Candida strains. Approximately 30-50% Candida biofilm reduction was noticed in sealant resins containing vanillin compared with controls without vanillin. In conclusion, the adding of vanillin (0.5-5% w/v) to dental sealant resins is effective in inhibiting biofilm formation of fungus related to early childhood caries, C. albicans. Therefore, the use of dental sealants containing vanillin has the potential to prevent this type of dental caries in young children and biofilm formation by oral Candida. Further clinical studies are required to investigate physical properties of this sealant and clinical evaluation in the patients.

QPCR Screening of Pediatric Saliva Samples to Evaluate Effects of Dental Sealants on Cariogenic Bacteria Streptococcus Mutans and Scardovia Wiggsiae

Dental caries is an alarmingly prevalent multifactorial disease worldwide but is most common as a chronic disease among children and adolescents. Within the oral cavity there are hundreds bacterial species, including specific cariogenic pathogens such as Streptococcus mutans and Scardoviawiggsiae. Although dental caries are highly prevalent, it may also be preventable using methods such as dental sealants or fluoride treatment, which have proven to be highly effective in reducing caries risk – although there is limited evidence on the exact effect of these treatments on S. wiggsiaeinparticular. Due to the lack of conclusive evidence, this study is aimed to evaluate the microbial burden of S. mutans and S. wiggsiae among pediatric saliva samples to analyze the effects dental sealants have on these oral microbiota. Saliva samples derived from pediatric patients pre- and post-sealant were obtained from an existing repository. DNA was extracted and screened using qPCR and primers specific for the cariogenic organisms, S. mutans (SM) and S. wiggsiae (SW). These data demonstrated an overall reduction in SW among Post-sealant samples (11.14 U/uL) compared with Pre-sealant samples (11.68 U/uL), as well as a reduction in the overall number of samples harboring S. wiggsiae (n=8). The Pre-sealant average amount of SM (14.54 U/uL) was slightly increased among the Post-sealant samples (15.67 U/uL) with half of the samples analyzed (n=13) exhibiting slight increases in SM levels, and nearly one-third (n=8) exhibiting slight decreases in SM levels. The data from this study may suggest that dental sealants have an impact on certain cariogenic pathogens in the oral microbiota. Whether or not the impact is positive or not in light of the increase in S. mutans remains an observation that should be further analyzed. More research is required to address the limitations found in this study in order to localize the exact effect on the teeth with dental sealants.

Formation of Cariogenic Bacterial Biofilm on Vanillin-Incorporated Resin-Based Dental Sealant

Tooth decay or dental caries is an important oral health problem involving people of all age groups. The disease is the outcome of the demineralize process in which aciduric and acidogenic bacteria in a biofilm decompose tooth structure. Dental sealant, a resin material, which is applied on the occlusal pit and fissure surfaces of the teeth as a protective layer has been commonly used to prevent dental caries. However, the microbial effect on food residue is found to be a major cause of microleakage of sealant and secondary caries. Several types of antimicrobial agents were introduced to increase the caries preventive effect of dental sealants. Vanillin, the main component of flavoring agent vanilla, has been found to have antimicrobial property against Gram-positive and Gram-negative bacteria. The objective of this study was to investigate the antimicrobial effect of vanillin-incorporated dental sealant against biofilm formation of cariogenic bacteria. Dental sealant resin samples (Clinpro; 3M ESPE, USA) were prepared in 96-well plate in accordance with the amount of vanillin adding (0%, 0.5%, 1% and 5% vanillin). The cariogenic bacterial suspensions of Streptococcus mutans ATCC 25175 and Lactobacillus casei ATCC 334 were added to saliva-coated samples and incubated at 37°C in 5% CO2 atmosphere for 48 h to allow the biofilm formation. The quantity of vital biofilm was determined by WST Microbial Cell Counting Kit (Dojindo Molecular Technologies, USA) at 460 nm. One-way ANOVA and Tukey’s test were applied to the statistical analysis. A significant inhibitory effect against L. casei biofilm was observed in all vanillin incorporated samples (0.5%, 1% and 5% vanillin) compared with samples without vanillin. The percentage of biofilm reduction was 32-39%. For S. mutans, the suppressive effect was noticed only at >1% vanillin with 18-25% biofilm reduction. In conclusion, the incorporation of vanillin to dental sealants could decrease biofilm formation of cariogenic bacteria (S. mutans and L. casei). The use of dental sealants containing vanillin could be a promising measure to prevent dental caries due to their antibacterial biofilm formation property.

Dental Sealant Composition-Retention Assessment in Young Permanent Molars

Tooth decay in children and adolescents remains a public health problem, despite prophylaxis and preventive measures being largely available. The aim of our study was to evaluate the clinical behavior of four dental sealants, related to first permanent molar topography and patient age (when sealant was applied for the first time). We assessed, by means of visual inspection and palpation with a dental probe, a group of 200 children, enrolled corresponding to school age-grade (mean age of 7 years at baseline) and randomly divided according to the material used as dental sealant (Admira seal©, Embrace Wet Bond©, Fotoseal©, GC Fuji Triaje©) in 4 groups (n = 50). Sealant clinical evaluation was made at 6-, 12-, 18-month intervals for dental material retention assessment. At 6 months, the sealant detached the most from 3.6 molars, and the material used was Fotoseal© (27.6%). At 12 months, Fotoseal© (48.3%) and GC Fuji Triaje© (41.4%) from 3.6 molars express detachment. At 18 months, 4.6. molars sealed with Admira Seal© (25.7%) and Embrace Wet Bond© (28.6%) lost the sealant. We noticed less detachment in maxillary molars and if sealant was applied around 7 years of age. In conclusion, sealant application on first permanent molars must be encouraged and practitioners can choose between various materials available.

The Antibacterial Effects of Resin-Based Dental Sealants: A Systematic Review of In Vitro Studies

This review aimed to assess the antimicrobial effects of different antibacterial agents/compounds incorporated in resin-based dental sealants. Four databases (PubMed, MEDLINE, Web of Science and Scopus) were searched. From the 8052 records retrieved, 275 records were considered eligible for full-text screening. Nineteen studies met the inclusion criteria. Data extraction and quality assessment was performed by two independent reviewers. Six of the nineteen included studies were judged to have low risk of bias, and the rest had medium risk of bias. Compounds and particles such as zinc, tin, Selenium, chitosan, chlorhexidine, fluoride and methyl methacrylate were found to be effective in reducing the colony-forming unit counts, producing inhibition zones, reducing the optical density, reducing the metabolic activities, reducing the lactic acid and polysaccharide production and neutralizing the pH when they are added to the resin-based dental sealants. In addition, some studies showed that the antibacterial effect was not significantly different after 2 weeks, 2 months and 6 months aging in distilled water or phosphate-buffered saline. In conclusion, studies have confirmed the effectiveness of adding antibacterial agents/compounds to dental sealants. However, we should consider that these results are based on laboratory studies with a high degree of heterogeneity.