Comparison of clinical retention of fissure sealants with and without using sodium hypochlorite after enamel etching

Abstract

Introduction: Prevention of childhood dental caries is still one of the most important challenges for pediatric dentists all around the world. Fissure sealant therapy is a method based on covering the retentive parts of tooth, which could trap food and debris and consequently develop dental caries , thereby preventing occlusal decays. 32 Sealant placement is very technique sensitive. There is a risk of leaving residual material, moisture, or air bubbles inside of the fissures, preventing proper sealant penetration and endangering optimal retention and structural integrity of sealants. The cariostatic properties of sealants are attributed to the physical obstruction of the pits and fissures,which prevents bacterial colonization and acid production. Advantages of sealant prevention can only be achieved when the sealants remain as completely as possible intact for a long period of time and remain attached to the enamel and fissure sealants retention on the occlusal surface are essential for the effectiveness of the sealant. Despite the improvement in the quality of the sealants and gradually getting user_ friendly, the retention and practical longevity of which remain a challenge in dentistry. Enamel deproteinization involves the removal of the organic content (proteins) from the enamel surface. NaOCl has been shown to degrade protein efficiently and to be capable of eliminating excess protein. Proteins interfere with establishment , and it is capable of a clinically successful etched pattern and their elimination improves the bond. Sodium hypochlorite (NaOCl), a halogenated compound , is routinely used to irrigate the root canal during endodontic treatments. It has antimicrobial potency. In addition to its antibacterial action , sodium hypochlorite has the ability to dissolve the pulpal remnants and organic component of dentin. The purpose of this study is comparison of clinical retention of fissure sealants with and without using sodium hypochlorite after enamel etching.

Material and Method: In this randomized clinical trial study, 34 people in the age group of 7-12 years old were randomly selected from among the children and community care department of the college; So that each of the patients had a pair of healthy and decay-free permanent first molars in the lower jaw bilaterally and were also eligible for fissure sealant therapy. After obtaining a written consent form from the parents, in each of the patients, one side of the tooth was randomly etched using the usual method (preparation of tooth enamel with acid etching along with bonding) and on the other side, the tooth was first etched and then sodium hypochlorite and then From that, bonding was applied and fissure sealant treatment was done for both teeth. After 6 months, each of them was evaluated by clinical observation and the use of probe, and the results of the two groups were compared and the results were judged statistically using the chi-square test. Results: In this clinical trial study, 38 patients were examined at first, and 34 patients were referred in the 6-month follow-up: In the period of 6 months, among the samples that were treated with fissure sealant by the usual method (tooth enamel preparation with acid etching along with bonding) without sodium hypo-chlorite : 79.4% of the samples were healthy (with complete grip) and 20.6% of the samples had failure (loss of grip). Also, in the period of 6 months, among the samples that were first etched, then sodium hypochlorite and then bonding was applied and finally fissure sealant treatment was done for them : 88.2 % of the samples were healthy (with complete grip) and 11.8% of the samples had failure (loss of grip); Based on chi-square test , the difference between the two groups was not statistically significant .

Conclusion: This study showed that there is no statistical difference in fissure sealing in two methods after 6 months. (p = 0.323) Keywords: fissure sealant treatment, sodium hypochlorite, deproteinization