title: A comparison of the effects of toothbrushing and handpiece prophylaxis on retention of sealants.
abstract: BACKGROUND
  Tooth surface cleaning before acid etching is considered to be an important step in the retention of resin-based pit-and-fissure sealants.
  
  
  METHODS
  The authors reviewed and summarized instructions for cleaning tooth surfaces from five manufacturers of 10 unfilled resin-based sealants marketed in the United States. The authors also searched electronic databases for studies that directly compared the effects of different surface-cleaning methods on sealant retention and for systematic reviews of the effectiveness of sealants. They explored the association between surface-cleaning methods and sealant retention in the studies included in the systematic reviews. They calculated the summary weighted retention rates for studies that used either a handpiece or toothbrush prophylaxis.
  
  
  RESULTS
  All of the sealant manufacturers' instructions for use (IFU) recommended cleaning the tooth before acid etching. None of the IFU directly stated that a handpiece was required to perform the cleaning, but five IFU implied the use of handpiece prophylaxis. None of the IFU recommended surface-altering procedures in caries-free teeth. Direct evidence from two clinical trials showed no difference in complete sealant retention between surfaces cleaned mechanically with pumice or prophylaxis paste and those cleaned with air-water syringe or dry toothbrushing. Indirect evidence from 10 studies found that weighted summary retention by year after sealant placement in studies that used toothbrush prophylaxis was greater than or equivalent to values for studies that used handpiece prophylaxis.
  
  
  CONCLUSIONS
  Levels of sealant retention after surface cleaning with toothbrush prophylaxis were at least as high as those associated with hand-piece prophylaxis.
  
  
  CONCLUSIONS
  This finding may translate into lower resource costs for sealant placement.
authors.affiliation: Public Health Division, Northrop Grumman, Atlanta, GA, USA.
authors.forename: Shellie
authors.initials: S
authors.lastname: Kolavic Gray
authors.forename: Susan O
authors.initials: SO
authors.lastname: Griffin
authors.forename: Dolores M
authors.initials: DM
authors.lastname: Malvitz
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Gooch
mesh_terms: D000134:Acid Etching, Dental; D003742:Dental Devices, Home Care; D003754:Dental High-Speed Equipment; D003777:Dental Prophylaxis / Q000295:instrumentation*; D019232:Dental Restoration Failure; D006801:Humans; D010895:Pit and Fissure Sealants; D014099:Toothbrushing / Q000295:instrumentation*
chemical_list: D010895:Pit and Fissure Sealants