Comparison of sealant and infiltrant penetration into pit and fissure caries lesions in vitro.
OBJECTIVE
The aim of this in vitro study was to evaluate the penetration of an infiltrant and a sealant, when applied as recommended, into fissure caries lesions.


METHODS
The fissure systems of extracted human teeth were classified according to the international caries detection and assessment system (ICDAS, codes: 0, 1, 2). Within each ICDAS-code ten teeth were either etched with 37% H3PO4-gel for 60s and subsequently sealed ('Fissure Sealing'; Helioseal; Ivoclar Vivadent) or etched with 15% HCl-gel for 120s and subsequently infiltrated ('Resin Infiltration'; Icon; DMG). Additionally, ten teeth with ICDAS-code 2 were etched with 37% H3PO4-gel for 120s and infiltrated ('Soft-Etch-Infiltration'). Specimens were cut perpendicular to their surfaces, polished, and confocal microscopic images were obtained. Lesion depths (LDmax) and penetration depths (PDmax) were measured and percentage penetration was calculated as PPmax=PDmax/LDmax×100.


RESULTS
Baseline LDmax [median (interquartile range)] for ICDAS-code 2 lesions was 1192 (805-1512)μm. In ICDAS-code 2 lesions PPmax was significantly higher for specimens treated with 'Resin Infiltration' [41 (30-78)%] compared to 'Soft-Etch-Infiltration' [11 (0-21)%] or 'Fissure Sealing' [5 (0-9)%] (p<0.05; Mann-Whitney test). PPmax did not differ significantly between groups in ICDAS-code 0 and 1 lesions (p>0.05).


CONCLUSIONS
The fissure sealant when applied after etching with H3PO4-gel only penetrates superficially into non-cavitated fissure caries lesions. Penetration of an infiltrant is superior in particular after etching with HCl-gel.


CONCLUSIONS
Compared with sealing, infiltration of fissure caries lesions leads to more deeply infiltrated lesions, which might in turn result in superior abilities to hamper caries progression.
Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany.
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S
Paris
Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany. Electronic address: jlausch@ukaachen.de.
J
J
Lausch
Clinic for Operative Dentistry and Periodontology, Christian-Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany.
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T
Selje
Clinic for Operative Dentistry and Periodontology, Christian-Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany.
C E
CE
Dörfer
Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.
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H
Meyer-Lueckel
D000134:Acid Etching, Dental / Q000379:methods; D003188:Composite Resins / Q000737:chemistry; D003731:Dental Caries / Q000473:pathology*; D003743:Dental Enamel / Q000473:pathology; D003750:Dental Fissures / Q000473:pathology*; D019793:Fluorescein; D005456:Fluorescent Dyes; D006801:Humans; D006851:Hydrochloric Acid / Q000737:chemistry; D008422:Materials Testing; D018613:Microscopy, Confocal; D010756:Phosphoric Acids / Q000737:chemistry; D010895:Pit and Fissure Sealants / Q000737:chemistry*; D011897:Random Allocation; D012117:Resins, Synthetic / Q000737:chemistry*; D013499:Surface Properties
D003188:Composite Resins; D005456:Fluorescent Dyes; D010756:Phosphoric Acids; D010895:Pit and Fissure Sealants; D012117:Resins, Synthetic; C578177:icon infiltrant; C059908:Helioseal; C030242:phosphoric acid; D006851:Hydrochloric Acid; D019793:Fluorescein
Enamel; Fissure caries; Fissure sealant; Infiltrant; Micro-invasive treatment