Comparison of sealant and infiltrant penetration into pit and fissure caries lesions in vitro

Abstract

ObjectivesThe 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. MethodsThe 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. ResultsBaseline 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). ConclusionThe 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. Clinical significanceCompared 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.