International Journal of Paediatric Dentistry 2004; 14: 272–278
272 © 2004 BSPD and IAPD
Blackwell Publishing, Ltd.
Microleakage assessment of pit and fissure sealant with and
without the use of pumice prophylaxis
G. ANSARI
1
, K. OLOOMI
2
& B. ESLAMI
3
1
Department of Pediatric Dentistry,
2
General Dental Practitioner, and
3
Department of
Oral and Maxillofacial Pathology, Dental School, Shahid Beheshti University of Medical
Sciences, Tehran, Iran
Summary. Objectives. This study evaluated the effect of pumice prophylaxis on the
level of microleakage around and between the sealant and enamel.
Materials and methods. A total of 32 freshly extracted sound upper first premolars,
assigned as suitable for sealant application, were chosen and divided randomly into two
groups: (1) a test group, without prophylaxis; and (2) a control group, with prophylaxis.
Sealant was applied to all teeth using the same conventional technique, with prophylaxis
being omitted in the test group. The sealed teeth were thermocycled (120 × 30 s, 5 and 55 °C
cycles) and then immersed in 2% Basic Fuchsin solution for 72 h. Each tooth was sec-
tioned and examined for dye penetration under a stereomicroscope (× 60 magnification).
Results. No dye penetration was seen in 19 (29·6%) of the teeth in the test group and
36 (56·2%) of the teeth in the control group. Dye had penetrated to the base of the
fissure in 31 (48·4%) of the teeth in the test group and 23 (35·9%) of the teeth in the
control group. Using a chi-square test for trend, the frequency of microleakage was
significantly higher in the test group compared to the controls (P < 0·016).
Conclusion. Prophylaxis has a role in improving sealant retention. Removing this step
may cause an increase in microleakage.
Introduction
The success of pit and fissure sealant in preventing
caries in fissures has been well-documented [1–3].
Indeed, it is considered to be the most effective caries-
preventive measure that may be offered to a patient
[4]. To achieve the greatest benefit, sealants should
bond appropriately to the enamel surface [1–3]. It
has been agreed that adequate retention of a sealant
will be achieved if the tooth has a wide surface area,
and deep, irregular pits and fissures. A number of
studies have suggested that bur preparation and air
abrasion will enhance sealant penetration and adapta-
tion, by virtue of providing a greater surface area
for retention as well as an increase in the bulk of
sealant which improves wear resistance [5–8]. It
has also been suggested that a combination of these
measures could lead to increased clinical longevity.
Conversely, a few investigators have reported no
significant difference between conventional acid
etch alone, and bur preparation followed by acid etch-
ing of pit and fissures [9,10]. A significantly greater
level of microleakage was seen following the use of
air abrasion alone compared to that following either
acid etching alone or tooth preparation using a
bur together with acid etching [11–14]. Hatibovic-
Kofman et al. (2001) indicated that microleakage
may be prevented most effectively with a combina-
tion of mechanical air abrasion and chemical acid
etching [10].
The surface should be clean and dry at the time
of the material placement [1–3]. This means that
sealant should be applied after cleaning and polishing
the teeth [1]. The use of drying agents such as ethyl
Correspondence: Ghassem Ansari, Department of Pediatric
Dentistry, Dental School, Shahid Beheshti University of Medical
Sciences, Tehran, Evin, Iran. E-mail: koloomi@yahoo.com