Assessment of Pit and Fissure Sealants Following Enamel Deproteinization Using Three Different Methods for Shear Bond Strength and Microleakage- A Comparative In Vitro Study
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Abstract
Background: Occlusal caries is thought to be most effectively prevented by sealing pits and fissures. The deproteinization may have an impact on the adhesiveness and retentive ability of pit and fissure sealant, among other factors.
Aim: To assess the impact of three deproteinizing agents applied before and after acid etching on the microleakage and shear bond strength of pit and fissure sealants.
Methodology: Included were one hundred fifty-four extracted, healthy human maxillary and mandibular molars. 6.25% sodium hypochlorite (NaOCl), 10% papain gel, and 6% bromelain gel were the deproteinizing agents that were used. Group A (deproteinization done after etchant application), Group B (deproteinization done before etching), and Group C (control group) were the three groups into which the samples were split. Based on the type of deproteinization agent used, Group A and Group B were further divided into three groups. After that, sealant (3M ESPE Clinpro) was applied and given a 20-second light cure. Using a stereomicroscope magnified 40 times to evaluate microleakage and a universal testing machine to measure shear bond strength (SBS), respectively.
Results: For microleakage, scores were lowest for Bromelain group, followed by Papain group and NaOCl group and highest for control group. Statistically significant difference was found between control and bromelain group (P=0.039). Mean values for shear bond strength was highest for Bromelain group (18.65±3.56), followed by Papain group (12.00±2.46), NaOCl group (9.77±2.31) and control group (7.71±1.58). Statistically significant differences were found for Papain group (P=0.047) and Bromelain group (P=0.047). Also, deproteinization before acid etching showed superior results both for SBS and microleakage.
Conclusion: When deproteinization is performed before acid etching, the SBS values increase and the sealant microleakage score decreases. As an alternative to 5.25% sodium hypochlorite, 10% papain enzyme and 6% bromelain enzyme can be used successfully. The bromelain group, however, demonstrated superior results because it effectively removed the organic materials from tooth surface.
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References
Prabakar J, Indiran MA, Kumar P, et al. Microleakage Assessment of Two Different Pit and Fissure Sealants: A Comparative Confocal Laser Scanning Microscopy Study. Int J Clin Pediatr Dent 2020;13(S-1):S29–S33.
Bayrak GD, Gurdogan-Guler EB, Yildirim Y, Ozturk D, Selvi-Kuvvetli S. Assessment of shear bond strength and microleakage of fissure sealant following enamel deproteinization: An in vitro study. J Clin Exp Dent. 2020 Mar 1;12(3):e220-e226. doi: 10.4317/jced.56281. PMID: 32190191; PMCID: PMC7071532.
Garcia-Godoy F, Gwinnett AJ. Penetration of acid solution and gel in occlusal fissures. J Am Dent Assoc. 1987;114:809-10.
Ciucchi P, Neuhaus KW, Emerich M, Peutzfeldt A, Lussi A. Evaluation of different types of enamel conditioning before application of a fissure sealant. Lasers Med Sci. 2015;30:1-9.
Harleen N, Ramakrishna Y, Munshi AK. Enamel deproteinization before acid etching and its effect on the shear bond strength - An in vitro Study. J Clin Pediatr Dent. 2011;36:19-24.
Abdelmegid FY. Effect of deproteinization before and after acid etching on the surface roughness of immature permanent enamel. Niger J Clin Pract. 2018;21:591-6
Mowiena, O., Wahba, N., El-Shabrawy, S., Talaat, D. The effect of deproteinization prior to enamel acid etching on pit and fissure sealant shear bond strength and nanoleakage in permanent teeth (in-vitro study). Alexandria Dental Journal, 2019; 44(2): 108-113. doi: 10.21608/adjalexu.2019.57373
Piva E, Ogliari FA, Moraes RR, Cora F, Henn S, Correr Sobrinho L. Papain based gel for biochemical caries removal: Influence on microtensile bond strength to dentin. Braz Oral Res 2008;22:364 70
Dayem RN, Tameesh MA. A new concept in hybridization: Bromelain enzymefor deproteinizing dentin before application of adhesive system. Contemp Clin Dent 2013;4:421-6.
Simsek Derelioglu, Sera & Yilmaz, Yücel & Celik, Pelin & Çarikçioğlu, Burak & Keles, Sultan. (2014). Bond strength and microleakage of self-adhesive and conventional fissure sealants. Dental materials journal. 33. 530-8. 10.4012/dmj.2013-227.
Butail A, Dua P, Mangla R, et al. Evaluation of Marginal Microleakage and Depth of Penetration of Different Materials Used as Pit and Fissure Sealants: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(1):38–42
Reddy VK, Nagar P, Reddy S, et al. Bromelain vs Papain Gel for Caries Removal in Primary Teeth. J Contemp Dent Pract 2019;20(11):1345–1349.
Ovrebo RC, Raadal M. Microleakage in fissures sealed with resin or glass ionomer cement. Scand J Dent Res 1990;98(1):66–69. DOI: 10.1111/j.1600-0722.1990.tb00941.x.
Espinosa R, Valencia R, Uribe M, Ceja I, Cruz J, Saadia M. Enamel deproteinization and its effect on acid etching: an in vitro study. J Clin Pediatr Dent. 2008;33:13-9
Aras S, Küçükeşmen C, Küçükeşmen HC, Sönmez IS. Deproteinization treatment on bond strengths of primary, mature and immature permanent tooth enamel. J Clin Pediatr Dent 2013;37:275 9.
Pal S, Galui S, Sarkar S. Deproteinizing agent, a fore step to better bonding: A literature review. Int J Pedod Rehabil 2021;6:1-5
Ahuja B, Yeluri R, Baliga S, Munshi AK. Enamel deproteinization before acid etching – A scanning electron microscopic observation. J Clin Pediatr Dent 2010;35:169 72
Ramakrishna Y, Bhoomika A, Harleen N, Munshi AK. Enamel deproteinization after acid etching Is it worth the effort? Dentistry 2014;4:200.
Bussadori SK, Castro LC, Galvão AC. Papain gel: a new chemo-mechanical caries removal agent. J Clin Pediatr Dent. 2005 Winter;30(2):115-9.
Pithon MM, Ferraz Cde S, de Oliveira Gdo C, Pereira TB, Oliveira DD, de Souza RA, et al. Effect of 10% papain gel on enamel deproteinization before bonding procedure. Angle Orthod 2012;82:541 5.
Chauhan K, Basavanna RS, Shivanna V. Effect of bromelain enzyme for dentin deproteinization on bond strength of adhesive system. J Conserv Dent 2015;18:360 3.
Ekambaram M, Anthonappa RP, Govindool SR, Yiu CKY. Comparison of deproteinization agents on bonding to developmentally hypomineralized enamel. J Dent 2017;67:94 101
Hasija P, Sachdev V, Mathur S, Rath R. Deproteinizing agents as an effective enamel bond enhancer an in vitro study. J Clin Pediatr Dent 2017;41:280 3.
Aras S, Küçükeşmen C, Küçükeşmen HC, Sönmez IS. Deproteinization treatment on bond strengths of primary, mature and immature permanent tooth enamel. J Clin Pediatr Dent 2013;37:275 9.