The effect of the Er: YAG laser on the clinical success of hydrophilic fissure sealant: a randomized clinical trial

Year 2020, Volume: 54 Issue: 3, 148 - 153, 05.01.2021

Hulya Yilmaz Sultan Keles

https://doi.org/10.26650/eor.20200029

Abstract

Purpose: The aim of this study was to assess the effect of the Er:YAG laser on the clinical success of a hydrophilic fissure sealant over 12 months.
Subject and methods: This study was conducted on 132 permanent first molars from 44 (19 girls and 25 boys) patients aged 7-11 years. The teeth were divided into three groups. The first group (Group A-control) of teeth were etched with phosphoric acid, the second group of teeth (Group L) were etched with an Er:YAG laser, and the third group of teeth (Group A+L) were etched with both the Er:YAG laser and phosphoric acid. Clinical evaluations were performed at baseline and at 3-, 6-, 9- and 12-month follow-up visits. The data were analyzed with Pearson chi-square tests, Cochran Q tests and Kaplan-Meier analysis.
Results: At the end of the 12 months, total retention rates were 72.7%, 59.1%, and 65.9% in the acid group, the laser group and the laser and acid group, respectively. Although there was no statistically significant difference between group retention rates (p>0.05), the lowest retention rate was found in the laser group at the end of the 12-month follow-up period. No new caries were observed in any group during the study period.
Conclusion: Etching with the Er:YAG laser, phosphoric acid or a combination of both methods provided similar results for the clinical success of hydrophilic based fissure sealant.

Keywords

Pit and fissure sealant, UltraSeal XT® hydro™, Er:YAG laser, Phosphoric acid, Preventive dentistry

Supporting Institution

The authors declared that they have received no financial support.

References

• 1. Peutzfeldt A, Nielsen LA. Bond strength of a sealant to primary and permanent enamel: phosphoric acid versus self-etching adhesive. Pediatr Dent 2004;26(3):240-244.
• 2. Cueto EI, Buonocore MG Sealing of pits and fissures with an adhesive resin: its use in caries prevention. JADA 1967;75:121–128.
• 3. Arrow P, Riordan PJ. Retention and caries preventive effects of a GIG and a resin‐based fissure sealant. Community Dent Oral Epidemiol 1995;23:282–285.
• 4. Garcia-Godoy F, Gwinnett AJ Penetration of acid solution and gel in occlusal fissures. J Am Dent Assoc 1987;114:809–810.
• 5. Burrow MF, Makinson O. Pits and fissures: Remnant organic debris after acid etching. J Dent Child 1990; 57:348–351.
• 6. 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.
• 7. Bader C, Krejci I. Indications and limitations of Er:YAG laser applications in dentistry. Am J Dent 2006;19:178-186.
• 8. Oho T, Morioka T. A Possible Mechanism of Acquired Acid Resistance of Human Dental Enamel by Laser Irradiation. Caries Res 1990;24:86–92.
• 9. Khogli AE, Cauwels R, Vercruysse C, Verbeeck R, Martens L. Microleakage and penetration of a hydrophilic sealant and a conventional resin-based sealant as a function of preparation techniques: A laboratory study. Int J Paediatr Dent 2013;23:13–22.
• 10. Brinker SP. Preventing carious lesions: Clinical steps for applying a newly introduced hydrophilic sealant. Dent Today 2013;32:82-83.
• 11. Schlueter N, Klimek J, Ganss C. Efficacy of a moisture-tolerant material for fissure sealing: A prospective randomised clinical trial. Clin Oral Investig 2013;17:711-716.
• 12. Askarizadeh N, Hesmat H, Zangeneh N. One-Year Clinical Success of Embrace Hydrophilic and Helioseal-F Hydrophobic Sealants in Permanent First Molars: A Clinical Trial. J Tehran 2017;14:92–99.
• 13. Bhatia MR, Patel AR, Shirol DD. Evaluation of two resin based fissure sealants: a comparative clinical study. J Indian Soc Pedod Prev Dent 2012;30:227-230.
• 14. Karaman E, Yazici AR, Baseren M. Comparison of acid versus laser etching on the clinical performance of a fissure sealant: 24-month results. Oper Dent 2013;38:151–158.
• 15. Simonsen RJ. Retention and effectivenessof dental sealant after 15 years. J Am Dent Assoc 1991;122:34-42.
• 16. Zhang Y, Wang Y, Chen Y, Zhang Q, Zou J. The clinical effects of laser preparation of tooth surfaces for fissure sealants placement: a systematic review and meta-analysis. BMC oral health 2019;19:203.
• 17. Rattanacharoenthum A, Prisana NL, Kantrong N. Altered adhesion of dental sealant to tooth enamel microscopically modified by Er: YAG laser irradiation: An in vitro study. Laser Ther 2019;28:19-25.
• 18. Frankl SN. Should the parent remain with the child in the dental operatory?. J Dent Child 1962;29:150-163.
• 19. Khare M, Suprabha BS, Shenoy R, Rao A. Evaluation of pit‐and‐fissure sealants placed with four different bonding protocols: a randomized clinical trial. Int J Paediatr Dent 2017;27:444-453.
• 20. Simonsen RJ. Pit and fissure sealant: review of the literature. Pediatr Dent 2002;24: 393–414.
• 21. Spiguel MH, Tovo MF, Kramer PF, Franco KS, Alves KMRP, Delbem ACB. Evaluation of laser fluorescence in the monitoring of the initial stage of the demineralization process: an in vitro and in situ study. Caries Res 2009;43:302-307.
• 22. Alsabek L, Al-Nerabieah Z, Bshara N, Comisi JC Retention and remineralization effect of moisture tolerant resin-based sealant and glass ionomer sealant on non-cavitated pit and fissure caries: Randomized controlled clinical trial. J Dent 2019; 86:69-74.
• 23. Iranzo-Cortes JE, Terzic S, Montiel-Company JM, Almerich Silla JM. Diagnostic validity of ICDAS and DIAGNOdent combined: an in vitro study in precavitated lesions. Lasers Med Sci 2017;32:543–548.
• 24. Güçlü ZA, Dönmez N, Tüzüner T, Odabaş ME, Hurt AP, Coleman NJ. The impact of Er: YAG laser enamel conditioning on the microleakage of a new hydrophilic sealant—UltraSeal XT® hydro™. Lasers Med Sci 2016;31:705-711.
• 25. Baygin O, Korkmaz FM, Tüzüner T, Tanriver M. The effect of different enamel surface treatments on the microleakage of fissure sealants. Lasers Med Sci 2012;27:153-160.
• 26. Shahabi S, Bagheri H, Ramazani K. Tensile bond strength of sealants following Er:YAG laser etching compared to acidetching in permanent teeth. Lasers Med Sci 2012;27: 371–375.
• 27. Durmus B, Giray F, Peker S, Kargul B. Clinical evaluation of a fissure sealant placed by acid etching or Er: YAG laser combined with acid etching. Oral Health Prev Dent 2017;15:157-62.
• 28. Hibst R, Keller U. Experimental studies of the application of the Er:YAG laser on dental hard substances: I. Measurement of the ablation rate. Lasers Surg Med 1989;9:338–344.
• 29. Silverstone LM. Fissure Sealants: The Enamel‐Resin Interface. J Public Health Dent 1983,43:205-215.
• 30. Apel C, Franzen R, Meister J, Sarrafzadegan H, Thelen S, Gutknecht N. Influence of the pulse duration of an Er:YAG laser system on the ablation threshold of dental enamel. Lasers Med Sci 2002;17:253-257.
• 31. Chimello-Sousa DT, De Souza DE, Chinelatti MA, Pécora JD, Palma-Dibb RG, Milori Corona SA. Influence of Er:YAG laser irradiation distance on the bond strength of a restorative system to enamel. J Dent 2006;34:245-251.
• 32. Üşümez S, Orhan M, Üşümez A. Laser etching of enamel for direct bonding with an Er,Cr:YSGG hydrokinetic laser system. Am J Orthod Dentofac Orthop 2002;122: 649–656.
• 33. Prabakar J, John J, Arumugham IM, Kumar RP, Srisakthi D. Comparative evaluation of retention, cariostatic effect and discoloration of conventional and hydrophilic sealants-A single blinded randomized split mouth clinical trial. Contemp Clin Dent 2018;9: 233-239.
• 34. Hossain M, Yamada Y, Masuda-Murakami Y, Nakamura Y. Removal of organic debris with Er: YAG laser irradiation and microleakage of fissures sealants in vitro. Lasers Med Sci 2012,27:895-902.