Indiana University-Purdue University Indianapolis (IUPUI) / Occlusal pits and fissures are ideal places for caries development. Placement of dental sealants has been reported to be effective in preventing this process. However, the effectiveness of dental sealants has been reported to be influenced by clinical factors, such as preparation and placement techniques. A report recently published by the American Dental Association on the clinical recommendations for use of pit-and-fissure sealants included critical evaluation and a summary of relevant scientific evidence on the use of sealants aimed at assisting clinicians. The report addressed concerns such as: Does placing sealants over early (noncavitated) lesions prevent progression of the lesions? Are there any techniques that could improve sealants’ retention and ffectiveness in caries prevention? The investigators concluded that there is limited and conflicting evidence to support that mechanical preparation with a bur results in higher retention rates in children and recommend that pit-and-fissure sealants should be placed on early (noncavitated) carious lesions. The purpose of this in vitro study was to evaluate two methods of fissure treatment before sealant placement on different caries levels. In this study, 135 extracted human molars (ICDAS codes 0 to 2) were collected and ranked by a calibrated examiner into three groups. These were further divided into three subgroups (nine total). Occlusal surfaces were prepared with: 1) a ¼-mm round bur, 2) air abrasion, and 3) no treatment as a control. All groups were etched with 3.0- percent phosphoric acid for 15 seconds, rinsed thoroughly, and dried with an air water syringe. Opaque dental sealants were placed on the etched occlusal surfaces according to the accepted clinical standards and light-cured for 30 seconds. All groups were thermocycled for 5000 cycles. The roots of the teeth were painted with nail varnish, root apices were sealed with wax, and the occlusal surfaces were immersed in 1.0-percent methylene blue for a full 24 hours. The next day the teeth were cleaned, and the roots were sectioned to expose the crowns. Crowns were cut along the occlusal surfaces in the buccolingual direction. The sectioned surfaces were examined under the Nikon SMZ 1500 microscope for sealant penetration in the fissure and microleakage along the sealant enamel interface. The analyses were performed on a transformation of the sealant penetration percentage commonly used for calculated percentages: sin-1(p1/2). The effects of the type of group, the ICDAS code, and the fissure type on sealant penetration percentage were compared using ANOVA. The effects on microleakage and bubbles were compared using GEE methods applied to logistic regression. The effects on dye penetration were compared using GEE methods applied to cumulative logistic regression to account for the ordered categories of the dye penetration scale. In the findings of sealant penetration, the group type did not have a significant effect on sealant penetration (p = 0.195). ICDAS codes had a significant effect on sealant penetration (p = 0.0113) where ICDAS Code 0 had greater penetration than ICDAS codes 1 and 2. Fissure type had a significant effect on sealant penetration (p = 0.0001) where fissure types V and U had greater sealant penetration than Fissure types Y and W. In the findings of microleakage, the type of group had a significant effect on microleakage (p = 0.0004) where the abrasion group had increased microleakage as compared with the 1/4 round bur and control groups. ICDAS code had a significant effect on microleakage (p = 0.0022) where ICDAS code 0 had less microleakage as compared with ICDAS code 1 and 2. Fissure types V, U, Y, and W did not have a significant effect on microleakage (p = 0.721).

Indiana University-Purdue University Indianapolis (IUPUI) / Purpose: Dental sealant forms a physical barrier to prevent pit and fissure caries; therefore, the retention rate becomes a main factor of the sealant’s effectiveness. Electrospun nylon-6/N6 nanofibers have shown good mechanical properties, such as high tensile strength and fracture toughness. Chitosan/CH has received significant attention due to properties such as antibacterial activity. The purpose of this study was to synthesize and evaluate the effect of incorporating N6 and CH electrospun nanofibers on the physical-mechanical and antibacterial properties of an experimental resin-based sealant. Methods and Materials: Nanofiber synthesis: N6 pellets were dissolved in 1,1,1,3,3,3-hexafluoro-2-propanol at a concentration of 10wt%. Practical-grade chitosan was dissolved in trifluoroacetic acid and dichloromethane (60:40 TFA/DCM) at 7 wt%. Electrospinning parameters were optimized in order to fabricate defect-free N6 and chitosan nanofiber mats. Morphological and chemical characterizations were performed by scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy, respectively after vacuum drying the mats for 48 h. The average fiber diameter was determined from SEM images by measuring the diameter of 120 fibers using ImageJ software. Experimental Sealant: N6 and CH electrospun mats (3×3cm2) were immersed into a resin mixture of BIS-GMA/TEGDMA. Once no bubbles were seen, the resin-modified N6 and CH mats were put on a glass plate, light-cured (“TRIAD 2000”) for 2 min and then submitted to a cryomilling process to obtain a fine micron-sized powder. Three different filler levels (1 wt%, 2.5 wt%, 5 wt%) were used to prepare the N6 and CH incorporated resin-based sealants. Additionally, a commercially available resin-based sealant and the experimental resin mixture (unfilled) were used as controls. Three-point flexural testing, Vickers microhardness testing, and agar diffusion testing were performed on the experimental sealants and the commercial sealant. Data were analyzed by one-way ANOVA and Fisher's Protected Least Significant Differences Pair-wise comparisons between groups (5%). Results: The average fiber diameter for N6 was found to be 503±304 nm and 595±411 nm for CH. No significant difference was found between fiber diameter (p = 0.0601). FTIR confirmed the characteristic peaks for N6 ((CO-NH and [-(CH2)5-].) and CH (N-H and C2F3O2-). CH-5% group had significantly higher (p = 0.0000) FS (115.3±4.5 MPa) than all other groups. CH-1% and CH-2.5% groups had significantly higher FS than the control (unfilled) (p = 0.0016 and p = 0.0033 respectively); Helioseal Clear (p = 0.0000), and nylon groups. N6-5% had significantly higher flexural strength than Helioseal Clear (p = 0.0013) and N6-2.5% (p = 0.0250). CH-1% had significantly higher hardness values than all other groups, and CH-5% (p = 0.0414) had significantly higher values than N6-2.5%. No antibacterial inhibition was seen in any of the tested groups. Conclusions: CH and N6 nanofibers were successfully prepared via electrospinning and used to modify the experimental resin-based dental sealants. The overall results indicated that CH-containing sealants presented the highest flexural strength and hardness; however, none of the CH groups displayed antimicrobial properties. Further investigation is needed to enhance the physico-mechanical properties of the experimental resin-based sealants using nylon-6 and CH.