Comparative Evaluation of the Effect of Different Cleaning Methods on Sealant Penetration and Nanoleakage

Background: The objectives of this study were to compare the effect of cleaning occlusal surface using a toothbrush to a rotary brush before application of fissure sealant on the depth of sealant penetration and nanoleakage occurrence and; to assess the influence of fissure morphology on sealant penetration.

Methods: Thirty-three sound extracted maxillary premolars were randomly divided into three groups of different cleaning methods (1) No cleaning of the occlusal surface (control), (2) occlusal surface cleaned with a toothbrush, and (3) occlusal surface cleaned with a rotary brush attached to a slow-speed handpiece. Following fissure sealant application, teeth were sectioned into halves. Slabs were stained with modified silver staining technique and polished. Depth of sealant penetration was determined using scanning electron microscopy (SEM) according to the scoring method: (1) sealant penetrated one-third of the total length of the fissure, (2) sealant penetrated half of the total length of the fissure, and (3) sealant penetrated the total length of the fissure. Nanoleakage expression was observed along the sealant-enamel interface by measuring silver nitrate uptake using EDX. Data management and analysis were performed using SPSS version 23. Different cleaning methods were compared using Fisher’s exact test (sealant penetration) and Kruskal-Wallis (nanoleakage). Association between fissure morphology and sealant penetration was determined using Fisher’s exact test. The test was considered significant when p

Results: No significant association was observed between the different cleaning methods (toothbrush and rotary brush); and the sealant penetration and nanoleakage expression (p>0.05). A significant difference was observed between fissure morphology and the depth of sealant penetration (p=0.025).

Conclusions: Cleaning of the occlusal surface prior to sealant application using a toothbrush is as effective as a rotary brush in relation to sealant penetration and occurrence of nanoleakage. Alternatively, toothbrush can be recommended to clean occlusal surface before application of fissure sealant.