Flowable resin used as a sealant in molars affected by dental fluorosis: a comparative study

The decline in prevalence and incidence of dental caries in developed countries over the last two decades is considered to be due mainly to the widespread use of fluoride in different forms, but simultaneously with decline in caries, an increase in dental fluorosis has been reported. The aim of this study was to compare the Conventional Sealant Technique (CST) and Enameloplasty Sealant Technique (EST) using a flowable resin as sealant in molars affected by dental fluorosis. A total of 40 extracted third molars affected by dental fluorosis were divided at random into two groups of 20 teeth each, and Tetric Flow resin was used as sealant. All teeth were studied for lateral adaptation and resin penetration by direct and indirect techniques; all samples were replicated in epoxy resin and were evaluated with Scanning Electron Microscopy (SEM). The results demonstrated that EST allowed a deeper sealant penetration and a superior sealant adaptation than CST, both in direct and indirect evaluations by SEM. The most important variables being penetration-interface and penetration depth both being statistically significant (p<0.05). The CST did not flow into the bottom of the fissures, leaving spaces that can favor the fracture of the material and initiate the process of dental caries. We conclude that a flowable ceromer is an excellent material alternative to be used as sealant and that EST is quite necessary in molars affected by dental fluorosis, the combination of both being a reliable method to be used as primary prevention approach of dental caries in endemic areas of dental fluorosis.