Microleakage and bond strength of sealant to primary enamel comparing air abrasion and acid etch techniques

The objective of this study was to compare the effect of air abrasion (KCP 2000), acid etching (37% phosphoric acid), and the combination of both procedures on the shear bond strength and microleakage of a light-cured pit-and-fissure sealant to the enamel of human primary molar teeth.

Noncarious extracted human primary molars were randomly divided into 4 groups in preparation for enamel bonding. The enamel surface was treated as follows for each group: (1) group 1 (control group); (2) group 2 (acid etch group); (3) group 3 (KCP [Kinetic Cavity Preparation System] group); and (4) group 4 (KCP and acid etch group). Delton, a light-cured pit-and-fissure sealant, was then applied to the occlusal surface after conditioning. The bonded specimens were maintained in distilled water at 37 degrees C+/-2 degrees C for 7 days, after which they were subjected to thermocycling followed by shear bond testing. Microleakage was determined by immersing the prepared teeth in 50% silver nitrate dye followed by sectioning and calculation of dye penetration.

The mean shear bond strength of the KCP+acid etch group exhibited nearly 50% higher bond strength than the acid etch group (P<.01). In addition, specimens bonded to enamel conditioned only with acid etch exhibited bond strengths that were nearly twice that of those conditioned with the KCP system alone. No significant difference was noted between the air abrasion and control groups.

In primary teeth, air abrasion combined with acid etching appears to provide the best conditions for enamel treatment prior to sealant placement.