Laser tooth preparation for pit and fissure sealing

Abstract Background Considerable evidence shows that sealing dental pits and fissures contributes to caries prevention in children and adolescents. Various approaches are available for pit and fissure sealing. Sealants can be inserted with or without mechanical preparation; etching can be applied, with or without bonding. Lasers can be used as an alternative for mechanical preparation. In this study, we systematically evaluated the retention and micro-leakage of pit and fissure sealants, comparing mechanical preparation and Er:Yag laser enamel preparation. For each of these preparations we compared sealants without etching to those with etching, with and without bonding.Methods Sixty extracted sound third molars were classified into 6 groups: A. bur mechanical preparation and sealant application; B. bur mechanical preparation, etching and sealant; C. bur mechanical preparation, etching, bonding and sealant; D. laser mechanical preparation and sealant; E. laser mechanical preparation, etching and sealant application; F. laser mechanical preparation, etching, bonding and sealant. Pit and fissure sealing were evaluated by assessing the retention and micro-leakage of the sealant.Results All the groups showed dye micro-leakage beneath the sealants. Less micro-leakage was observed for the groups that used bur (groups A, B, C) than laser (groups D, E, F): 41 versus 44 specimens. The number of specimens without micro-leakage decreased as follows: group E (24), group A (18), groups B and F (17), group C (14) and group D (5). The difference in penetration between group D and the other groups was statistically significant, p<0.001, chi square.Conclusion Mechanical preparation is important and increases the retention of sealants, especially when using etching material; bonding can help the retention. We recommend preparing sealant with laser, without etching and bonding before its application.