The effect of toothbrushing on materials used as fissure sealants: An in-vitro study

Pit and fissure sealants are used to prevent caries on the occlusal surfaces of permanent molar teeth with a high risk of caries. The aim of this study is to investigate the effect of toothbrushing on the surface properties of resin, giomer, glass ionomer, glass carbomer based fissure sealants and a self-adhesive flowable composite. Third molars without caries and disc-shaped samples prepared from were used in the study. Disc-shaped samples were prepared as 24 of each material and divided into two subgroups for different brushing cycles (n=12). 120 third molars were divided into two main groups for brushing and five subgroups for different materials (n=12). Initial records for microhardness, surface roughness and SEM-EDX analysis were obtained from disk-shaped samples. These samples were brushed in the brushing simulator in 5000 (6-month) and 10000 (12-month) cycles. After brushing, microhardness, surface roughness and SEM-EDX analyzes were repeated and compared with initial data. Fissure sealants were used to the teeth in line with the recommendations of the manufacturers. After the teeth were brushed in the 6-month and 12-month brushing cycles, they were scored by visual scoring method to evaluate their retention. As a result of the study, the statistical analysis of the data obtained by microhardness and surface roughness measurements were performed using Kruskal Wallis test and variance analysis at repeated measurement levels. Statistical analysis of the data obtained as a result of visual scoring was done by using chi square test. At the end of the brushing cycles, microhardness values of all materials decreased, but this difference was found statistically significant in flowable composite (Vertise Flow, Kerr) and glass carbomer based fissure sealant (GCP Glass Carbomer) (p<0,05). Although, surface roughness values of all materials increased after brushing cycles, statiscally significant increase was detected only in the fissure sealant with resin based (3M Clinpro Sealant) (p<0,05). After brushing, fluoride rates of all materials decreased. When the change in fluoride ratios was examined, the most change was detected in the giomer based fissure sealant (Beautiselant, Shofu) at the end of brushing. As a result of the visual scoring used to evaluate the retention of the materials, the highest scores were observed in the flowable composite (Vertise Flow, Kerr) and the resin based fissure sealant (3M Clinpro Sealant). The lowest scores were observed in glass ionomer (GC Fuji Triage) and glass carbomer (GCP Glass Carbomer) based fissure sealants. As a result, the surface properties of fissure sealants were negatively affected after brushing. In the study, self-adhesive flowable composites were found to be more successful than glass ionomer based materials. Keywords: Brushing simulation, Microhardness, Pit and fissure sealants, Surface roughness, Retention