Effectiveness of Placing ART GIC Sealants with a Hand instrument

Methods: 72 extracted sound molars with patent occlusal fissures were sealed with GIC: Fuji IX/GP ( powder/liquid) and Fuji IX GP/Fast (capsules). Two trained dentists placed the materials using the ART approach and a ball burnisher. The sealed teeth were thermocycled for 500 cycles in water between 6 and 55 degrees. The teeth were coated with nail varnish and kept in water. The crowns were immersed in 1% methylene blue dye for four hours, then washed and kept in water. The roots of teeth were cut off and the crowns were embedded in Epoxy resin. The occlusal surfaces were sectioned through the mesial, central and distal pits. The sections were evaluated by one examiner using a light reflection microscope. The outcome variables were marginal leakage and fissure penetration depth. ANOVA was used to analyze the effects and interactions of outcome variables, and it was also applied at tooth level following the ‘worse case scenario'.

Results: A total of 502 section surfaces were evaluated. The prevalence of sealants penetrated into more than three/quarter of fissure depth on all section surfaces was 43% whereas the prevalence of sealants with no marginal leakage at all section surfaces was 54%. There was no statistically significant difference observed in marginal leakage and fissure penetration depth between the two procedures in placing sealants. One operator performed significantly better than the other and had superior results using the press-finger than the ball burnisher approach.

Conclusion: There is no difference between the ball burnisher and ART press-finger technique in applying high-viscosity glass ionomer sealants. But, considering the operator effect observed and the reduced risk of saliva contamination, the use of press-finger technique is advocated.