Minimizing patients' exposure to uncured components in a dental sealant

Background. The authors conducted research to examine the effectiveness of six surface treatments in reducing the oxygen-inhibited layer of a commercially available, freshly polymerized, light-cured unfilled dental sealant. Methods. Surface treatments of a light-cured sealant (Delton Light Curing Pit & Fissure Sealant, Dentsply Ash) included no treatment (the control treatment), a 20-second exposure to an air/water syringe spray, 20 seconds' manual application of a wet or dry cotton roll, 20 seconds' manual application of pumice with a cotton pellet, and 20 seconds' application of a water/pumice slurry using a prophy cup on a slow-speed handpiece. The authors used high-pressure liquid chromatography to analyze the amount of monomers - bisphenol A glycidyl dimethacrylate, or Bis-GMA; triethylene glycol dimethacrylate, or TEGDMA; and bisphenol A dimethacrylate, or Bis-DMA - remaining after each treatment. Results. A one-way analysis of variance indicated that use of only an air/water spray removed the least (P = .0001) amount of all monomers (only 68.3 percent of the control value). Application of wet or dry cotton reduced equivalent amounts of monomers (86.1 to 88.9 percent of the control value), and the amount of monomer remaining was less than that for the air/water syringe treatment (P = .0001). The use of pumice on either a cotton ball or in a prophy cup achieved the greatest reduction (P = .0001) in total amount of residual monomer (92.9 to 95.3 percent of the control value). Conclusions. Treatment that used pumice eliminated the greatest amount (from 93 percent to 95 percent of the untreated control values) of any type of residual monomer. A slurry of pumice is significantly more effective in removing the oxygeninhibited layer from freshly cured sealants than either an air/water spray or wet or dry cotton alone. Clinical Implications. Clinicians can most effectively reduce patients' exposure to the uncured components in the oxygen-inhibited layer of sealants by using a mild abrasive, such as pumice, either on a cotton applicator or in a prophy cup.