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    How to achieve both retention and prevention with BioCoat

    Why this sealant should be added to clinicians’ caries management armamentarium.

    Sealants are one of the most effective preventive procedures we can offer to our patients.1 With proper placement, sealants have proven efficacy and can provide a protective barrier for the occlusal surface of the tooth against decay. Dental sealants are esthetic and noninvasive, they don’t require local anesthesia, and they can be a cost-effective method for prevention of caries. However, dental sealants are still underutilized, as the Centers for Disease Control and Prevention estimates that the prevalence of sealants in the United States for children ages 6-11 is 43.2 percent.2

    Tooth decay is largely preventable via appropriate oral hygiene and diet, but it remains one of the most common diseases of childhood — five times as common as asthma and seven times as common as hay fever, according to the American Dental Association.3,4 Because of this, oral healthcare professionals (OHCPs) should always be looking to add new, effective tools to their caries management armamentarium.

    Trending article: How bioactive materials are changing restorative dentistry

    Choosing a sealant: retention or prevention

    When choosing a dental sealant, clinicians have several factors to consider, including retention, durability, strength, flow, ease of use, esthetics and if it offers fluoride release for added protection. Modern pit and fissure sealants are typically resin-based or glass-ionomer-based (GI). Resin-based sealants are stronger and offer better retention, whereas GI sealants are more soluble but may offer additional prevention because of fluoride release.5,6 So, the dilemma for OHCPs involves choosing retention or prevention when selecting their dental sealant material.

    Resin-based sealants are sometimes additionally classified as either containing glass filler (filled) or not containing glass filler (unfilled). Fillers are present to provide hue, strength and added wear resistance by increasing shear bond strength and compressive strength. But too much filler can affect the handling of the material. Sealants have to be “thixotrophic,” meaning that as shearing force is applied by expressing the material through a metal cannula, it lowers viscosity. This is essential to help create a sealant that easily flows into pits and fissures, with or without manipulation.6,7

    Most resin sealants are hydrophobic and need to be placed in a dry field, but this also helps make resin-based sealants less soluble and highly retentive. Resin sealants typically have a wide range of characteristics, including several color choices and varying means of polymerization (light-cured, dual-cured). Resin-based sealants are also associated with better retention rates compared to GI sealants.  

    Glass ionomer sealant materials are composed of an aqueous solution of polyacrylic acid that reacts with calcium fluoro-aluminosilicate glass powder.8 The glass powder creates the potential for fluoride release; however, because fluoride is part of the material’s matrix, this also contributes to solubility in the oral environment. GI sealants are more hydrophilic compared to resin sealants and can be suitable for placement in a moist (not wet) environment and are specifically indicated for partially erupted teeth or as interim sealants.5 Because the strength of GI materials is lower than that of resin sealants, and combine that with higher solubility, GI sealants can be less retentive.5,6

    So, what do you choose: retention or prevention? What if there was a sealant that offered both?

    Read more: I Use That: BioCoat

    Bioactivity and remineralization

    The term bioactivity when applied to dental materials has been defined as: “the property of a biomaterial to form apatite-like material on its surface when immersed in a simulated body fluid (SBF) for a period of time.”9 So, the fluoride released from a dental material is really more “bio-available” because in order to form calcium fluorophosphate (aka fluorapatite), there must be calcium and phosphate present.

    The availability of calcium and phosphate in the remineralization process is essential. Although fluoride serves as a catalyst for remineralization, it will not occur unless adequate amounts of calcium and phosphate ions are available.10

    When fluoride, calcium and phosphate ions are present, the ions can help prevent carious lesions, limit the progression of carious lesions and enhance the repair of early lesions already present by promoting remineralization and preventing demineralization. 

    Up next: BioCoat with SmartCap Technology...

    Sandra R. White, BS, RDH
    Sandra White received her Bachelors of Science degree in dental hygiene from the University of California-San Francisco School of ...

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