Wear pathways of tooth occlusal fissure sealants: an integrative review

Abstract

Sealing the occlusal pits and fissures of molars and premolars is considered an effective therapy for the prevention of dental caries. However, such sealants have limited wear resistance, resulting in surface damage and sealant volume loss. The purpose of this study was to perform an integrative review of the literature on wear pathways of current tooth occlusal fissure sealants. A scoping review of the literature was performed based on database search (Medline/PubMed) using the following combination of key terms: “occlusal fissure sealant” OR “fissure sealant” OR “pit sealant” AND “degradation” OR “wear” OR “erosion” OR “aging”. The inclusion criteria involved articles published in the English language within the last 20 years on the dominant degradation mechanisms of occlusal sealant fissures. The literature search identified a total of 228 articles and then 21 studies were selected considering the scope of this study. Studies revealed a detrimental effect of acidic conditions on the wear of tooth occlusal fissure sealants. The corrosion effect of such acidic medium was higher on glass-ionomer materials when compared to resin-matrix composite sealants. Additionally, the content, size, and type of fillers in the materials affected their wear resistance. Unfilled sealants showed a higher damage by wear than filled sealants. An increase in fillers' size induced an increased wear rate while a decrease in the fillers' content exposed the organic matrix of the fissure sealant to the acidic medium and occlusal loading. The wear of resin-matrix sealants depends on the size, shape, volume, type of filler particles, filler content, the organic matrix type, and distance between the particles exposing the organic matrix.