The significance of a dental sealant is to protect against and avert dental caries. Dental sealants are one of the most universally used safeguarding materials, as well as the most inadvertently misused product today.
Sealants have a shelf-life of five to 10 years, but it is imperative to have them checked at each dental check-up visit to be sure they have not chipped or worn over time.
The slightest chip or break can lead to leakage and trap food and bacteria underneath, which can cause decay.
Resin-based dental sealants are hydrophobic. Due to this property, they cannot stand even slight moisture contamination. Dentinal bonding agents have hydrophilic properties so that they can infiltrate wet dentin.
Utilizing a layer of bonding agent between the enamel and hydrophobic resin sealant has been studied to determine if this additional step could enhance retention rates.
Numerous laboratory studies have found decreased microleakage and enhanced penetration of sealant material into the fissures with the adjunct of a bonding agent.
A recent systematic review and meta-analysis (highest level of evidence) examined five studies that met inclusion criteria. Results of the meta-analysis indicated that adhesive systems beneath fissure sealants had a significant positive benefit on retention and thus caries prevention.
The authors note that the positive effect was seen in studies that used fifth-generation bonding agents. It seems that the smaller molecular size of the adhesive components, compared with the sealant components, penetrate better into enamel porosities, and this improves bond strength.
Not only do permanent teeth benefit from the adjunct of a bonding agent, but studies are also favorable for primary teeth, they also show similar laboratory results to that of permanent teeth with increased bond strengths and decreased microleakage when a bonding agent is utilized.