OPTION 3

֍ Saliva contamination of the etched enamel surface before sealant placement is the most common reason for sealant failure either in the rubber dam or cotton roll groups.
֍ Saliva contamination generally causes adhesive bond failures, fracturing at the enamel-resin interface ,whereas, uncontaminated teeth most frequently show cohesive bond failures, occurring within the resin itself, leaving the bond intact.
Factors influencing sealant retention:
1. Moisture contamination in the primary cause of failure of sealant retention.
2. Inadequate etching is also a factor in loss of sealant retention.
3. Wear factors (bruxism-abrasive dentifrices).
Considerations for premature sealant failure
֍ Partially erupted tooth
֍ Poor isolation
֍ Occlusal parafunctional habits (wear of sealant)
֍ Patient behavioral problems
֍ Age of patient (very young patients, difficult adequate isolation, and patient behavioral issues)
֍ Enamel structural defects (amelogenesis imperfecta, dentinogenesis imperfecta)
֍ The rationale of pit and fissure sealants is related to the fact that occlusal fissures are connected to the dentin and lesion can therefore spread along the enamel- dentin interface in a fast rate.
֍ Retention still remains the main determinant factor for success, where this is defined in terms of long lasting protection, absence of open margins, and sound enamel of the occlusal surface.
֍ In other words, effectiveness and preventive ability is related to the complete retention of the material on the occlusal surfaces.
֍ Failure, on the other hand, is marked by an early loss, usually during the first year after application, mainly due to inadequate adhesion or by gradual failure of the sealant when exposed to wear.
֍ Longevity, results from many factors contributing to better retention, such as fissure type, the kind of sealant, the profile of the operator, the nature of isolation, the type and place of the tooth, the enamel, eruption status and other factors.
֍ Literature strongly supports that saliva contamination is detrimental to sealant retention.
֍ The moisture and the saliva encourage creation of an organic layer in contact with the etched surface and thereby jeopardize retention.
⸙  Key concept:       
Prerequisites for a sealant to be effective — suggested by Brauer
1. Retention
2. Viscosity allowing penetration into deep and narrow fissures even in maxillary teeth
3. Adequate working time
4. Rapid cure
5. Good and prolonged adhesion to enamel
6. Low sorption and solubility
7. Resistance to wear
8. Minimum irritation to tissues
9. Cariostatic action