Product Description
Pit and fissure sealants have been available to
dentistry for more than 40 years and have
been recommended by the National Institutes
of Health for the prevention of pit and fissure caries
since 1983. Sealants are intended to fill pits and fissures
that reside on the occlusal surfaces of teeth.
Because these areas harbor bacteria, plaque, and
food particles, they are susceptible to the formation
of carious lesions. While brushing is an effective
means of plaque control, it is not as effective at
cleaning these smaller grooves because these surface
irregularities are smaller than the bristles of a
toothbrush. Pit and fissure sealants are indicated to
protect at-risk teeth that exhibit this form of susceptibility.
1,2
However, the level of use of pit and fissure
sealants, especially for patients at a higher risk for
caries, has not reached the goal set by Healthy
People 2000 of having sealant applied to at least
one permanent tooth in 50% of children under the
age of 14.3 This goal has been pushed out to 2010,
but the reason for the lack of greater usage in clinical
practice is not entirely clear. This lack of use
may be the result of the challenges associated with
effectively placing the material.
Technique Simplification
With Embrace WetBond Pit and Fissure Sealant,
Pulpdent (Watertown, MA) has sought to address
some of the issues associated with the application of
sealants by simplifying the technique with a proprietary,
self-adhesive resin formulation. Introduced in
2002, Embrace WetBond Pit and Fissure Sealant
was the first sealant that could be effectively applied
onto moist tooth structure without compromising
the bond and without requiring a separate bonding
agent. Embrace WetBond Pit and Fissure Sealant is
available in 1.2 mL or 3 mL syringes in
both natural and off-white shades.
Until Embrace WetBond Pit and
Fissure Sealant was launched, dentists
and hygienists faced the challenge of
achieving a clean, dry field under isolation
before bonding agent and then
sealant could be applied. Achieving
these conditions and the proper
“frosty” appearance of etched enamel
for bonding is difficult enough under
normal conditions. Add to these
requirements the difficulties associated
with working on children, who are the
primary recipients of sealants, and the
reliable application of sealants becomes
even more technique sensitive, leading
to less predictable results. Self-etch
bonding agents with or without a
primer step do simplify the bonding
process, but still require the extra bonding
step(s) that Embrace WetBond Pit
and Fissure Sealant incorporates with
the sealant application itself.
The self-adhesive nature of Embrace
WetBond Pit and Fissure Sealant eliminates
the need for a separate application
of bonding agent, saving material
as well as steps. In addition, the material’s
affinity for moist bonding not only
reduces technique sensitivity, but also
saves additional drying steps. The
demand for materials that are better
and faster are just that much more
important when children are involved
because their patience and cooperation
during treatment can be unpredictable.
When treating children, speed is essential
for patient compliance and effective
treatment.
Long-Term Effectiveness
While the ease and reliability of
application of Embrace WetBond Pit
and Fissure Sealant is intuitively clear,
the ultimate test of the material is its
long-term clinical effectiveness. With in
vitro studies verifying its effectiveness
against marginal microleakage and a
long-term clinical study that at 2 years
exhibited 100% effectiveness with
regard to caries control, Embrace
WetBond Pit and Fissure Sealant has
proven its ability to effectively seal
teeth at risk for carious lesions. The 5-
year results for the clinical study are
due out this year.4,5
Clinicians experience the effectiveness
of the material at placement
through its seamless integration with
tooth structure. Margins not only disappear
visually, but blend so well that
they cannot be found with an explorer.
The improved adhesion of Embrace
WetBond Pit and Fissure Sealant along
with its ability to create smooth margins,
contribute to its longevity and
clinical effectiveness.
As an added benefit to its proprietary
formulation, Embrace WetBond Pit and
Fissure Sealant is one of the few sealants
that does not include Bis-GMA and
therefore contains no Bisphenol-A,
which has generated some public concern
regarding potential harmful effects.
Among the leading sealants on the market,
Embrace WetBond is the only
sealant able to make the claim of being
Bisphenol-A free.
From Education to Adoption
In addition to making a sealant that
is more readily accessible to dentists by
simplifying technique, Pulpdent promoted
the increased use of sealants in
2007 by donating 60,000 units of
Embrace WetBond Pit and Fissure
Sealant to the National Sealant
Alliance’s Smiles Across America program
sponsored by Oral Health
America, and is donating another
60,000 units in 2008. Education of the
public and clinicians alike on the use
and benefits of sealants is critical for
their increased adoption, and products
like Embrace WetBond Pit and Fissure
Sealant that simplify technique and
increase reliability can help to increase
the frequency of clinical use and ultimately
reduce the incidence of caries in
both children and adults.
—Monica Roy-Smith
References
1. Heller KE, Reed SG, Bruner FW, et al.
Longitudinal evaluation of sealing molars
with and without incipient dental caries in a
public health program. J Public Health Dent.
1995;55(3):148-153.
2. Feigal RJ, Donly KJ. The use of pit and fissure
sealants. Pediatr Dent. 2006;28(2):143-150;
discussion 192-198.
3. Rindal DB, Rush WA, Boyle RG. Clinical inertia
in dentistry: a review of the phenomenon.
J Contemp Dent Pract. 2008;9(1):113-121.
4. Degrange M, Courson F, Legoff S, et al.
Penetration and marginal leakage of Embrace
WetBond Pit & Fissure Sealant. Available at:
http://www.pulpdent.com/embrace_products/
michel_degrange.html. Accessed February
25, 2008.
5. O’Donnell JP. A longitudinal study assessing
the clinical performance of a new pit and fissure
sealant material: Embrace WetBond (Twoyear
report, May 2005). Available at:
http://www.pulpdent.com/embrace_products/j
oe_odonnel.html. Accessed February 25, 2008.
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