Moisture tolerant sealants to arrest incipient caries in newly erupted molars

An experienced investigator will screen all possible candidates for inclusion and exclusion criteria. Patients that meet inclusion criteria will be seated on a dental unit and bite wing radiographs will be taken to rule out proximal caries. Then a thorough oral prophylaxis will be conducted using a bristle brush and pumice paste. Occlusal surfaces of mandibular first permanent molars will be assessed by a visual and tactile method and scored according to International Caries Detection and Assessment System (ICDAS) criteria. If one of the teeth failed to score 1, or 2, the patient will be excluded. After that, Teeth will be diagnosed using DIAGNOdent device (Kavo, Germany). Measurements will be done after drying the teeth with air flow and isolating them by cotton rolls. First of all, calibration with a ceramic standard will be done, then baseline values for each tooth will be recorded by measuring the sound buccal surface of the examined teeth then moving upward toward the occlusal surface. After probing the whole occlusal surface, the procedure will be repeated three times. At the end, the peak value will be recorded as the baseline value for this tooth. If one of the teeth failed to get a score between 14-30, the patient will be excluded. No treatment will be provided in the first visit. A standard oral-hygiene training will be provided to the children. They will be asked to brush their teeth in the instructed way two times a day. One week later, selected participants will draw from two opaque envelopes. The first draw will be to determine on which side the treatment will take apart first (Right or left). The Second draw will be to determine which type of the sealant will be applied on the selected side (group A or group B).So at the end each participant will be applied the two materials Before the application of pit and fissure sealants, another oral prophylaxis will be conducted then tooth surface will be rinsed with water. After that, isolation of the tooth will be done using cotton rolls and saliva ejector. In group A, teeth will be sealed with Embrace WetBond Sealant (Pulpdent Corporation, Watertown, Mass., USA) following the manufacturer’s instructions. The occlusal surface will be dried using compressed air, followed by acid etching with 37 percent phosphoric acid gel for 20 seconds (Total Etch, Ivoclar Vivadent, Schaan, Liechtenstein). Then, tooth will be rinsed with water for approximately 30 seconds. Excess moisture will be removed from the tooth surface using cotton pellets, but the tooth will still be slightly moist, glossy, or shiny. Embrace WetBond sealant will be applied to the pits and fissures with a small applicator tip attached to the syringe. The sealant will be light cured for 20 seconds using a visible light cure unit.A very little amount of capsule will be used to fill the fissures and pits without extensive material which can just cover the fissures is 0.04 ml In group B, teeth will be sealed with Fuji Triage (GC, Tokyo, Japan) following the manufacturer’s instructions. The occlusal surface will be dried using compressed air, followed by applying Cavity conditioner (GC, Tokyo, Japan) for approximately 15 seconds. Then, tooth will be rinsed with water for approximately 15 seconds. Tooth surface will be blot dried by air flow and cotton pellets. Fuji Triage capsule will be mixed by an amalgamator for 10 seconds. Then the capsule will be inserted into the GC capsule applicator (GC, Tokyo, Japan) and will be triggered and applied to pits and fissures on the selected tooth surface. After 2 and a half minutes (setting time for Fuji triage), petroleum gel will be wiped on the sealant surface. A few drops will be used to fill the fissures and pits without extensive material which can just cover the fissures is approximately 0.04 ml Both interventions will be done by an experienced investigator. The follow up recalls will be conducted after 3 and 6 months for all participants. Retention and remineralization effect of the applied sealants will be evaluated by two calibrated investigators. Each sealant will be examined for retention at 3 and 6 months follow up recalls using a dental explorer At the second recall and after retention evaluation, sealants will be removed using an air abrasion device (Rondoflex-plus 360 Kavo®, Biberach, Germany). After that, Remineralization assessment will be conducted using DIAGNOdent device using the same technique that was used at baseline measurements.