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Original Research

Open Access

The effect of the use of the deproteinization agent hypochlorous acid and two different pit and fissure sealant self-adhesive flowable composites upon its bonding with the enamel

  • Simge Polat1,*,
  • Çağdaş Çinar1

1Department of Pediatric Dentistry, Faculty of Dentistry, Gazi University Ankara, 06490 Ankara, Turkey

DOI: 10.22514/jocpd.2024.016 Vol.48,Issue 1,January 2024 pp.144-151

Submitted: 11 May 2023 Accepted: 12 June 2023

Published: 03 January 2024

*Corresponding Author(s): Simge Polat E-mail:


This study evaluates the effect of the deproteinization agents hypochlorous acid and sodium hypochlorite upon the bonding of the two different pit and fissure sealant, self-adhesive flowable composites with the enamel. Thirty-six third molars were randomly divided into six different groups. The groups were formed as follows: Group 1: 37% phosphoric acid + VertiseTM Flow; Group 2: 200 ppm hypochlorous acid + 37% phosphoric acid VertiseTM Flow; Group 3: 5.25% sodium hypochlorite + 37%phosphoric acid + VertiseTM Flow; Group 4: 37% phosphoric acid + Constic; Group 5: 200 ppm hypochlorous acid + 37% phosphoric acid + Constic; Group 6: 5.25% sodium hypochlorite + 37% phosphoric acid + Constic. In each group, samples were obtained that were rectangular prisms in shape (n = 12). Groups to which a deproteinization agent was applied (Groups 2, 3 and 5, 6) showed statistically higher microtensile bonding strength than Group 1, Group 4. There was no statistically significant difference in terms of microtensile bonding strength values between the Groups 3 and the Group 6. The study found that the groups to which deproteinization agents were applied had statistically higher microtensile bonding strength values compared with those groups to which acid and fissure sealants were applied. In this study, it was concluded that the use of fissure-sealing self-adhesive flowable composites after acid application to permanent tooth enamel provides an acceptable bond strength given the limitations of in vitro studies. In line with the results obtained, it was observed that in addition to the removal of the inorganic structure with the application of acid, the removal of the organic structure with the use of deproteinization agent increased the bond strength to the enamel.


Enamel; Deproteinization; Sodium hypochlorite; Phosphoric acid; Etching; Permanent teeth

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Simge Polat,Çağdaş Çinar. The effect of the use of the deproteinization agent hypochlorous acid and two different pit and fissure sealant self-adhesive flowable composites upon its bonding with the enamel. Journal of Clinical Pediatric Dentistry. 2024. 48(1);144-151.


[1] Cheng L, Zhang L, Yue L, Ling J, Fan M, Yang D, et al. Expert consensus on dental caries management. International Journal of Oral Science. 2022; 14: 17.

[2] Singh R, Lakhanam M. An in vitro study of three types of pit and fissure sealants for viscosity, resin tag, and microleakage: a scanning electron microscope study. International Journal of Clinical Pediatric Dentistry. 2022; 15: 304–310.

[3] Ramamurthy P, Rath A, Sidhu P, Fernandes B, Nettem S, Fee PA, et al. Sealants for preventing dental caries in primary teeth. Cochrane Database of Systematic Reviews. 2022; 2: CD012981

[4] Sreedevi A, Brizuela M, Mohamed S. Pit and fissure sealants. StatPearls Publishing: Treasure Island (FL). 2023.

[5] Memarpour M, Abedinzade A, Rafiee A, Hashemian A. Penetration ability and microhardness of infiltrant resin and two pit and fissure sealants in primary teeth with early enamel lesions. Scientific Reports. 2022; 12: 4652.

[6] Bagheri E, Sarraf Shirazi A, Shekofteh K. Comparison of the success rate of filled and unfilled resin-based fissure sealants: a systematic review and meta-analysis. Frontiers in Dentistry. 2022; 19: 10.

[7] Estay J, Pardo-Diaz C, Reinoso E, Perez-Inigo J, Martin J, Jorquera G, et al. Comparison of a resin-based sealant with a nano-filled flowable resin composite on sealing performance of marginal defects in resin composites restorations: a 36-months clinical evaluation. Clinical Oral Investigations. 2022; 26: 6087–6095.

[8] Kanodia S, Kalola A, Sreejith S, Parmar A, Iyer J, Parmar G. Comparative clinical evaluation of a self-adhering flowable composite with conventional flowable composite in class I cavity: an in vivo study. Journal of Conservative Dentistry. 2022; 25: 156.

[9] David C, Cardoso de Cardoso G, Isolan CP, Piva E, Moraes RR, Cuevas-Suarez CE. Bond strength of self-adhesive flowable composite resins to dental tissues: a systematic review and meta-analysis of in vitro studies. The Journal of Prosthetic Dentistry. 2022; 128: 876–885.

[10] Poyurovskaya IY, Polikarpova AP, Rusanov FS. Laboratory methods for measuring adhesive bond strength between restoration materials and hard tooth tissues. Stomatologiya. 2021; 100: 88.

[11] Lanteri V SM, Doldi J, Butera A. Pre-bonding prophylaxis and brackets detachment: an experimental comparison of different methods. International Journal of Clinical Dentistry. 2014; 7: 191–197.

[12] Takamiya H, Tsujimoto A, Teixeira EC, Jurado CA, Takamizawa T, Barkmeier WW, et al. Bonding and wear properties of self-adhesive flowable restorative materials. European Journal of Oral Sciences. 2021; 129: e12799.

[13] Perdigão J, Araujo E, Ramos RQ, Gomes G, Pizzolotto L. Adhesive dentistry: current concepts and clinical considerations. Journal of Esthetic and Restorative Dentistry. 2021; 33: 51–68.

[14] Amend S, Frankenberger R, Boutsiouki C, Scharrelmann V, Winter J, Krämer N. Microleakage of pit and fissure sealings placed after enamel conditioning with phosphoric acid or with self-etching primers/adhesives. Clinical and Experimental Dental Research. 2021; 7: 763–771.

[15] Beresescu L, Kovacs M, Vlasa A, Stoica AM, Benedek C, Pop M, et al. Retention ability of a glass carbomer pit and fissure sealant. International Journal of Environmental Research and Public Health. 2022; 19: 1966.

[16] S Z, Z M, P W, Z B, G L. Effect of exposure times of sodium hypochlorite before acid etching on the microshear bond strength to fluorotic enamel. Journal of Clinical Pediatric Dentistry. 2021; 45: 317–322.

[17] Zhang C, Li Y, Zhang Z, Tian Y, Ding N, Ma Y. Improvement of pit-and-fissure sealant bonding to enamel with subpressure treatment. BioMed Research International. 2019; 2019: 1–9.

[18] Sibai N, El Mourad A, Al Suhaibani N, Al Ahmadi R, Al Dosary S. Shear bond strength of self-adhesive flowable resin composite. International Journal of Dentistry. 2022; 2022: 1–8.

[19] Valizadeh S, Alimohammadi G, Nik TH, Etemadi A, Tanbakuchi B. In vitro evaluation of shear bond strength of orthodontic metal brackets to aged composite using a self-adhesive composite: effect of surface conditioning and different bonding agents. International Orthodontics. 2020; 18: 528–537.

[20] Shaalan O, Abou-Auf E. A 24-month evaluation of self-adhering flowable composite compared to conventional flowable composite in conservative simple occlusal restorations: a randomized clinical trial. Contemporary Clinical Dentistry. 2021; 12: 368.

[21] Wang R, Shi Y, Li T, Pan Y, Cui Y, Xia W. Adhesive interfacial characteristics and the related bonding performance of four self-etching adhesives with different functional monomers applied to dentin. Journal of Dentistry. 2017; 62: 72–80.

[22] Rangappa A, Srinivasulu J, Rangaswamy V, Eregowda S, Lakshminarasimhaiah V, Lingareddy U. Comparative evaluation of bond strength of self-adhering flowable composites to the dentin prepared with different burs: an in vitro study. Journal of Conservative Dentistry. 2018; 21: 618.

[23] İşman E, Karaarslan ES, Okşayan R, Tunçdemir AR, Üşümez S, Adanir N, et al. Inadequate shear bond strengths of self-etch, self-adhesive systems for secure orthodontic bonding. Dental Materials Journal. 2012; 31: 947–953.

[24] Lopez-Lujan NA, Munayco-Pantoja ER, Torres-Ramos G, Blanco-Victorio DJ, Siccha-Macassi A, Lopez-Ramos RP. Deproteinization of primary enamel with sodium hypochlorite before phosphoric acid etching. Acta Odontologica Latinoamericana. 2019; 32: 29–35.

[25] Espinosa R VR, Rabelero M, Ceja I. Detachment resistance to resin and deproteinized and etch enamel; microtensile study. Revista de Operatoria Dental y Biomateriales. 2014; 3: 1–15.

[26] Hobson RS, Crotty T, Thomason JM, Jepson NJA. Quantitative study of enamel acid etch patterns on surfaces used for retention of resin-bonded fixed prostheses. European Journal of Prosthodontics and Restorative Dentistry. 005; 13: 123–128.

[27] Espinosa R, Valencia R, Uribe M, Ceja I, Saadia M. Enamel deproteinization and its effect on acid etching: an in vitro study. Journal of Clinical Pediatric Dentistry. 2008; 33: 13–19.

[28] Aras S, Küçükeçmen H, öaroğlu SI. Deproteinization treatment on bond strengths of primary, mature and immature permanent tooth enamel. Journal of Clinical Pediatric Dentistry. 2013; 37: 275–280.

[29] Alshaikh KH, Hamama HHH, Mahmoud SH. Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis. Restorative Dentistry & Endodontics. 2018; 43: e14.

[30] Sanon K, Hatayama T, Tichy A, Thanatvarakorn O, Prasansuttiporn T, Wada T, et al. Smear layer deproteinization with NaOCl and HOCl: do application/wash-out times affect dentin bonding of one-step self-etch adhesives? Dental Materials Journal. 2022; 41: 353–362.

[31] Paing SY, Tichy A, Hosaka K, Nagano D, Nakajima M, Tagami J. Effect of smear layer deproteinization with HOCl solution on the dentin bonding of conventional and resin‐modified glass‐ionomer cements. European Journal of Oral Sciences. 2020; 128: 255–262.

[32] Valencia R, Espinosa R, Borovoy N, Pérez S, Ceja I, Saadia M. Deproteinization effectiveness on occlusal enamel surfaces and resultant acid etching patterns: an in vitro study. Journal of Clinical Pediatric Dentistry. 2018; 42: 434–441.

[33] Peterson J, Rizk M, Hoch M, Wiegand A. Bonding performance of self-adhesive flowable composites to enamel, dentin and a nano-hybrid composite. Odontology. 2018; 106: 171–180.

[34] Juloski J, Goracci C, Rengo C, Giovannetti A, Vichi A, Vulicevic ZR, et al. Enamel and dentin bond strength of new simplified adhesive materials with and without preliminary phosphoric acid-etching. American Journal of Dentistry. 2012; 25: 239–243.

[35] Veli I, Akin M, Kucukyilmaz E, Uysal T. Shear bond strength of a self-adhering flowable composite when used for lingual retainer bonding. Journal of Orofacial Orthopedics. 2014; 75: 374–383.

[36] Buonocore MG, Matsui A, Gwinnett AJ. Penetration of resin dental materials into enamel surfaces with reference to bonding. Archives of Oral Biology. 1968; 13: 61–70.

[37] Labunet A, Tonea A, Kui A, Sava S. The use of laser energy for etching enamel surfaces in dentistry—a scoping review. Materials. 2022; 15: 1988.

[38] Scribante A, Dermenaki Farahani MR, Marino G, Matera C, Rodriguez y Baena R, Lanteri V, et al. Biomimetic effect of nano-hydroxyapatite in demineralized enamel before orthodontic bonding of brackets and attachments: visual, adhesion strength, and hardness in in vitro tests. BioMed Research International. 2020; 2020: 1–9.

[39] Uzel I, Gurlek C, Kuter B, Ertugrul F, Eden E. Caries-preventive effect and retention of glass-ionomer and resin-based sealants: a randomized clinical comparative evaluation. BioMed Research International. 2022; 2022: 1–7.

[40] Lo YF, Crispin A, Kessler A, Hickel R, Kuhnisch J. What is an appropriate etching time for sealant application on permanent molars? Results from a meta-analysis. The Journal of Adhesive Dentistry. 2019; 21: 487–495.

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