A comparative study of pumice versus hydrogen peroxide as pretreatments for acid etching for resin bonding.

controlled by the organic content of the enamel. Marshall, Olson, and Lee4 in 1975 studied acid etching for pit and fissure sealants without precleaning the teeth and found significant advantage in having a clean, debris-free, and uniformly roughened surface for good sealing. They proposed longer etching time. Other studies proposed using other materials to solve this problem of debris. In 1979, Lee and Skobe5 suggested using 1.0 N sodium hydroxide to remove the organic matter. In their study, when the organic matter was removed by exposing the enamel to 1.0 N sodium hydroxide, the acid etched the enamel surface uniformly. When the enamel was not pretreated, the acid etchant created a honeycomb pattern with the prism cores dissolving faster than the interprismatic substance. The pattern of etching appeared to be influenced by the distribution of organic matter in the prisms, the rate of dissolution of the organic matter in various reagents, and the relative dissolution of the mineral component. Some doubt remains regarding the need for a preliminary prophylaxis. At least two laboratory studies6, 7 have shown little difference in the surface pattern of enamel, and two clinical trials s, 9 have demonstrated favorable sealant retention rates for bonded resins, composites, and glass ionomers when pumice prophylaxis of the tooth surface was omitted. Main et al. 7 stated that under laboratory conditions or in vivo, acquired pellicle is completely removed by a standard acid-etching treatment, yet Ripa1° still concluded that there is insufficient evidence to recommend changes in the currently recommended clinical procedure, which involves a prophylaxis with pumice slurry. Donnan and Bali’s11 recent study found no statistically significant differences in sealant retention rates between two groups: One wherein no prophylaxis preceded acid etching and the other wherein the teeth were cleaned with pumice slurry before etching. Two most important factors in obtaining a clean enamel surface receptive to the sealant material are the removal of pellide and surface debris, and the quality of the etched surface22,13 Previous reports suggest that pumicing re-