Enhancing Sealant Retention: The Role of Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) Laser Preconditioning Under Saliva-Contaminated Conditions

Introduction Laser-assisted enamel conditioning combined with acid etching has shown potential in enhancing micromechanical retention. However, most prior studies were conducted under ideal dry conditions, overlooking the impact of saliva contamination, a common clinical challenge during sealant placement. Objective This study aimed to evaluate the effect of erbium-doped yttrium aluminium garnet (Er:YAG) laser pre-conditioning and saliva contamination on the shear bond strength (SBS) of a hydrophilic fissure sealant, <i>UltraSeal XT® hydro™.</i> Methods Forty extracted human mandibular molars were randomly divided into four groups (n = 10). Group 1 received acid etching only, Group 2 underwent acid etching followed by saliva contamination, Group 3 was treated with Er:YAG laser followed by acid etching, and Group 4 received Er:YAG laser, acid etching, and subsequent saliva contamination. The sealant was applied following treatment, after which all samples underwent thermocycling. SBS was tested using a universal testing machine, and the results were analyzed using descriptive statistics, one-way ANOVA, and Tukey's post hoc test. Results Group 3 demonstrated the highest SBS (mean: 22.3 MPa), significantly outperforming the other groups (p < 0.001). Group 2 exhibited the lowest SBS (mean: 19.6 MPa). Group 4 showed improved SBS compared to Group 2, suggesting partial mitigation of moisture effects by laser pre-conditioning. Conclusion Within the limitations of this in vitro study, Er:YAG laser pre-conditioning significantly enhances the SBS of hydrophilic sealants, particularly under saliva-contaminated conditions, offering a promising strategy for improving sealant retention in clinically challenging scenarios.