Effectiveness of fluoride sealant in the prevention of carious lesions around orthodontic brackets: an OCT evaluation.

Matheus Melo Pithon,Renato Evangelista De Araujo,Camilla Andrade De Souza,Ana Karla Souza Braz,Mariana De Jesus Santos,Jorge César Borges Leão Filho,Orlando Motohiro Tanaka,Dauro Douglas Oliveira

doi:10.1590/2177-6709.20.6.037-042.oar

Abstract

Objective: This article aimed to evaluate in vitro the efficiency of Pro Seal fluoride sealant application in the prevention of white spot lesions around orthodontic brackets. Material and Methods: Brackets were bonded to the buccal surface of bovine incisors, and five groups were formed (n = 15) according to the exposure of teeth to oral hygiene substances and the application of enamel sealant: G1 (control), only brushing was performed with 1.450 ppm fluoride; G2 (control) brushing associated with the use of mouthwash with 225 ppm fluoride; G3, only Pro Seal sealant application was performed with 1.000 ppm fluoride; G4 Pro Seal associated with brushing; G5 Pro Seal associated with brushing and mouthwash. Experimental groups alternated between pH cycling and the procedures described. All specimens were kept at a temperature of 37 °C throughout the entire experiment. Both brushing and immersion in solutions were performed within a time interval of one minute, followed by washing in deionized water three times a day for 28 days. Afterwards, an evaluation by Optical Coherence Tomography (OCT) of the spectral type was performed. In each group, a scanning exam of the white spot lesion area (around the sites where brackets were bonded) and depth measurement of carious lesions were performed. Analysis of variance (ANOVA) was applied to determine whether there were significant differences among groups. For post hoc analysis, Tukey test was used. Results: There was statistically significant difference between groups 1 and 2 (p = 0.003), 1 and 3 (p = 0.008), 1 and 4 (p = 0.000) and 1 and 5 (p = 0.000). The group in which only brushing was performed (Group 1) showed deeper enamel lesion. Conclusion: Pro Seal sealant alone or combined with brushing and/or brushing and the use of a mouthwash with fluoride was more effective in protecting enamel, in comparison to brushing alone.

Highlights

The literature has shown irrefutable evidence of the multifactorial nature of caries disease, emphasizing the combination of biological, environmental and behavioral factors determinant for its appearance.[1]
The first clinical sign of the disease is white spot lesion which results from surface mineral loss from tooth enamel
The groups in which enamel was protected by Pro Seal sealant presented the lowest carious lesion depths when compared to other groups

Summary

Introduction

The literature has shown irrefutable evidence of the multifactorial nature of caries disease, emphasizing the combination of biological, environmental and behavioral factors determinant for its appearance.[1]. The opaque white appearance of carious lesion on enamel can be attributed to subsurface demineralization associated to increased porosity and consequent changes in the optical properties of tooth enamel. This type of lesion occurs as a result of repeated episodes of mineral loss from the surface caused by dental biofilm and saliva, and mineral loss from the subsurface in reconstitution of enamel surface.[2]. Provided that enamel surface is intact, there is a possibility of reverting, or even eliminating, white spot lesion This may occur spontaneously by means of the combined action of salivary minerals and fluoride present in dentifrices, or may be achieved by therapeutic intervention.[2,3]

Methods

Discussion

Conclusion