Abstract
BackgroundSealant application during fixed appliances orthodontic treatment for enamel protection is common, however, reliable data on its durability in vivo are rare.ObjectiveThis study aims at assessing the durability of a sealant (OpalSeal, Ultradent) for protection against white-spot lesion formation in orthodontic patients over 26 weeks in vivo, taking into account the provision or absence of an adequate oral hygiene. We tested the null hypothesis of (1) no significant abatement of the sealant after 26 weeks in fixed orthodontic treatment compared to baseline, and (2) no significant influence of the factor of brushing and oral hygiene (as screened by approximal plaque index, API) on the abatement of the sealant.MethodsIntegrity and abatement of OpalSeal applicated directly following bracketing was assessed in thirty-six consecutive patients (nteeth = 796) undergoing orthodontic treatment with fixed appliances (male/female12/24; mean age/SD 14.4/1.33 Y). Assessment of the fluorescing sealant preservation was by a black-light lamp, using a classification that was concepted in analogy to the ARI index: (3, sealant completely preserved; 2= > 50% preserved; 1 = <50%; 0 = no sealant observable) immediately following application (Baseline, T0), after 2 (T1), 8 (T2), 14 (T3), 20 (T4) and 26 weeks (T5). API was assessed at T0 and T1. Statistical analysis was by non-parametric repeated measures ANOVA (α = 5%, power >80%).ResultsAt baseline, 43.4% of teeth had a positive API. Oral hygiene deteriorated after bracketing (T1, 53%) significantly. Null hypothesis (1) was rejected, while (2) was accepted: Mean values of both the well brushed and non-brushed anterior teeth undercut the score “1” at T3 (week 14). Despite a slightly better preservation of the sealer before and after T3 in not-sufficiently brushed (API-positive) teeth, this finding was statistically not significant.ConclusionOne single application of OpalSeal is unlikely to last throughout the entire fixed appliance treatment stage. On average, re-application of the sealant can be expected to be necessary after 3.5 months (week 14) in treatment.
Highlights
Prevention of white-spot lesions (WSL) during fixed appliances orthodontic treatment is still a challenge in today’s orthodontic treatment: There is evidence that neglecting oral hygiene during orthodontic treatment with fixed appliances can cause WSL formation within weeks [1,2,3,4]
Study aims This study aims at assessing the durability of a sealant (OpalSeal, Ultradent Products, South Jordan, Utah) for protection against white-spot lesion formation in orthodontic patients over more than six months (26 weeks) in vivo, taking into account the provision or absence of an adequate oral hygiene
Effect of oral hygiene (API) on sealant abatement At T1, we found that teeth with positive approximal plaque index (API) scores showed no significant differences in terms of sealant layer preservation, in contrast to teeth with negative API scores (Table 1)
Summary
Prevention of white-spot lesions (WSL) during fixed appliances orthodontic treatment is still a challenge in today’s orthodontic treatment: There is evidence that neglecting oral hygiene during orthodontic treatment with fixed appliances can cause WSL formation within weeks [1,2,3,4]. Other than mechanical plaque removal by tooth brushing, Sealant application for enamel protection is common in fixed appliances orthodontic treatment patients, reliable data on its durability in vivo are rare [7]. It is conceivable that the factors of oral hygiene and abrasion caused by mechanical tooth brushing, as well as acidic or mechanical assaults during consumption of food and beverages may have an impact on the sealant condition and durability in vivo: Varnish layers may be reduced in thickness and extension by daily mechanical wear. Study aims This study aims at assessing the durability of a sealant (OpalSeal, Ultradent Products, South Jordan, Utah) for protection against white-spot lesion formation in orthodontic patients over more than six months (26 weeks) in vivo, taking into account the provision or absence of an adequate oral hygiene. Sealant application during fixed appliances orthodontic treatment for enamel protection is common, reliable data on its durability in vivo are rare
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