Abstract
ObjectivesThe aim of this single-center randomized controlled trial (NCT03753256) was to assess orthodontic surface sealant layer thickness and integrity in vivo during a 12-month follow-up by optical coherence tomography (OCT).Materials and methodsUsing a split-mouth design, quadrants of 20 patients treated with fixed orthodontic appliances were included. Quadrants were randomly assigned to the sealants Pro Seal® (PS) or Opal® Seal™ (OS). OCT scans were performed immediately after the application of the sealants and after 3, 6, 9, and 12 months. Sealant layer thicknesses and their integrity were determined at 5 regions of interest (ROIs) known for high risks of demineralization. Sealant integrity loss was determined using a self-developed scale.ResultsA total of 16 patients successfully completed the study. The studied sealants showed significant differences in initial layer thickness. Mean layer thickness was significantly lower for PS (67.8 μm, (95% CI, 56.1–79.5)) than for OS (110.7 μm, (95% CI, 97.3–124.1)). Layer thickness loss was significant after 3 months for PS and after 6 months for OS. Sealant integrity was compromised in more than 50% of the ROIs already after 3 months for both sealants.ConclusionsPatients treated with fixed orthodontic surface sealants lost the integrity of the protective layer in more than 50% of cases after 3 months, and the layer thickness of the sealants was significantly reduced after 3–6 months.Clinical relevanceThe protective effect against demineralization lesions of orthodontic sealants in patients treated with fixed appliances appears to be limited in time. Further preventive measures should be investigated.Trial registrationClinicalTrials.gov (NCT 03753256)
Highlights
The application of orthodontic surface sealants became one of the most popular methods to prevent demineralization during orthodontic treatment with fixed appliances, partly because these materials substitute conventional bracket adhesives in commonly used pre-Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.For instance, Premaraj et al tested two commercially available orthodontic sealants Pro Seal® (PS) and Opal® SealTM (OS) against acid resistance
Seeking a tool to non-invasively assess surface sealant layer thickness and integrity longitudinally in patients, we recently showed that optical coherence tomography (OCT) applied as a cross-sectional imaging method can successfully be used for the assessment of orthodontic surface sealant layer abrasion in vitro and in vivo [8]
Five regions of interest (ROIs) on a middle incisor treated with PS or OS were analyzed per sample
Summary
Premaraj et al tested two commercially available orthodontic sealants Pro Seal® (PS) and Opal® SealTM (OS) against acid resistance. They could show that both sealants can protect enamel surfaces from 0.1 M lactic acid (pH 4.5) penetration after 4 weeks of exposure. They evaluated adherence of Streptococcus mutans and Lactobacilli on both sealants and found significantly higher S. mutans adherence on PS than on OS, whereas Lactobacillus adherence was comparable between both sealants. The authors doubt its clinical relevancy, because no continuous release could be observed from both sealants [1]
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