Abstract
ObjectivesTo investigate the antimicrobial potential of organo-selenium compound when applied as enamel surface sealant or primer (DenteShield™ [DS]) around orthodontic brackets to prevent enamel demineralization. MethodsHuman teeth were randomly assigned to seven treatment groups (15/group): control (No primer or sealant), Leopard light primer (LLP), DS Primer (DS-P), DS Enamel Surface Sealant (DS-S), Pro Seal, Opal Seal and combined DS-P/DS-S (DS-PS). Following etching, the tooth surface was coated with their respective material (except control group) and a bracket was bonded on each treated surface. All samples were subject to cariogenic challenge in a continuous flow microbial caries model at 37 °C in an incubator for 28 days. Demineralization was evaluated with Transerse microradiography to determine mineral loss (Δz) and lesion depth (LD). Data was statistically analyzed using Bonferroni protected Mann-Whitney tests (α = 0.05). ResultsDemineralization was obsessrved only in Control and LLP groups. Control group had significantly (p < 0.001) greater mean LD (109.47 ± 34.22 μm) and mean Δz (2251.07 ± 514.26 vol%μm) when compared with the LLP with mean LD (44.98 ± 11.69 μm) and Δz (700.67 ± 310.66 vol%μm). All other groups did not develop any lesions. ConclusionsSelenium-based primer and sealant used alone or in combination were effective in protecting enamel from demineralization around brackets. The combination of primer and enamel surface sealant has no added benefit. SignificanceDS-S and DS-P containing antimicrobial organo-selenium compound can prevent whitespot lesions development when applied on tooth surface during orthodontic treatment. Light primer applied alone on tooth surface may not provide adequate protection for the enamel around orthodontic appliances.
Highlights
With the increasing demand for esthetics in dentistry, the treatment options have been drastically diversified including veneers, biomimetic dentistry, tooth bleaching, implants and periondontal surgery, orthognathic surgery, and orthodontics
A total of 106 sections were produced from the 53 teeth, and 105 were used and allocated randomly to seven experimental groups (15/group) based on the materials used (Table 1): Group 1: Control group - No Sealant or Primer; Group 2: Leopard Light Primer (LLP); Group 3: DenteShieldTM Primer (DS-P); Group 4: DenteShieldTM Enamel Surface Sealant (DS-S); Group 5: Reliance Pro-SealTM (RPS); Group 6: Ultradent Opal-SealTM (UOS); Group 7: DenteShieldTM Primer & Enamel Surface Sealant (DS-PS)
One sequel of orthodontic treatment is the development of white spot lesions (WSL) around the periphery of the orthodontic brackets, which is the early stage of dental caries due to enamel demineralization by organic acids, a byproduct of bacteria metabolism1
Summary
With the increasing demand for esthetics in dentistry, the treatment options have been drastically diversified including veneers, biomimetic dentistry, tooth bleaching, implants and periondontal surgery, orthognathic surgery, and orthodontics. Orthodontics, combined with other treatment modalities, could result in change to the patient's teeth alignment and occlusion, and the soft and hard tissue reaching a dentofacial harmony. The incidence of WSL was reported to be higher in orthodontic patients than the general public [3]. The presence of bracket creates a platform that accumulates plaque on the surface of a tooth. The physical barrier from the combination of bracket, the wire and ligature hinders the self-cleaning mechanism of musculature and saliva as well as the maintenance of oral hygiene [1,4]. Studies have shown that orthodontic treatment increases the plaque formation with the significantly lower pH compared to those of non-orthodontic patients [5]. The low pH of plaque inhibits enamel remineralization and promotion demineralization, which leads to WSL
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