Potential Inhibition Of Enamel Demineralization In Vitro By a New Filled Orthodontic Sealant.
Abstract: Introduction: Enamel demineralization during orthodontic treatment is an unpleasant problem. Resin-based orthodontic sealants have been developed to protect enamel from demineralization. The purpose of this in-vitro study was to compare between the integrity of two highly filled orthodontic resin sealants (OPAL®SEAL and ProSeal) after extensive tooth-brushing simulation and thermocycling... read more, and to compare the efficacy of the two sealants (OPAL®SEAL and ProSeal) on the inhibition of enamel demineralization during orthodontic treatment. Methods: Forty-five non-carious specimens, either buccal or lingual surface from human premolars were divided into 3 groups (15 per group) and received 1 of the following treatments: no treatment (control), ProSeal (by Reliance Orthodontic Products, Itasca, IL) or OPAL®SEAL (Opal Orthodontics by Ultradent). The teeth were subjected to extensive tooth-brushing simulation and thermocycling followed by acidic challenge for 96 hours in Ten Cate solution. They were examined macroscopically to identify any lost sealant and then sectioned bucco-lingually for lesion depth examination with polarized light microscopy. Results: Mann Whitney U test revealed a non-significant effect for type of sealant on the integrity of the sealant after subjecting the specimens to extensive mechanical wear & temperature fluctuation (P = 0.217). Kruskal-Wallis test revealed a p value < 0.001 for lesion depth comparison among the three study groups. Accordingly, the null hypothesis was rejected. Post-hoc Mann Whitney U indicated that the median lesion depth observed in ProSeal and OPAL®SEAL were significantly lower (P-value < 0.001) than the control group. There were no statistical difference in lesion depth between ProSeal and OPAL®SEAL groups. ProSeal and OPAL®SEAL performed significantly better, decreasing lesion depth by 92.49% and 84.68% respectively compared with the controls and completely inhibiting lesion formation in 8 and 5 specimens respectively. Spearman's rank correlation coefficient test for sealant integrity and lesion depth revealed a substantial correlation in ProSeal group (rs = 0.866, P < .001), a weak correlation in OPAL®SEAL (rs = 0.153, P = .587) and a moderate correlation for the two groups combined (rs = 0.537, P = .002). Conclusions: ProSeal and OPAL®SEAL show promise as an effective method of preventing enamel demineralization during orthodontic treatment without patient compliance. Both sealants survived the extensive tooth abrasion and thermocycling well and expected to have adequate integrity throughout the average orthodontic treatment time. The exact correlation between the sealant integrity and the resultant enamel demineralization could not be identified from this study.
Thesis (M.S.)--Tufts University, 2012.
Submitted to the Dept. of Orthodontics.
Advisor: Gerard Kugel.
Committee: Matthew Finkelman, Masly Harsono, Vassiliki Cartsos, and Lokesh Suri.
Keyword: Dentistry.read less