The Efficacy of Fluoride-releasing Sealant in Controlling Demineralization around Brackets

Undesirable enamel decalcification can sometimes occur during orthodontic treatment.  To inhibit its development, different fluoride modalities have been investigated.  

Objective: To determine the efficacy of a highly-filled resin-based fluoride releasing sealant (Pro Seal ^TM) in controlling enamel demineralization adjacent to brackets when compared to a control adhesive (Transbond XT ^TM).  

Method: This study presents the 6 months results of a double-blind split-mouth longitudinal clinical trial with random assignment of two types of sealants for contralateral quadrants.  Thirty-eight patients, 21 females and 17 males, between 10 and 18 year old, seeking treatment at the Orthodontic Graduate Program Clinic, University of Puerto Rico initially participated in this study.  One senior examiner conducted the examinations using the International Caries Detection & Assessment System (ICDAS) criteria prior to orthodontic bonding and 6 months after initial bonding.

Result: Thirty-two (5.7%) of the 281 pairs of teeth evaluated at 6 months had caries progression, in the following order: maxillary lateral incisors, maxillary central incisors, and maxillary canines .  Although the proportion of caries progression was similar in the control (0.067) and treatment groups (0.067) (OR=1.00, 95% CI=0.50-2.0), important interactions were found.  Older males (>14) had more caries progression in the teeth from the control group (0.099) (Fisher’s p=0.04).  Males who attended public schools had more proportion of caries progression overall (0.103) (X² p=0.01).

Conclusion: Although the proportion of caries progression in the control and treatment groups appeared to be the same, important interactions were found between the variables, showing that inside each group, caries progressed differently.