Light-Cured Filled Sealant Prevented Enamel Demineralization around Orthodontic Brackets

Objective: Formation of whitespot lesions around orthodontic brackets during treatment is a significant clinical and esthetic problem. The aims of the present study were to determine (1) the efficacy of light-cured filled sealant, Pro-Seal, in the prevention of enamel demineralization around orthodontic brackets, and (2) the ability of the sealant to withstand toothbrushing force. Methods: Using self-etching primer, lower incisor brackets were bonded to each of sixty enamel blocks cut from extracted human teeth. All surfaces of each block were painted with two coats of non-fluorescent, colorless, acid-resistant nail-varnish, except for ring of exposed enamel (1mm from bracket edge) around the bracket. Elastomeric ligature was placed on each bracket and then the blocks were randomly assigned to four groups (15/group) treated respectively as follows:  Group-A, no Pro-Seal applied and no toothbrushing;   Group-B, no Pro-Seal but toothbrushed; Group-C, Pro-Seal applied on the ring of exposed enamel surface in accordance with the manufacturer's instruction but no toothbrushing; Group-D, Pro-Seal and toothbrushed.  Blocks were subjected to 14-day period of plaque formation and demineralization in a continuous flow Microbial Caries Model. Demineralization was quantified using quantitative light-induced fluorescence. Data were statistically analyzed (a=0.05) using Bonferroni protected Mann-Whitney tests to identify pairwise differences. Results:            

Groups (n=15)	Treatment	Mean DQ±SD (%.mm2)
A	No Pro-Seal, No toothbrushing	184.50±56.4
B	No Pro-Seal, Toothbrushed	70.66±50.6
C	Pro-Seal, No toothbrushing	0.86±0.8
D	Pro-Seal, Toothbrushed	2.58±2.2

Groups B, C, and D showed less demineralization (p<0.001) when compared with Group A. Groups with Pro Seal (C, D) exhibited less demineralization (p<0.001) when compared to Group B (toothbrushed only). No significant difference was observed between the brushed and unbrushed Pro-Seal groups, indicating that the abrasion of toothbrushing did not significantly compromise the barrier to demineralization. Conclusions: Pro-Seal inhibited enamel demineralization around orthodontic brackets and demonstrated considerable resistance to the force of toothbrushing.