Aim: Decalcification remains a serious problem when treating patients with a multibracket appliance. The objective of this study was to classify patients with decalcification in terms of where it occurs, and to compare its potential reduction using a smooth surface sealant with a control group with no sealant. We also aimed to discover whether this enamel sealant would affect the incidence of bracket loss.

Material And Methods: A total of 78 patients aged 11.6 to 39.5 years (median: 15.9 years) treated at a private orthodontic practice were examined for signs of decalcification within a maximum of 3 months after debonding. The indexing system used for evaluation subdivided the tooth's labial surface into four zones for quantifying the area affected (0-3) and severity of the decalcification (0-3). Preexisting areas of demineralization were excluded based on photographic evidence. We used cumulative logistical regression to investigate the sealant effect. Bracket loss was evaluated according to patient records.

Results: In patients with sealed labial surfaces, we observed a significantly reduced level of severity in the areas affected by decalcification (p = 0.013) and the depth of demineralization (p = 0.080). Sealant application reduced the median incidence of bracket loss by half.

Conclusions: Our results demonstrate that Light Bond Reliance, the viscous sealant used in this study, may assist in preventing or reducing the incidence of enamel demineralization. We also noted a correlation between the sealant's use and the incidence of bracket loss in the treatment group.

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Source
http://dx.doi.org/10.1007/s00056-008-0741-6DOI Listing

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