Evaluation of Potential Inhibition of Enamel Demineralization by a Fluoride Releasing Sealant

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Despite extensive research on various preventive technologies over years, development of white spot lesions (WSLs) in association with orthodontic treatment remains a common undesirable clinical problem. High prevalence of these lesions after debonding is due to the difficulties encountered in performing oral hygiene measures on teeth covered with braces and arch wires.

Several mechanisms have been suggested to reduce the incidence of white spot lesions, including the improvement of oral health-related behaviors, changing dietary habits altogether with topical application of fluoride. Considering that the first line of management of white spots is remineralization, professional sources of fluoride such as varnishes and fluoride releasing sealants have become viable treatment alternatives.

Subsequently, this study aimed to investigate the efficacy of a fluoride releasing sealant (Pro Seal) in reversing WSLs intra orally as well as its fluoride release and recharge abilities.

For clinical assessment, 24 patients were enrolled from the Pediatric Dentistry and Dental public Health Department and the Orthodontic Department clinics– Faculty of Dentistry, Ain-Shams University, after completion of their orthodontic treatment. Subjects were recruited according to certain inclusion and exclusion criteria, and a written consent was signed by their parents before conducting the research. Scaling, polishing and oral health education was conducted before intervention and each quadrant received either fluoride varnish or Pro Seal in a cross over design. Randomization was done by a coin tossing and materials were applied according to manufacturers’ instructions. Photographs were taken preoperatively and 3 and 6 months post treatment for detecting changes in size of WSLs using both visual and computerized techniques for assessment.

Three participants dropped out and were excluded from the analysis. Based on both assessments, there was a significant decrease in total surface area of WSLs in both groups over the evaluation duration. In addition, Pro Seal produced higher percent improvement of WSLs after 3 and 6 months in comparison to fluoride varnish.

The laboratory investigations of our study included 36 specimens of Pro Seal with 1mm thickness and 5 mm diameter each. These specimens were immersed in de-ionized water and changed every other day for 40 days. Baseline measurements were done using an ion analyzer and the specimens were then divided into 3 groups: 12 specimens served as controls, 12 specimens recharged with 0.24% sodium fluoride containing tooth paste and 12 specimens recharged with 0.4% stannous fluoride gel. After 7 days, second fluoride measurement was done using the same ion analyzer.

The results showed that PS released fluoride ions after 40 days and has the ability to be recharged with 0.4% stannous fluoride gel. 0.24%. Sodium fluoride tooth paste, however, did not exert any significant recharging effect on Pro Seal