OCT evaluation of orthodontic surface sealants: a 12-month follow-up randomized clinical trial

Abstract

Objectives The aim of this single-center randomized controlled trial (NCT03753256) was to assess orthodontic surface sealant layer thickness and integrity in vivo during a 12-month follow-up by optical coherence tomography (OCT). Materials and methods Using a split-mouth design, quadrants of 20 patients treated with fixed orthodontic appliances were included. Quadrants were randomly assigned to the sealants Pro Seal® (PS) or Opal® Seal™ (OS). OCT scans were performed immediately after the application of the sealants and after 3, 6, 9, and 12 months. Sealant layer thicknesses and their integrity were determined at 5 regions of interest (ROIs) known for high risks of demineralization. Sealant integrity loss was determined using a self-developed scale. Results A total of 16 patients successfully completed the study. The studied sealants showed significant differences in initial layer thickness. Mean layer thickness was significantly lower for PS (67.8 μm, (95% CI, 56.1-79.5)) than for OS (110.7 μm, (95% CI, 97.3-124.1)). Layer thickness loss was significant after 3 months for PS and after 6 months for OS. Sealant integrity was compromised in more than 50% of the ROIs already after 3 months for both sealants. Conclusions Patients treated with fixed orthodontic surface sealants lost the integrity of the protective layer in more than 50% of cases after 3 months, and the layer thickness of the sealants was significantly reduced after 3-6 months. Clinical relevance The protective effect against demineralization lesions of orthodontic sealants in patients treated with fixed appliances appears to be limited in time. Further preventive measures should be investigated. Trial registration ClinicalTrials.gov (NCT 03753256

Demineralisationsprophylaxe bei festsitzenden kieferorthopädischen Apparaturen

“…Bei über 50 % der untersuchten Zahnoberflächen kam es zum Verlust der Integrität der Versiegelungsschicht nach drei Monaten (▶ Abb. 12) [18]. Glattflächenversiegelungen geben also nur einen zeitlich sehr begrenzten Schutz.…”

“…Um die Zahnhartsubstanz zu schützen, muss die Materialschicht intakt sein. Dabei ist die Schichtdicke abhängig vom verwendeten Material 18 . In einer eigenen Studie konnte gezeigt werden, dass es bereits nach 3 – 6 Monaten zu einer deutlichen Schichtdickenabnahme kommt.…”