A clinical, study of the protective effects of the application of fissure sealant prior to the direct bonding of orthodontic brackets

Abstract

Orthodontic treatment sometimes has the unfortunate sequela of white spots forming around the margins of the brackets. These white spots or demineralized areas are of concern to the orthodontist ds they may present an aesthetic problem which might require costly restorative work later. AIso at debonding the orthodontist is often faced with the time consuming and arduous task of removing residual composite from the tooth surface. The purpose of this study was to establish whether a fissure sealant used with or without a fluoride containing mouth rinse would prevent white spot formation around orthodontic brackets and whether, coincidently, the use of the fissure sealant moved the fracture site closer to the enamel/resin interface, thereby leaving a clean enamel surface at debonding, saving the orthodontist chairside time. One hundred patients undergoing orthodontic treatment at the Dental Faculty of University of the Western Cape were chosen for this study. The patients were given basic oral hygiene instruction, scaling and polishing and instructed to brush with a fluoride containing dentifrice. The mouth of each patient was divided into four quadrants, with fissure sealant (pelton clear unfilled resin) being applied to two alternate quadrants. The sample was divided into two groups, one of which rinsed with a fluoride containing mouthrinse. There was a significant difference in white spot formation when comparing fissure sealed and non-fissure sealed surfaces. Of the group which rinsed with fluoride mouthrinse, 86t had no white spots or demineralization. Also, the results of this study have shown unequivocally that the prior use of fissure sealant moved the fracture site closer to the enamel/resin interface, thereby leaving Iittle or no residual composite on the enamel surface at debanding.