Laboratory evaluation of toothbrush/toothpaste abrasion resistance after smooth enamel surface sealing

The use of dental sealants has been extended to smooth enamel surfaces. The present study was conducted to test the in vitro performance of four sealants with different characteristics (highly and lowly filled, self-etching features).

Eighty human teeth (lower incisors and premolars) were randomly divided into following sealant test groups: ProSeal(TM), LightBond(TM), OrthoSolo(TM), and Seal&Protect(®). Twenty untreated teeth served as a control group. Tooth brushing was conducted for a period of time simulating 12, 18, and 24 months. During the toothbrush abrasion protocol, the specimens were subjected to thermal and acidic challenge. Sealant thickness was determined with μCT imaging, and qualitative and quantitative surface effects were investigated using stereo microscopy and raster electron microscopy, respectively. Data were subjected to t test or Kruskal-Wallis/Mann-Whitney tests (alpha, 5%).

The wear behavior and film integrity of highly filled sealants were superior to lowly filled sealants. Even after 1 year of tooth brushing, significant surface deterioration with deleterious loss of enamel and discoloration was observed in all tested materials (χ(2) = 15.349; P = 0.004). The size of the observed defects increased over time.

These results suggest that the application of sealants on smooth enamel surfaces should be limited to special indications, and their usefulness has to be revisited.

Based on the results of this in vitro study, the general overall application of enamel sealants needs to be questioned.