Enamel sealants: a clinical evaluation of their value during fixed appliance therapy

A clinical trial was undertaken to evaluate the effectiveness of two new enamel sealing systems in the prevention of enamel decalcification following bracket bonding. Eighty patients undergoing fixed appliance therapy were included. Of these, 40 were treated with a viscous chemically-cured sealant and bonding system (Maximum Cure), while 40 patients were treated using a non-viscous visible light-cured sealant and bonding agent (Transbond resin). Alternate teeth were used as controls where no sealant was used. A total of 289 experimental and 282 control teeth were included in the chemically-cured sealant group, the figures for the light-cured sealant group being 306 and 305, respectively. Enamel decalcification incidence and distribution were recorded using a modified index by direct clinical observation. The results showed that 75 per cent of patients were affected by some decalcification. The viscous sealant reduced the extent of decalcification of tooth zones by 13 per cent. The non-viscous sealant produced no significant difference. Over 60 per cent of decalcification occurred in the gingival areas. Maxillary lateral incisors and canines, and mandibular canines and second premolars were the teeth most severely affected, and the most likely to benefit from sealing. Further research is needed to develop a material which provides greater enamel protection.