Effects of sealant and self-etching primer on enamel decalcification. Part II: an in-vivo study.
BACKGROUND
A self-etching primer (SEP) saves valuable time by eliminating the many steps required to etch, rinse, and place a sealant before application of the adhesive and placement of the bracket. The purpose of this study was to compare the effects of a conventional etch and sealant (CES) and a SEP on enamel decalcification in vivo.


METHODS
Twenty-five patients who required comprehensive orthodontic treatment were included in this study. Before bonding, enamel surfaces were treated with either a CES (Light Bond, Reliance Orthodontic Products, Itasca, Ill) or a SEP (Transbond Plus, 3M Unitek, Monrovia, Calif) by using a split-arch technique. At the end of the observation period (18-24 months), the O'Leary plaque index was used to determine patients' oral-hygiene compliance, and enamel decalcification around the orthodontic bracket was scored based on the amount and severity of decalcification. Scanning electron microscopy images and x-ray spectrum analysis were performed to examine the etched pattern of the 2 bonding systems. Data were analyzed by using analysis of variance (ANOVA) and the Tukey-Kramer test; the confidence level was set at a significant level of P = 0.05.


RESULTS
Significantly higher decalcification scores were found in the SEP group (27.5%) compared with the CES group (13.9%, P <0.001). No significant differences were found in the decalcification scores for teeth in the maxillary and mandibular arches. Significant differences were found between level of hygiene and decalcification (P <0.0001). Patients with fair or poor hygiene compliance had higher decalcification scores in the SEP group than in the CES group.


CONCLUSIONS
Using a SEP might save chair time and improve cost-effectiveness, but it provides less resistance to enamel decalcification than a CES, especially in patients with poor oral hygiene.
Ghiz
Matthew A
MA
Department of Orthodontics, West Virginia University, School of Dentistry, Morgantown, WV 26506-9480, USA.
Ngan
Peter
P
Kao
Elizabeth
E
Martin
Chris
C
Gunel
Erdogan
E
D000134:Acid Etching, Dental; D002327:Cariostatic Agents / Q000627:therapeutic use*; D003188:Composite Resins / Q000627:therapeutic use*; D003731:Dental Caries / Q000517:prevention & control; D003743:Dental Enamel / Q000648:ultrastructure*; D003774:Dental Plaque Index; D004577:Electron Probe Microanalysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055115:Light-Curing of Dental Adhesives; D008297:Male; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D009910:Oral Hygiene; D016910:Orthodontic Brackets; D019279:Resin Cements / Q000627:therapeutic use*; D017001:Tooth Demineralization / Q000517:prevention & control*
D002327:Cariostatic Agents; D003188:Composite Resins; C429652:Reliance Light Bond; D019279:Resin Cements; C429625:Transbond Plus Self-Etching Primer