Award Date

5-15-2026

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Dental Medicine

First Committee Member

John Colombo

Second Committee Member

Jessica Immonen

Third Committee Member

Charles Hill

Fourth Committee Member

Maxim Gakh

Number of Pages

51

Abstract

Background:

White spot lesions are one of the most common complications encountered during orthodontic treatment. These lesions begin as demineralization of enamel around the appliance due to plaque buildup, resulting in compromised aesthetics. As they continue to develop, white spot lesions progress to cavitation, potentially threatening pulpal vitality, resulting in an increased financial burden for patients. Preventative strategies include patient education, consistent oral hygiene protocols, and the use of fluoride-releasing agents. Orthodontic sealants such as Opal® Seal™ (Ultradent) (OS) and L.E.D. Pro Seal® (Reliance) (PS) have been developed to release and recharge fluoride, thereby reducing the incidence of white spot lesions in high-risk patients. However, the clinical effectiveness of these materials depends on their resistance to degradation and their ability to limit bacterial colonization. Streptococcus mutans, a primary cariogenic microorganism, contributes significantly to white spot lesion formation by adhering to enamel surfaces and producing acidic biofilms. This study aims to evaluate the durability of Opal® Seal™ and L.E.D. Pro Seal® over time and to compare the extent of S. mutans adhesion on each sealant material. Findings from this study may provide insight, particularly for clinicians, into the longevity of orthodontic sealants, optimal reapplication intervals, and their role in minimizing white spot lesion development during orthodontic treatment.

Objectives:

This study aimed to investigate the durability of two widely used orthodontic sealants, Opal® Seal™ and L.E.D. Pro Seal® on extracted, healthy human teeth. Thermocycling was utilized to simulate artificial aging in an oral environment and profilometric analysis was utilized to assess surface roughness of the sealed teeth at several time points. Additionally, streptococcus mutans was inoculated onto sealed and unsealed tooth fragments to evaluate microbial adherence.

Methods:

Healthy, extracted posterior teeth were acquired, sterilized, and stored in artificial saliva and subsequently distilled water. Opal® Seal™ and L.E.D. Pro Seal® orthodontic sealants were applied to the buccal surfaces utilizing manufacturer recommendations and surface roughness was evaluated at time point zero with a profilometer, along with a non-sealed control. Sealed teeth were subjected to simulated aging using a thermocycler for 6 months, 12 months, 18 months, 24 months and 30 months. At each time point, sealed teeth were imaged and analyzed with a profilometer to determine degradation of the sealant surface by assessing changes in surface roughness. To evaluate microbial adherence to the sealants, tooth fragments sealed with either Opal® Seal™, L.E.D. Pro Seal® and controls were inoculated with S. mutans and DNA was extracted to quantify the adherence of S. mutans by qPCR.

Results:

Quantitative profilometric analysis revealed no significant changes in surface roughness for neither L.E.D. Pro Seal® nor Opal® Seal™ and no statistically significant differences were observed between any of the experimental time points. At the scale measured, both orthodontic sealants maintained a relatively stable surface integrity throughout the simulated gaining period of 30 months. Visual qualitative findings demonstrated that both sealants showed visual degradation, appearing sooner in teeth sealed with L.E.D. Pro Seal® than in teeth sealed with Opal® Seal™, which may indicate that Opal® Seal™ may degrade at a slower rate than L.E.D. Pro Seal®. However, visual examination may be subject to bias, and therefore was not utilized as a standard method for this study. QPCR results were unsuccessful in demonstrating the adherence of S. Mutans to control teeth as well as sealed teeth.

Conclusion:

Within the limitations of this study, both Opal® Seal™ and L.E.D Pro Seal® demonstrated sufficient durability to provide enamel protection during early critical phases of fixed orthodontic treatment. Neither of the sealants are considered a permanent solution in preventing white spot lesions, however these findings support the use of orthodontic enamel sealants as a noncompliance dependent preventative adjunct. Both sealants demonstrated their ability to aid as a preventative strategy in addition to the normal protocols established through regular fluoride use and oral hygiene maintenance. Further studies are warranted to evaluate the long-term clinical performance and re-application protocols.

Controlled Subject

Orthodontics; Sealing compounds; Teeth--Wounds and injuries

Disciplines

Dentistry | Medicine and Health Sciences | Oral Medicine

File Format

PDF

File Size

9100 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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