Prevention of Enamel Demineralization Around Orthodontic Brackets with BisCover LV

Objectives: Orthodontic braces make it difficult for patient to achieve proper and adequate oral hygiene, thereby causing whitespot lesions in patient undergoing orthodontic treatment. There is an increasing demand for an effective method of protecting the tooth surfaces from demineralization during orthodontic treatment.  The aims of the present study were to evaluate the effectiveness of a dental sealant, BisCover LV, in preventing whitespot lesion formation around orthodontic brackets, and to assess its resistance to abrasion from daily toothbrushing. Methods: 72 enamel blocks with orthodontic brackets bonded to each block were randomized to the following four experimental groups (18 blocks/group) that received different combinations of sealing with BisCover LV and daily toothbrushing with a fluoride toothpaste: (A) Neither sealed nor brushed, (B) Not sealed but brushed twice daily, (C) Sealed but not brushed, and (D) Sealed and brushed. The blocks were exposed for plaque formation and demineralization in a mixed-organisms continuous flow microbial caries model (Artificial Mouth System) for 30 days. Demineralization was measured using quantitative light-induced fluorescence (QLF™) to quantify the integrated fluorescence loss (ΔQ). Data were analyzed using the rank-based Wilcoxon robust general linear models method (α=0.05). Results: All groups showed significantly (p<0.01) less demineralization than group A (Neither sealed nor brushed). Significantly less demineralization (p<0.05) occurred in the sealed groups (C and D) compared to the unsealed groups (A and B). The difference between the brushed (D) and non-brushed (C) sealed groups was not significant, but the unsealed and brushed group (B) showed significantly less demineralization than the unsealed and non-brushed group (A). Conclusion:  Application of BisCover LV to the tooth surface during orthodontic treatment reduced the severity of enamel demineralization, and its effectiveness was not significantly reduced by the abrasive force of toothbrushing.