The purpose of this study was to investigate the effects of a fluoride releasing orthodontic primer on demineralization adjacent to brackets. Twenty-two patients were recruited for this study. One premolar was randomly chosen as the experimental tooth, the contralateral tooth was the control. Teeth were visually analyzed for white spot lesions (WSLs). Knoop microhardness was used to determine hardness. Visual examination results showed no significant difference in the number of WSLs observed between Opal Seal and Transbond XT over the duration of this study. Solid conclusions could not be drawn from the results of microhardness testing. Therefore, it cannot be concluded that there is a difference in enamel hardness between Opal Seal and Transbond XT. However, prior to 90 days, teeth showed a significant difference in WSLs. Suggesting a protective effect of Opal Seal that diminished with time. Future studies are necessary to determine the clinical performance of this product.

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Objective: This study was conducted to determine the resistance to wear and effectiveness of Opal®Seal (Opal Orthodontics by Ultradent, South Jordan, UT, USA) against enamel demineralization in comparison to L.E.D. Pro Seal® (Reliance Orthodontic Products, Itasca, IL, USA). Background: Development of white spot lesions (WSL) is a primary concern during fixed orthodontic treatment. With poor oral hygiene during orthodontic therapy, it is almost inevitable that enamel demineralization will occur and WSLs will be seen clinically. Numerous materials have demonstrated successful prevention of WSLs, including topical varnishes and sealants, gels, pastes and bonding agents. The newly developed sealant Opal Seal is claimed by the manufacturer to prevent demineralization and subsequent WSLs from forming during orthodontic treatment. To evaluate the effectiveness of Opal Seal, we tested and compared it to Pro Seal, which has proven to be successful at WSL prevention and is, like Opal Seal, a fluoride-releasing, light-cured, low viscosity filled resin sealant. Methods: A total of 48 non-carious extracted human premolar teeth were divided into 3 groups representing one of the following topical treatments: no treatment (C), Opal Seal (OS) or L.E.D. Pro Seal (PS). Each group was subdivided into either T1 or T2 time interval groups (C1, C2, OS1, OS2, PS1 and PS2) and teeth were subjected to 10,000 or 20,000 simulated brush strokes, respectively, followed by exposure to an acidic solution for 96 hours. Teeth were examined macroscopically for product wear and assessment of WSL development and then sectioned for quantitative examination with polarized light microscopy. Results: Visual assessment revealed wear of L.E.D. Pro Seal in 62.5% of the PS2 teeth following exposure to toothbrush abrasion and acidic challenge. No L.E.D. Pro Seal or Opal Seal wear was found in any PS1 or OS teeth, respectively. WSLs involving 50-100% of the exposed enamel surface developed in all control teeth and 37.5% of PS teeth had WSLs involving less than 50% of their enamel surface. These WSLs were visible as small, white, isolated points. No visible WSLs were found in any teeth in the OS group. A Fisher's Exact test was used to evaluate any differences in demineralization within groups over time. The results indicate a significant difference in the number of lesions found at T1 compared to T2 in the PS group (p = 0.003). A non-parametric Kruskal-Wallis test using a Wilcoxon test for all multiple comparisons was conducted to evaluate any differences among the treatment groups for change in depth of demineralization (µm) at two different time points. PS and OS groups were found to have significant differences in average lesion depth compared to the control groups at T1 and T2 (pConclusions: Our results showed that both Opal Seal and L.E.D. Pro Seal reduce enamel demineralization when teeth are subjected to simulated toothbrush abrasion and an acidic environment over time. Opal Seal provided superior protection of the enamel surface and demonstrated complete wear resistance and prevention of demineralized lesion development in our experimental groups.