Influence of enamel sealing with a light-cured filled sealant before bracket bonding on the bond failure rate during fixed orthodontic therapy

  • Christian KirschneckEmail author
  • Carina Rohn
  • Peter Proff
  • Claudia Reicheneder
Original Article



Fluoride-containing adhesives for enamel sealing are commonly used for the prevention of white spot lesions during fixed orthodontic treatment. Thus, we examined whether enamel sealing with L.E.D. ProSeal® (Reliance Orthodontic Products Inc., Itasca, IL, USA) before bracket bonding increases the rate of bond failure during orthodontic treatment.


In 20 adolescents (11–16 years, 10 male/10 female) at the start of fixed therapy, self-ligating SmartClip™SL3 metal brackets (3M Unitek, Monovia, CA, USA) were bonded to cleaned and conditioned (40% H3PO4, 30 s) buccal enamel surfaces of all permanent teeth except molars using Transbond™ XT (3M Unitek). In a split-mouth design, either L.E.D. ProSeal® (1st/3rd quadrant) or Clinpro™ XT Varnish (2nd/4th quadrant; 3M Unitek) was applied to enamel surfaces before (ProSeal®) or after (Clinpro™ XT Varnish) bracket bonding (200 teeth each; light curing: 20 s, Ortholux™ Luminous, 3M Unitek). Cumulative bond failure as total number of teeth with bracket detachment since start of therapy was documented every 3 months for a total of 12 months.


Cumulative bond failure was higher for enamel sealing before bonding from 6 months onward reaching significance at 12 months (34/200) compared to sealing after bonding (24/200): p = 0.038; Cramér’s V = 0.488; odds ratio (OR) = 1.5; relative risk (RR) = 1.4. The higher loss rate was limited to the lower arch, but evident within 3 months reaching significance at 9 and 12 months (p = 0.019/0.011, V = 0.636/0.630; OR = 1.7/1.75, RR = 1.5/1.6). In general, cumulative bond failure at 12 months was higher in the lower arch, but this was only significant for teeth sealed before bonding (p = 0.001, V = 0.303, OR = 3.4, RR = 2.8).


Enamel sealing with L.E.D. ProSeal® should be performed after bracket bonding to prevent increased bond failure and bracket loss in the lower dental arch.


Enamel sealing Bracket loss Orthodontics L.E.D. ProSeal® Clinpro™ XT Varnish 

Einfluss einer Schmelzversiegelung mit einem lichthärtenden, gefüllten Versiegler vor dem adhäsiven Kleben auf die Bracketverlustrate während festsitzender kieferorthopädischer Therapie



Eine Schmelzversiegelung mittels fluoridhaltiger Adhäsive zur Vermeidung von White-Spot-Läsionen hat in der festsitzenden kieferorthopädischen Therapie eine weite Verbreitung gefunden. In dieser Studie wurde untersucht, ob eine Versiegelung mittels L.E.D. ProSeal® (Reliance Orthodontic Products Inc., Itasca/IL, USA) vor dem adhäsiven Kleben von Brackets die Bracketverlustrate während der kieferorthopädischen Behandlung erhöht.


Bei 20 jugendlichen Patienten (11–16 Jahre, 10 m., 10 w.) wurden zu Beginn einer festsitzenden Therapie selbstligierende SmartClip™-SL3-Metallbrackets (3M Unitek, Monovia/CA, USA) auf die gereinigten und konditionierten (40% H3PO4, 30 s) bukkalen Schmelzoberflächen aller bleibenden Zähne mit Ausnahme der Molaren adhäsiv geklebt (Transbond™ XT, 3M Unitek). In einem Split-Mouth-Design erfolgte eine Schmelzversiegelung mittels entweder L.E.D. ProSeal® (1./3. Quadrant) oder Clinpro™XT-Varnish (2./4. Quadrant; 3M Unitek) vor (ProSeal®) oder nach (Clinpro™XT) dem Kleben der Brackets (200 Zähne, Lichthärtung 20 s mit Ortholux™ Luminous, 3M Unitek). Die kumulative Bracketverlustrate als Gesamtzahl der Zähne mit Bracketablösung seit Therapiebeginn wurde alle 3 Monate für insgesamt 12 Monate dokumentiert.


Die kumulative Bracketverlustrate war für die Schmelzversiegelung vor gegenüber nach dem Kleben der Brackets ab 6 Monaten erhöht mit Signifikanz nach 12 Monaten (34/200 vs. 24/200): p = 0,038; Cramérs V = 0,488; OR (Odds Ratio) = 1,5; RR (relatives Risiko) = 1,4. Die höhere Verlustrate war auf den unteren Zahnbogen begrenzt, trat jedoch innerhalb von 3 Monaten auf und erreichte nach 9 sowie nach 12 Monaten Signifikanz (p = 0,019/0,011, V = 0,636/0,630; OR = 1,7/1,75, RR = 1,5/1,6). Im Allgemeinen war die kumulative Bracketverlustrate nach 12 Monaten im unteren Zahnbogen höher; signifikant war dies jedoch nur für Zähne, die vor dem Kleben der Brackets versiegelt worden waren (p = 0,001, V = 0,303, OR = 3,4, RR = 2,8).


Eine Schmelzversiegelung mittels L.E.D. ProSeal® sollte nach dem Kleben von Brackets durchgeführt werden, um eine erhöhte Versagens- und Bracketverlustrate im unteren Zahnbogen zu vermeiden.


Schmelzversiegelung Bracketverlust Kieferorthopädie L.E.D. ProSeal® Clinpro™ XT Varnish 



This work was awarded with the Best Poster Award (Parallel Symposium) at the 90th Scientific Annual Meeting of the German Orthodontic Society in Bonn, 2017.

Compliance with ethical guidelines

Conflict of interest

C. Kirschneck, C. Rohn, P. Proff and C. Reicheneder declare that they have no competing interests.

Ethical standards

All procedures performed were in accordance with the ethical standards of the institutional ethics committee and the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study and in addition, if underage, from their legal guardians.


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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Christian Kirschneck
    • 1
    Email author
  • Carina Rohn
    • 1
  • Peter Proff
    • 1
  • Claudia Reicheneder
    • 1
  1. 1.Department of OrthodonticsUniversity Hospital RegensburgRegensburgGermany

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