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Tooth DemineralizationORTHOCOLLAGENCT07355322

Comparison of a 3-step Bonding System (Transbond™ XT) and a 2-step System (GC Ortho Connect™) on Demineralization Around Maxillary Orthodontic Brackets

A study testing Transbond™ XT bonding procedure and GC Ortho Connect™ bonding procedure in people with Tooth Demineralization and White Spot Lesion, run by University Hospital, Montpellier at 1 site in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

White spot lesions (WSLs) are one of the most common adverse effects of fixed orthodontic treatments, affecting up to 97% of patients treated with labial appliances. These early enamel demineralizations, caused by microleakage between enamel and adhesive, can appear as early as the fourth week of treatment. Read more about this study

Who is it for?
Ages 10 to 16 years
What is being tested?
Transbond™ XT bonding procedure and GC Ortho Connect™ bonding procedure
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
34 participants
Where
1 siteFrance
Study dates
Jan 2026to Apr 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 10 to 16 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Patient aged 10 to 16 years included,
  • Patient attending their first dentofacial orthopedics consultation at the Montpellier Dental Care Center, in adolescent or young adult dentition (according to Démogé classification),
  • Patient requiring the placement of a bimaxillary multi-bracket treatment and opting for a metallic vestibular technique.

Who cannot join

  • Syndromic patient (all syndromes included, e.g., cleft lip) or with a severe long-term condition (ALD),
  • Patient previously treated with a multi-bracket orthodontic treatment using a mixed, lingual, or vestibular technique,
  • Any medical condition deemed incompatible with bracket placement by the investigator,
  • Patient with severe MIH (molar-incisor hypomineralization) and/or severe demineralization on one or more teeth (including severe amelogenesis imperfecta or dentinogenesis imperfecta),
  • Patient with restorations such as metal crowns, ceramic crowns, porcelain-fused-to-metal crowns, inlays, onlays, or amalgam on one or more vestibular surfaces,
  • Patient with oral hygiene incompatible with orthodontic treatment,
Show all 16Show fewer
  • Agenesis of lateral incisors,
  • Subject already participating in another interventional clinical trial that could interfere with this study,
  • Uncontrolled psychiatric disorder,
  • Lack of written informed consent from a legal representative after a reflection period,
  • Lack of cooperation or difficulty in communication/comprehension, or refusal of participation by the minor,
  • Subject with a dependency or employment relationship with the sponsor or investigator,
  • Subject participating in another research study with an ongoing exclusion period,
  • Subject not affiliated with the French social security system or not a beneficiary of such a system,
  • Protected populations according to the French Public Health Code:
  • Pregnant or breastfeeding women Subjects deprived of liberty (by judicial, administrative decision, or involuntary hospitalization) Subjects under guardianship or curatorship

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Stéphane BARTHELEMI, PU-PH contact

+33 6 47 75 55 33

s-barthelemi@chu-montpellier.fr

France1 site
  • University Hospital Montpellier

    Montpellier

    Stéphane BARTHELEMI, +33 6 47 75 55 33, s-barthelemi@chu-montpellier.fr

Other trials in France

About this study

Official title: Comparison of a 3-step Bonding System (TRANSBOND™ XT) Versus a 2-step System (GC ORTHO CONNECT™) on Demineralization Around Maxillary Orthodontic Brackets: a Randomized Split-mouth Clinical Trial.

White spot lesions (WSLs) are one of the most common adverse effects of fixed orthodontic treatments, affecting up to 97% of patients treated with labial appliances. These early enamel demineralizations, caused by microleakage between enamel and adhesive, can appear as early as the fourth week of treatment. They not only pose aesthetic concerns but also increase the risk of bracket failure.

This randomized split-mouth clinical trial compares two bonding systems : the traditional three-step system (Transbond™ XT) and the simplified two-step system (GC Ortho Connect™) to assess their impact on enamel demineralization around orthodontic brackets. The degree of demineralization will be measured using the Enamel Decalcification Index (EDI) based on intraoral photographs and confirmed with a fluorescence camera (C50 Acteon).

The aim of the study is to determine whether the simplified bonding protocol can reduce clinical time and saliva contamination risk without increasing enamel demineralization, thus offering a potentially more efficient and conservative approach for orthodontic bonding procedures.

Read the detailed description

Introduction:

White spot lesions (WSLs) (localized, non-cavitated enamel demineralizations) represent one of the most frequent side effects of fixed orthodontic treatments. Clinically visible in up to 97% of patients undergoing labial orthodontic therapy, these lesions can emerge as early as the fourth week of treatment. They result from microleakage at the adhesive enamel interface, which facilitates bacterial colonization and acid production. Beyond their aesthetic impact, WSLs can compromise bracket adhesion and increase the risk of failure

Fixed orthodontic appliances modify the oral ecosystem, favoring plaque accumulation and hindering efficient brushing, particularly around complex elements such as ligatures, brackets, and springs. Consequently, WSLs constitute a significant clinical concern for both orthodontists and dental surgeons, as these lesions can persist five years after treatment completion.

Bonding Systems Under Investigation :

The conventional bonding protocol, Transbond™ XT, involves three steps: etching, primer application, and adhesive placement. Conversely, the GC Ortho Connect™ system integrates the primer directly into the adhesive, simplifying the bonding procedure to a single step following orthophosphoric acid etching. This reduced protocol minimizes saliva exposure time and enhances bonding strength.

Furthermore, GC Ortho Connect™ contains functional monomers such as 10-MDP (10-methacryloyloxydecyl dihydrogen phosphate), which chemically interacts with hydroxyapatite, forming a stable bond resistant to moisture. While some studies suggest this system reduces the risk of contamination and shortens chairside time, others report slightly deeper and larger lesions compared to the conventional three-step approach. Evidence remains contradictory, with several in vitro studies showing no significant difference in enamel quality between the two bonding systems.

Research Hypothesis and Objectives :

This clinical trial aims to determine whether a significant difference exists in enamel demineralization between a three-step (Transbond™ XT) and a two-step (GC Ortho Connect™) bonding system.

  • Primary Objective: Compare the degree of enamel demineralization around orthodontic brackets at debonding between the two systems using intraoral photographs (Enamel Decalcification Index, EDI) and fluorescence imaging (C50 Acteon camera).
  • Secondary Objectives:
  • Assess enamel demineralization before bonding, at 6 months, and at 12 months.
  • Compare bracket failure rates throughout treatment.
  • Evaluate plaque accumulation using the Silness and Löe plaque index.

Methodology :

A monocentric randomized split-mouth trial will be conducted at the Montpellier Dental Care Center. Each patient will serve as their own control:

One hemi-arch (control) bonded with Transbond™ XT (3-step system).

The opposite hemi-arch (experimental) bonded with GC Ortho Connect™ (2-step system).

Randomization will be stratified by gender and brushing hand dominance to reduce confounding factors. Inclusion criteria target minors aged 10-16 years requiring fixed labial metallic appliances.

The split-mouth design minimizes interindividual variability (e.g., enamel quality, saliva composition, hygiene habits) and increases statistical power. Additionally, enamel demineralization assessment will be conducted by a blinded examiner to ensure unbiased evaluation.

Conclusion :

This study proposes an innovative clinical comparison between two orthodontic bonding systems to assess their effects on enamel demineralization. If the simplified GC Ortho Connect™ system demonstrates similar or superior outcomes to the conventional Transbond™ XT, it could represent a time-saving, contamination-resistant, and more conservative alternative for orthodontic bonding procedures ultimately improving patient safety and clinical efficiency.

Being tested
Transbond™ XT bonding procedure, GC Ortho Connect™ bonding procedure
Keywords
White spot lesions, Orthodontic bonding, Enamel demineralization, Transbond XT, GC Ortho Connect, Split-mouth trial, Orthodontic Brackets, Fixed Orthodontic Appliances, Adolescents, Oral Hygiene, Dental Plaque, Orthodontic Adhesives, Bracket detachment, Bracket debonding
Medical subject headings
Tooth Demineralization, Dental Plaque

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Transbond™ XT bonding procedureDevice

    Brackets are bonded to one hemi-arch using the 3-step protocol: 1) acid etching, 2) primer application, 3) adhesive placement and light curing.

  • GC Ortho Connect™ bonding procedureDevice

    Brackets are bonded to the contralateral hemi-arch using the 2-step protocol: 1) acid etching, 2) adhesive with integrated primer, followed by light curing.

Study groups in NCT07355322
Study groupRoleWhat they receive
Transbond™ XT (3-step system)Active comparatorConventional 3-step bonding system applied on one hemi-arch: acid etching, primer application, adhesive placement, and light curing. Serves as control.
Receives: Device: Transbond™ XT bonding procedure
GC Ortho Connect™ (2-step system)ExperimentalSimplified 2-step bonding system applied on contralateral hemi-arch: acid etching followed by adhesive with integrated primer and light curing. Evaluates potential reduction in enamel demineralization.
Receives: Device: GC Ortho Connect™ bonding procedure

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean Enamel Decalcification Index (EDI) after Debonding

    Mean Enamel Decalcification Index (EDI) per maxillary hemi-arch after debonding of fixed orthodontic appliances. The assessment will be performed using intraoral photographs, based on the 0-3 scoring system of the Enamel Decalcification Index (EDI) by Banks \& Richmond, 1994, evaluating white spot lesions (WSLs) around maxillary metallic orthodontic brackets (AO groove .022 x .028). Results will be confirmed using a fluorescence intraoral camera.

    Measured: Up to 24 months

Secondary outcomes (20)
  1. Mean EDI per Hemi-Arch

    Mean Enamel Decalcification Index (EDI) per maxillary hemi-arch, using intraoral photographs and fluorescence intraoral camera, to the 0-3 scoring system of the Enamel Decalcification Index (EDI) by Banks \& Richmond, 1994.

    Measured: Preprocedural

  2. Mean EDI per Hemi-Arch

    Mean Enamel Decalcification Index (EDI) per maxillary hemi-arch, using intraoral photographs and fluorescence intraoral camera, to the 0-3 scoring system of the Enamel Decalcification Index (EDI) by Banks \& Richmond, 1994.

    Measured: 6 months

  3. Mean EDI per Hemi-Arch

    Mean Enamel Decalcification Index (EDI) per maxillary hemi-arch, using intraoral photographs and fluorescence intraoral camera, to the 0-3 scoring system of the Enamel Decalcification Index (EDI) by Banks \& Richmond, 1994.

    Measured: 12 months

  4. EDI per Tooth

    Enamel Decalcification Index (EDI) measured per tooth, according to the 0-3 EDI scoring system.

    Measured: Preprocedural

  5. EDI per Tooth

    Enamel Decalcification Index (EDI) measured per tooth, according to the 0-3 EDI scoring system.

    Measured: 6 months

  6. EDI per Tooth

    Enamel Decalcification Index (EDI) measured per tooth, according to the 0-3 EDI scoring system.

    Measured: 12 months

  7. EDI per Tooth

    Enamel Decalcification Index (EDI) measured per tooth, according to the 0-3 EDI scoring system.

    Measured: Up to 24 months

  8. Occurrence of bracket Detachment per tooth

    Measured: 6 months

  9. Occurrence of bracket Detachment per tooth

    Measured: 12 months

  10. Occurrence of bracket Detachment per tooth

    Measured: Up to 24 months

  11. Total number of detachments per tooth

    Measured: 6 months

  12. Total number of detachments per tooth

    Measured: 12 months

  13. Total number of detachments per tooth

    Measured: Up to 24 months

  14. Total number of detachments per patient

    Measured: 6 months

  15. Total number of detachments per patient

    Measured: 12 months

  16. Total number of detachments per patient

    Measured: Up to 24 months

  17. Plaque Index

    Plaque Index scored 0-3 according to Silness \& Loe, measured with a probe N°6

    Measured: Preprocedural

  18. Plaque Index

    Plaque Index scored 0-3 according to Silness \& Loe, measured with a probe N°6

    Measured: 6 months

  19. Plaque Index

    Plaque Index scored 0-3 according to Silness \& Loe, measured with a probe N°6

    Measured: 12 months

  20. Plaque Index

    Plaque Index scored 0-3 according to Silness \& Loe, measured with a probe N°6

    Measured: Up to 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jan 2026
  2. Study startJan 2026 (estimated)
  3. Primary completionApr 2028 (estimated)
  4. Study completionApr 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
34 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07355322
Sponsor's protocol ID
RECHMPL24_0271
Other IDs
2025-A01740-49
Acronym
ORTHOCOLLAGE
Status last verified
Jan 2026
First submitted
10 Dec 2025
Last updated
21 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Transbond™ XT bonding procedure and GC Ortho Connect™ bonding procedure in people with Tooth Demineralization and White Spot Lesion, run by University Hospital, Montpellier at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 21 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Stéphane BARTHELEMI, PU-PH (+33 6 47 75 55 33, s-barthelemi@chu-montpellier.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean Enamel Decalcification Index (EDI) after Debonding (time frame: Up to 24 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jan 2026.

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