Effects of different topical agents on enamel demineralization around orthodontic brackets: an in vivo and in vitro study.
BACKGROUND
The aim of this study was to evaluate the in vivo and in vitro effects of a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride containing topical agents in reducing enamel demineralization around orthodontic brackets, and to compare this with a control group.


METHODS
Twenty-one patients and 60 extracted premolars were divided into three groups: two experimental and one control. Tooth Mousse® (CPP-ACP gel; GC-Corp, Tokyo, Japan) and Fluoridin N5® (Fluoride gel; Voco-GmbH, Cuxhaven, Germany) were applied to tooth surfaces around orthodontic brackets in the experimental groups. Teeth were extracted after 60 days to evaluate the in vivo effects of the testing materials. For the in vitro experiment, samples were cycled for 14 days through a daily procedure of demineralization. All teeth were sectioned and evaluated by superficial microhardness analysis. An indentation was made from two positions (occlusal-cervical) and one depth (10 μm).


RESULTS
Comparisons of occlusal and cervical microhardness scores for all specimens showed no statistically significant side differences. A multiple comparison test showed that the use of CPP-ACP and fluoride containing topical gels were more significantly efficient than the control group (p<0.001). No significant differences were detected between CPP-ACP and the fluoride groups against demineralization.


CONCLUSIONS
In vivo and in vitro evaluations indicated that CPP-ACP and fluoride containing agents successfully inhibited caries around orthodontic brackets.
Uysal
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T
Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey and King Saud University, Riyadh, Saudi Arabia. tancanuysal@yahoo.com
Amasyali
M
M
Koyuturk
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AE
Ozcan
S
S
D000134:Acid Etching, Dental / Q000379:methods; D000293:Adolescent; D002021:Buffers; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002364:Caseins / Q000627:therapeutic use*; D003722:Dental Alloys / Q000737:chemistry; D003743:Dental Enamel / Q000187:drug effects*; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use*; D005782:Gels; D006244:Hardness; D006801:Humans; D055115:Light-Curing of Dental Adhesives; D008297:Male; D008422:Materials Testing; D016910:Orthodontic Brackets; D019279:Resin Cements / Q000737:chemistry; D012463:Saliva / Q000378:metabolism / Q000502:physiology; D012636:Secretory Rate / Q000502:physiology; D013193:Stainless Steel / Q000737:chemistry; D019237:Tooth Cervix / Q000187:drug effects; D019228:Tooth Crown / Q000187:drug effects; D017001:Tooth Demineralization / Q000517:prevention & control*
D002021:Buffers; D002327:Cariostatic Agents; D002364:Caseins; D003722:Dental Alloys; D005460:Fluorides, Topical; D005782:Gels; D019279:Resin Cements; C477790:Transbond XT; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; C112191:fluoridin N-5; D013193:Stainless Steel