In-vitro evaluation of various treatments to prevent demineralization next to orthodontic brackets.
BACKGROUND
One common negative side effect of orthodontic treatment with fixed appliances is the development of incipient caries lesions around brackets, particularly in patients with poor oral hygiene. Bio-available minerals from cement containing amorphous calcium phosphate (ACP) might facilitate remineralization and inhibit lesion development. Our objective was to compare the potential of ACP-containing resin cement, fluoride varnish, resin sealer, and MI Paste (GC America, Alsip, Ill) under similar in-vitro conditions to prevent incipient caries lesions next to brackets on teeth.


METHODS
One hundred extracted premolars were randomly allocated to 5 groups (n = 20). Brackets were bonded with ACP cement (Aegis-Ortho, Bosworth, Skokie, Ill), resin (Transbond XT [3M Unitek, Monrovia, Calif], control), or resin followed by application of fluoride varnish (Vanish, 3M, St Paul, Minn), resin sealer (Pro-seal, Reliance Orthodontic Products, Itasca, Ill), or casein phosphopeptide-ACP paste (MI Paste). All groups were cycled for 15 days in demineralization solution for 8 hours a day, rinsed, placed in artificial saliva (30 minutes), brushed, and stored overnight in artificial saliva. The extent of demineralization in each group was assessed by using quantitative light-induced fluorescence and confocal laser scanning microscopy.


RESULTS
Only the Pro-seal and Vanish groups showed significantly smaller lesions than the controls (Kruskal-Wallis test, P <0.05) for both quantitative light-induced fluorescence and confocal laser scanning microscopy measurements. Fluorescence loss of Aegis-Ortho was similar to Vanish; Aegis-Ortho, MI Paste, and the controls were not different from each other.


CONCLUSIONS
Both light-cured filled resin (Pro-seal) and fluoride varnish (Vanish) might prevent enamel demineralization next to orthodontic brackets exposed to cariogenic conditions, but the observed positive effects of Aegis-Ortho and MI Paste were not significant.
Department of Orthodontics, School of Dentistry, University of Michigan, Ann Arbor, Mich, USA.
Scott M
SM
Behnan
Airton O
AO
Arruda
Carlos
C
González-Cabezas
Woosung
W
Sohn
Mathilde C
MC
Peters
D001641:Bicuspid / Q000473:pathology; D002130:Calcium Phosphates / Q000737:chemistry / Q000627:therapeutic use; D002327:Cariostatic Agents / Q000737:chemistry / Q000627:therapeutic use*; D002364:Caseins / Q000627:therapeutic use; D003738:Dental Cements / Q000737:chemistry; D005453:Fluorescence; D005460:Fluorides, Topical / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D008422:Materials Testing; D018613:Microscopy, Confocal; D016910:Orthodontic Brackets / Q000009:adverse effects*; D019279:Resin Cements / Q000737:chemistry; D012464:Saliva, Artificial / Q000737:chemistry; D012969:Sodium Fluoride / Q000737:chemistry / Q000627:therapeutic use; D013997:Time Factors; D019228:Tooth Crown / Q000473:pathology; D017001:Tooth Demineralization / Q000473:pathology / Q000517:prevention & control*; D014099:Toothbrushing
C528777:Aegis Ortho adhesive; D002130:Calcium Phosphates; D002327:Cariostatic Agents; D002364:Caseins; D003738:Dental Cements; D005460:Fluorides, Topical; C090340:Reliance resin cement; D019279:Resin Cements; D012464:Saliva, Artificial; C477790:Transbond XT; C519480:amorphous calcium phosphate; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D012969:Sodium Fluoride