title: Determinants of enamel decalcification during simulated orthodontic treatment.
abstract: OBJECTIVE
  To determine the relative effects that phosphoric acid etching, metal brackets, composite resin adhesives, and filled resin sealants have on enamel decalcification.
  
  
  METHODS
  One hundred and fifty teeth were randomly divided into six groups to test the effects of acid etching, brackets, and a composite resin adhesive. The right side of each tooth was sealed. The teeth were submitted to a simulated carious challenge by Streptococcus mutans in a nutritive media for 42 days. Scanning electron photomicrographs (SEMs) were used to qualitatively evaluate the tooth surfaces. DIAGNOdent laser fluorescence was used to quantify the decalcification changes that occurred.
  
  
  RESULTS
  SEMs showed normal enamel on the control teeth, etching patterns on the acid-etched teeth, surface degradation on the teeth that had resin, and sealant tags on the sealed side. The untreated control group showed significantly less decalcification (P ≤ .05) than did all groups except the no etch+bracket group. The no etch+bracket group showed significantly less decalcification than did the etch+bracket, no etch+resin, and the etch+resin groups. Acid-etched teeth demonstrated significantly more decalcification (34%) than did those that were not etched. The teeth with resin showed significantly more decalcification (24%) than did those without resin. There was no significant difference between teeth that did and did not have brackets. The unsealed side of the teeth showed small amounts of--but significantly more--decalcification (5%) compared to the sealed side.
  
  
  CONCLUSIONS
  Acid etching and composite resin adhesives increase enamel decalcification in vitro, while brackets do not. Filled resin sealants protect the teeth from decalcification.
authors.affiliation: Private Practice, Baton Rouge, LA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hess
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Campbell
authors.forename: Allen L
authors.initials: AL
authors.lastname: Honeyman
authors.forename: Peter H
authors.initials: PH
authors.lastname: Buschang
mesh_terms: D000134:Acid Etching, Dental / Q000009:adverse effects / Q000379:methods*; D003188:Composite Resins / Q000009:adverse effects / Q000737:chemistry*; D003470:Culture Media; D003731:Dental Caries / Q000209:etiology / Q000382:microbiology; D003743:Dental Enamel / Q000382:microbiology / Q000648:ultrastructure*; D005453:Fluorescence; D006801:Humans; D007834:Lasers; D008855:Microscopy, Electron, Scanning; D016910:Orthodontic Brackets / Q000009:adverse effects; D010756:Phosphoric Acids / Q000737:chemistry; D019279:Resin Cements / Q000009:adverse effects / Q000737:chemistry*; D013295:Streptococcus mutans / Q000502:physiology; D017001:Tooth Demineralization / Q000209:etiology* / Q000382:microbiology
chemical_list: D003188:Composite Resins; D003470:Culture Media; D010756:Phosphoric Acids; D019279:Resin Cements; C477790:Transbond XT; C516047:Transbond XT Light Cure Adhesive Primer; C030242:phosphoric acid