title: Efficacy of different strategies in protecting enamel against demineralization during fixed orthodontic treatment.
abstract: OBJECTIVE
  Sealant application is a common strategy for preventing enamel demineralization during multibracket treatment. The aim of this study was to assess the efficacy in enamel demineralization prevention of two fluoride-containing enamel varnishes compared to a non-fluoride varnish, weekly fluoride gel application, and a non-treated control group.
  
  
  METHODS
  Enamel specimens obtained from 75 human upper permanent incisors were randomly allocated to five trial groups (each n = 15): A), ProSeal (Reliance), B), Maximum Cure® (Reliance), C), CervitecPlus (Ivoclar Vivadent, Schaan, Liechtenstein), D) elmex® gelée (GABA, Lörrach, Germany), and E), a non-treated control group. Groups A-C received a baseline varnish application, whereas group D specimens received a once weekly gel application for 2 min. Six demineralization cycles per day were carried out for 5 min each using 0.05 M citric acid, with the specimens stored in remineralization solution between cycles. Lesion depth expressed in percentage fluorescence loss (Δ-F in %) compared to baseline (T0) was assessed quantitatively with light-induced fluorescence (QLF) after 3 (T1), 7 (T2), 14 (T3), and 30 (T4) days globally and for each time point, and analyzed for compounds using the Kruskal-Wallis test (α = 5%), and additional one-sample Wilcoxon tests for each time/compound combination (Bonferroni-corrected α-levels α* = 0.05/4 = 0.0125).
  
  
  RESULTS
  Significant fluorescence loss revealing greater lesion depth was detected in the untreated controls (E) at T3, and in groups A (ProSeal) and C (CervitecPlus) at T4. No significant Δ-F changes were seen in the specimens from groups B (Maximum Cure®) and D (elmex® gelée).
  
  
  CONCLUSIONS
  Maximum Cure® sealant seems to offer efficient protection against demineralization during fixed orthodontic treatment, as does weekly application of elmex® fluoride gel.
authors.affiliation: mknoesel@yahoo.de
authors.forename: Michael
authors.initials: M
authors.lastname: Knösel
authors.forename: Linda
authors.initials: L
authors.lastname: Forslund
authors.forename: Klaus
authors.initials: K
authors.lastname: Jung
authors.forename: Dirk
authors.initials: D
authors.lastname: Ziebolz
mesh_terms: D002327:Cariostatic Agents / Q000627:therapeutic use; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000187:drug effects*; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009967:Orthodontic Appliances / Q000009:adverse effects*; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D011859:Radiography; D017001:Tooth Demineralization / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D002327:Cariostatic Agents; D005460:Fluorides, Topical; D010895:Pit and Fissure Sealants