title: Effectiveness of varnish with CPP-ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation.
abstract: OBJECTIVE
  To evaluate the in vitro efficiency of applying varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) in prevention of caries lesions around orthodontic brackets.
  
  
  METHODS
  For this purpose, brackets were bonded to the vestibular surface of bovine incisors, and eight groups were formed (n = 15) according to exposure of oral hygiene substances and enamel varnish: 1 (control) brushing only performed, 2 (control) brushing + use of mouth wash with fluoride, 3 Duraphat varnish application only (Colgate-Palmolive Ind. E Com. Ltda, São Paulo, SP, Brazil), 4 Duraphat + brushing, 5 Duraphat + brushing + mouth wash, 6 MI Varnish application (GC America, USA), 7 MI + brushing, and 8 MI + brushing + mouth wash. The experimental groups alternated between pH cycling and the procedures described and were kept in an oven at temperature of 37°C. Both brushing and immersion in solutions was performed in a time interval of 1 minute, followed by washing in deionized water three times a day for 28 days of experimentation. Afterwards, evaluation by optical coherence tomography (OCT) of the special type (Ganymede OCT/Thorlabs, Newton, USA) was performed. In each group, a scanning exam of the white spot lesion area (around the region where brackets were bonded) and depth measurement of caries lesions were performed.
  
  
  RESULTS
  Groups 1 and 3 were shown to differ statistically from groups 5, 6, 7, and 8 (p = 0.000). MI Varnish was shown to be more effective in diminishing caries lesion depth, compared with Duraphat, irrespective of being associated with brushing and mouth wash, or not.
  
  
  CONCLUSIONS
  The major limitation of this study is that it is a study in which demineralization was obtained with the use of chemical products, and did not occur due to the presence of Streptococcus mutans and its acid byproducts.
  
  
  CONCLUSIONS
  Application CPP-ACP-containing varnish irrespective of being associated with brushing and mouthwash, or not, reduced depth of caries lesions around orthodontic brackets.
authors.affiliation: *Departments of Health, Southwest Bahia State University, Jequié, Bahia, Brazil, matheuspithon@gmail.com.
authors.forename: Matheus M
authors.initials: MM
authors.lastname: Pithon
authors.affiliation: *Departments of Health, Southwest Bahia State University, Jequié, Bahia, Brazil.
authors.forename: Mariana J
authors.initials: MJ
authors.lastname: Dos Santos
authors.affiliation: *Departments of Health, Southwest Bahia State University, Jequié, Bahia, Brazil.
authors.forename: Camilla S S
authors.initials: CS
authors.lastname: Andrade
authors.affiliation: **Program in Orthodontics, School of Health and Biosciences, Pontifıcia Universidade Catolica do Parana, Curitiba, Paraná, Brazil.
authors.forename: Jorge César B
authors.initials: JC
authors.lastname: Leão Filho
authors.affiliation: ***Biomedical Engineering Postgraduate Program, Universidade Federal de Pernambuco, Recife, Brazil, and.
authors.forename: Ana Karla S
authors.initials: AK
authors.lastname: Braz
authors.affiliation: ***Biomedical Engineering Postgraduate Program, Universidade Federal de Pernambuco, Recife, Brazil, and.
authors.forename: Renato E
authors.initials: RE
authors.lastname: de Araujo
authors.affiliation: **Program in Orthodontics, School of Health and Biosciences, Pontifıcia Universidade Catolica do Parana, Curitiba, Paraná, Brazil.
authors.forename: Orlando M
authors.initials: OM
authors.lastname: Tanaka
authors.affiliation: ****Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Brazil.
authors.forename: Tatiana K S
authors.initials: TK
authors.lastname: Fidalgo
authors.affiliation: ****Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Brazil.
authors.forename: Adrielle M
authors.initials: AM
authors.lastname: Dos Santos
authors.affiliation: ****Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Brazil.
authors.forename: Lucianne C
authors.initials: LC
authors.lastname: Maia
mesh_terms: D000818:Animals; D002364:Caseins / Q000627:therapeutic use*; D002417:Cattle; D001840:Dental Bonding; D003731:Dental Caries / Q000209:etiology / Q000517:prevention & control*; D003743:Dental Enamel / Q000187:drug effects; D004353:Drug Evaluation, Preclinical / Q000379:methods; D005459:Fluorides / Q000627:therapeutic use; D005460:Fluorides, Topical / Q000627:therapeutic use; D005899:Glass Ionomer Cements / Q000627:therapeutic use; D009910:Oral Hygiene / Q000379:methods; D016910:Orthodontic Brackets / Q000009:adverse effects*; D010150:Paint; D010710:Phosphates / Q000627:therapeutic use; D012969:Sodium Fluoride / Q000627:therapeutic use; D041623:Tomography, Optical Coherence / Q000379:methods
chemical_list: D002364:Caseins; D005460:Fluorides, Topical; C091837:GC dentin cement; D005899:Glass Ionomer Cements; D010710:Phosphates; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; C023807:sodium fluoride topical preparation; C012980:fluorophosphate; D012969:Sodium Fluoride; D005459:Fluorides