Casein phosphopeptide- amorphous calcium phosphate effects on brackets shear bond strength and enamel damage.

R Naseh,M Atai,F Fallahzadeh,R Setayeshrad,O Mortezai

doi:10.4317/jced.54017

Abstract

BackgroundThe aim of study was to evaluate the application of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride regarding their effect on the shear bond strength (SBS), bond failure pattern of brackets using the adhesive remnant index (ARI) and assessing the quality of enamel surface using the enamel damage index (EDI).Material and MethodsSixty extracted premolar teeth were randomly divided into four groups regarding pretreatment application of CPP-ACP and fluoride. Brackets were bonded using the conventional method. Specimens were thermocycled for 1000 cycles and were subsequently tested for the SBS in a universal testing machine. After debonding, the teeth were examined under a stereomicroscope to evaluate the ARI. Then, The EDI was assessed using a scanning electron microscope (SEM). Data were analyzed using ANOVA and the Chi-square test.ResultsEvaluation of SBS, ARI and EDI scores showed no significant difference among the study groups. However, a correlation was found between the ARI and EDI scores, indicating that with more adhesive remnants on enamel surface, enamel damage was lower.ConclusionsThe use of CPP-ACP and fluoride can be considered a prophylactic application since these agents did not compromise bracket bond strength although they did not reduce iatrogenic damage to the enamel. Key words:CPP-ACP, Enamel damage, SEM, Shear bond strength, ARI.

Highlights

The enamel is the strongest part of the human body
The Chi-square analysis revealed a significant relationship between adhesive remnant index (ARI) and enamel damage index (EDI) scores: the lower the ARI score, the higher the EDI score (P=0.037)
This study found no significant difference among the four groups in terms of ARI, but the P-value was 0.054, which was very close to statistical significance

Summary

Introduction

The enamel is the strongest part of the human body. Many studies have reported increased risk of caries creation, crack formation, and enamel decalcification during and after orthodontic treatment [1,2]. In addition to precise orthodontic procedures, using an agent that increases enamel strength can lead to more enamel resistance and decrease crack formation at the time of removing brackets, thereby reducing the possibility of iatrogenic damage [3]. The present study aims (A) to evaluate and compare CPP-ACP and fluoride in terms of their effect on the shear bond strength and bond failure pattern of brackets and (B) to assess the iatrogenic damage to the enamel after bracket removal. The aim of study was to evaluate the application of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride regarding their effect on the shear bond strength (SBS), bond failure pattern of brackets using the adhesive remnant index (ARI) and assessing the quality of enamel surface using the enamel damage index (EDI). Conclusions: The use of CPP-ACP and fluoride can be considered a prophylactic application since these agents did not compromise bracket bond strength they did not reduce iatrogenic damage to the enamel

Methods

Results

Conclusion