Abstract
Introduction: One of the most difficult problems in orthodontic treatment with fixed appliances is enamel demineralization around the brackets. This iatrogenically caused white spot lesions leads to poor esthetics; and in severe cases it may need restorative treatment.
 Objective: To evaluate in vivo effect of Amorphous Calcium Phosphate (ACP)-containing orthodontic composite on enamel demineralization around orthodontic brackets, and to compare it with the conventional resin based orthodontic composite.
 Materials & Method: 20 orthodontic patients planned for four first premolars extraction were selected for the study. All first premolars were bonded with Aegis Ortho, an ACP-containing orthodontic composite (experimental group), and Transbond XT, a resin-based orthodontic composite (control group). After 45 days teeth were extracted, sectioned for the microhardness group and evaluated by superficial-microhardness analysis and stereomicroscopic study. Unpaired t-test and analysis of variance (ANOVA) test was performed.
 Result: The ANOVA showed statistically significant differences for position, material, depth, and their interactions (p <0.001). The multiple comparison test showed that the ACP-containing orthodontic composite was significantly more efficient than the conventional composite, reducing enamel demineralization in almost all evaluations (p <0.001). The stereomicroscopic examinations showed a lesser extent of demineralization around orthodontic brackets for the ACP-containing orthodontic composite group.
 Conclusion: ACP-containing orthodontic composite for bonding orthodontic brackets successfully inhibited demineralization, which was localized to the area around the brackets.
Highlights
One of the most difficult problems in orthodontic treatment with fixed appliances is enamel demineralization around the brackets
According to Skrtic et al;[10] calcium and phosphate ions released from Amorphous Calcium Phosphate (ACP)-containing composites, especially in response to the change in oral environment caused by bacterial plaque or acidic foods can be deposited into the tooth structures as an apatite mineral, which is similar to the hydroxyapatite found naturally in teeth
Teeth bonded with ACP-containing material are significantly more resistant to demineralization than those bonded with the regular Transbond XT composite even in patients known for high caries risk
Summary
One of the most difficult problems in orthodontic treatment with fixed appliances is enamel demineralization around the brackets. This iatrogenically caused white spot lesions leads to poor esthetics; and in severe cases it may need restorative treatment. Objective: To evaluate in vivo effect of Amorphous Calcium Phosphate (ACP)-containing orthodontic composite on enamel demineralization around orthodontic brackets, and to compare it with the conventional resin based orthodontic composite. The stereomicroscopic examinations showed a lesser extent of demineralization around orthodontic brackets for the ACP-containing orthodontic composite group. One of the most difficult problems in orthodontic treatment with fixed appliances is enamel demineralization and formation of white spot lesions around the brackets. The prevalence of demineralization in orthodontic patients has been reported between 2% to 97% by Mizrahi[2] and Gorelick et al.[3]
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