Abstract
BackgroundDevelopment of white spot lesions around orthodontic fixed orthodontic appliances is a common finding, especially in patients with poor oral hygiene. One of the conservative interventions for regression of these lesions is using chemical solutions. The current study aimed to compare the effectiveness of fluoride and amorphous calcium phosphate (ACP) on microhardness improvement of affected enamel.Material and MethodsForty-five intact human incisor teeth were selected and randomly divided into 3 groups of 15. Fluoride group, ACP group and artificial saliva group (control group). Inducing of white spot lesion was done by PH-cycling model. Samples of the first and second group were submerged into 0.05% fluoride and 0.05% ACP solutions respectively for one minute a day. The rest of the time, all specimens were put in artificial saliva, which was incubated in 37 °c temperature. Microhardness of specimens was assessed by Vickers microhardness test in three stages: 1: Baseline microhardness assessment that was done before induction of white spot lesion, 2: Secondary microhardness assessment that was done after induction, 3: Final microhardness assessment that was done after chemical treatment. The SPSS 11.5 software was used for statistical analysis and p< 0.05 was considered as significant.ResultsMicrohardness of specimens in the fluoride and ACP groups had significantly improved after the treatment (between secondary assessment and final assessment). In the control group, no significant improvements were observed. In final assessment, there were significant differences between the ACP and control groups, but no significant differences were found neither between the fluoride and ACP, nor the Fluoride and control groups.ConclusionsAccording to the current study, both 0.05% ACP and 0.05% fluoride solutions enhanced enamel micro-hardness in treatment of white spot lesion. Key words:Microhardness, amorphous calcium phosphate, fluoride, white spot lesion.
Highlights
White spot lesions or enamel decalcification is the clinical manifestation of early enamel caries and attributes to the prolonged retention and accumulation of dental bacterial plaque
In order to compare the changes between groups, the analysis of the variance test (ANOVA test) was performed and it showed that in the final microhardness assessment, there were significant differences between the groups
No significant difference was found between the fluoride and control groups, but the amorphous calcium phosphate (ACP) group showed significant improvement in final microhardness assessment, compared to the control group
Summary
White spot lesions or enamel decalcification is the clinical manifestation of early enamel caries and attributes to the prolonged retention and accumulation of dental bacterial plaque. Evaluations using scanning electron microscopy (SEM) indicated that such bacterial plaque around orthodontic bands, could lead to marked etching of underneath enamel [8] Despite this evidence, there are studies showing that no correlation exists between orthodontic treatment and increased incidence of dental caries [9]. There are studies showing that no correlation exists between orthodontic treatment and increased incidence of dental caries [9] It is important for white spot lesions to be prevented, but these demineralized areas can be remineralized because the outermost layer of enamel remains intact and the underneath layer can be remineralized by absorbing minerals [10]. The current study aimed to compare the effectiveness of fluoride and amorphous calcium phosphate (ACP) on microhardness improvement of affected enamel. Conclusions: According to the current study, both 0.05% ACP and 0.05% fluoride solutions enhanced enamel micro-hardness in treatment of white spot lesion
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