Evaluation of remineralising agent on enamel around orthodontic brackets – an in-vitro study

Abstract

Objective: This study was designed to evaluate the relative efficiency of GC Tooth Mousse Plus which contains amorphous calcium phosphate casein phosphopeptide (ACP-CPPF) with sodium fluoride 0.2% w/w (900ppm) to inhibit enamel demineralization adjacent to orthodontic brackets in vitro. Materials and methods: 30 non carious, human maxillary premolars with no visible enamel defects were collected. For all thirty samples, pre adjusted edge wise stainless steel premolar brackets were bonded on the teeth with light cure composite resin. The teeth were randomly assigned into two groups of 15 teeth each and coded with unique colored nail varnish leaving a rectangular window extending occlusally The teeth in each group were immersed separately in an artificial saliva solution for 11 hours and an acid solution for 1 hr maintained at room temperature. After each acid challenge the surface layers in the exposed enamel windows in both groups were removed by brushing with a soft tooth brush. Group 1, control group didn’t receive any application and group 2 received GC Tooth mousse plus respectively. The teeth were immersed alternately in the saliva and acid solution for 31 days. After 31 days the brackets were removed and the teeth mounted in polyester resin. The teeth were sectioned longitudinally through the buccal window. Two sections, each approximately 0.5 mm thick were obtained from each specimen. The sections were mounted in water and photographed with a polarised light microscope at 4x magnifications. Results: The results of this study showed that amorphous calcium-phosphate casein phosphop eptide fluoride (ACP-CPPF) (GC Tooth mousse plus)on daily application will provide maximum protection against the enamel demineralization in orthodontic patients, by reducing the lesion formation and simultaneously remineralizing the demineralised area by providing calcium phosphate ions and fluoride ions constantly. Conclusion: Amorphous calcium-phosphate casein phosphopeptide fluoride (GC Tooth mousse plus) when applied has a definite benefit in preventing the enamel demineralization adjacent to orthodontic brackets over the controls. Amorphous calcium-phosphate casein phosphopeptide fluoride (GC Tooth mousse plus) showed better efficiency in reducing the demineralization and enhancing the remineralization around the orthodontic brackets with good patient compliance.