Abstract
Background. Enamel demineralization around orthodontic brackets is an important clinical problem. This study sought to compare the efficacy of sodium fluoride (NaF), casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACP-F; MI Paste Plus) and a water-based cream (Remin Pro), which contains hydroxyapatite and fluoride for prevention of enamel demineralization. Methods. Fifty-six sound human premolars extracted for orthodontic purposes were collected. After cleaning, the crowns were mounted in acrylic resin and all the surfaces were coated with nail varnish except for a 3×4-mm window on the buccal surface. The samples were randomly divided into four groups of 14 and subjected to pH cycling for 14 days, during which the teeth were immersed in artificial saliva for 21 hours and in demineralizing agent for three hours daily. Before transferring the samples from the saliva to the demineralizing solution, the remineralizing agent (0.05% NaF, MI Paste Plus or Remin Pro Paste, depending on the group) was applied on the samples once a day for five minutes. No remineralizing agent was used in the control group. Surface microhardness of samples was measured by Vickers microhardness tester at baseline and after the intervention. The data were analyzed using one-way ANOVA, ANCOVA, Bonferroni test and Tukey test. Statistical significance was set at P<0.05. Results. The mean microhardness was significantly different between the test and control groups (P<0.0001). Other differences were not significantly different (P>0.05). Conclusion. The results showed that 0.05% NaF was more efficient than Remin Pro and MI Paste Plus for prevention of white spot lesions (WSLs). Remin Pro and MI Paste Plus were not significantly difference from the control group in this regard.
Highlights
Enamel demineralization around orthodontic brackets is an important clinical problem
This study sought to compare the efficacy of sodium fluoride (NaF), casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACP-F; MI Paste Plus) and a water-based cream (Remin Pro), which contains hydroxyapatite and fluoride for prevention of enamel demineralization
The results showed that 0.05% NaF was more efficient than Remin Pro and MI Paste Plus for prevention of white spot lesions (WSLs)
Summary
Enamel demineralization around orthodontic brackets is an important clinical problem. The prevalence of white spot lesions (WSLs) in orthodontic patients ranges from 25% to 46%.1-3 These lesions most commonly occur in the cervical part of the middle third of the crowns of first molar, lateral incisor and canine teeth.[4] White spot lesions can be detected as white opaque lesions after air-drying the teeth.[5] These lesions often develop after four weeks if no anticariogenic agent is used, which highlights their fast occurrence.[6] High prevalence of enamel decalcification during fixed orthodontic treatment is partly attributed to the irregular bracket surface and presence of orthodontic wires, bands and other attachments, which enhance plaque retention, complicate oral hygiene and limit the self-cleaning capacity of teeth with the salivary flow and movement of oral muscles. Prevention is superior to treatment.[7] No consensus has been reached on an efficient, predictable and esthetically acceptable treatment for these lesions.[4] The most important preventive measure is to increase enamel resistance against acid attacks.[9] The ability of bacterial biofilm to absorb calcium, phosphate and fluoride from the saliva and extraoral sources results in enamel remineralization following demineralization. This study sought to compare the efficacy of sodium fluoride (NaF), casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACP-F; MI Paste Plus) and a water-based cream (Remin Pro), which contains hydroxyapatite and fluoride for prevention of enamel demineralization
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