Comparison of fluoride release protocols for in-vitro testing of 3 orthodontic adhesives

Effect of Fluoride Release on Enamel Demineralization Adjacent to Orthodontic Brackets

INTRODUCTION AND AIM

This study aimed to evaluate the ability of fluoride-releasing adhesives to inhibit enamel demineralization surrounding orthodontic brackets.

METHODS

Two groups of 40 sound human premolars were sectioned mesio-distally. The halves were varnished, and orthodontic brackets were bonded with different adhesive materials. An area 1 mm wide surrounding the brackets was left exposed. Each specimen was immersed daily in a pH cycle for 28 days. In the second group, the specimens were exposed daily to a fluoride solution (250 ppm F-) at 37°C. The fluoride release from different groups was measured. Quantitative light-induced fluorescence (QLF) was used to quantify fluorescence loss of enamel surfaces adjacent to the brackets. Results were statistically analyzed using ANOVA at (p<0.05).

RESULTS

Fluoride released from the three fluoride-releasing adhesives was significantly higher (p<0.001) in the group with daily fluoride exposures than in the group without fluoride exposures. Enamel adjacent to brackets bonded with Fuji Ortho LC, Ketac Cem, and Dyract Cem showed significantly less (p<0.001) changes in (ΔQ) value (less demineralization) than enamel bonded with Transbond, the control adhesive material.

CONCLUSIONS

Using fluoride-releasing adhesives significantly reduced the level of demineralization adjacent to orthodontic brackets.

Influence of resin-modified glass ionomer and topical fluoride on levels of Streptococcus mutans in saliva and biofilm adjacent to metallic brackets

Decalcification of enamel during fixed orthodontic appliance treatment remains a problem. White spot lesions are observed in nearly 50% of patients undergoing orthodontic treatment. The use of fluoride-containing orthodontic materials has shown inconclusive results on their ability to reduce decalcification. The aims of this investigation were to compare the levels of Streptococcus mutans (SM) in saliva and biofilm adjacent to orthodontic brackets retained with a resin-modified glass ionomer cement (RMGIC) (Fuji ORTHO LC) and a light cured composite resin (Transbond XT), and to analyze the influence of topical application of the 1.23% acidulated phosphate fluoride (APF) on SM counts. In a parallel study design, two groups (n=14/15) were used with random allocation and high salivary SM counts before treatment. Biofilm was collected from areas adjacent to the brackets on teeth 13, 22, 33, and 41. Both saliva and biofilm were collected on the 7th, 21st, 35th, and 49th days after appliance placement. Topical fluoride application was carried out on the 35th day. Bonding with RMGIC did not alter SM counts in saliva or biofilm adjacent to the brackets. On the other hand, the biofilm adjacent to brackets retained with composite resin showed a significant increase in SM counts along the trial period. Topical application of 1.23% APF did not reduce salivary or biofilm SM counts regardless of the bonding material. In conclusion, fluoride topical application did not show efficacy in reducing SM. The use of RMGIC as bonding materials allowed a better control of SM cfu counts in dental biofilm hindering the significant increase of these microorganisms along the trial period, which was observed in the biofilm adjacent to the composite material.

Fluoride release and uptake abilities of different fissure sealants

Background

The long-term capability of resin sealants and glass ionomer cements to release fluoride is associated to a reduction in pit and fissure caries. The regular use of fluoride varnishes/toothpastes can result in the absorption of fluoride into the sealant. The objective of the present study was to assess the fluoride release/uptake capacities of different fissure sealants.

Material and Methods

Three different fissure sealants (Fuji Triage/GC, Fissurit FX/Voco and Grandio Seal/Voco) were examined. Ten discs of each material were prepared. Each disc was incubated with distilled water and then the solution analyzed for diluted for fluoride concentration, using a combination of fluoride electrode (OrionGP 1 S/N 13824, Orion Research Inc, Boston, MA, USA) connected to an expandable ion analyzer (Orion 720A, Orion Research Inc, Boston, MA, USA). Standard curves between 1 and 100 ppm F- were used to calibrate the electrode. Cumulative fluoride release was measured on days 1, 2, 3, 5, 7, 21, 35 and 49, then two different fluoride varnishes/pastes (Profluorid Varnish/Voco, MI Paste Plus/GC), were applied to the sealants tested, and fluoride release (after reuptake) was measured on days 56, 70 and 84.

Results

Kruskal Wallis test confirmed significant differences in fluoride release between Fuji Triage/GC and Fissurit FX/Voco and Grandio Seal/Voco from day 1 (P < 0.001). The application of fluoride varnish Profluorid Varnish enhanced the fluoride release for all sealants (P < 0.05). MI Paste Plus enhanced the fluoride release for all sealants except for Fuji Triage/GC (P > 0.05).

Conclusions

The GIC-based sealant (Fuji Triage/GC) released significantly more fluoride than the resin sealants tested. The exposure to the fluoridated varnish (Profluorid Varnish) significantly recharged the sealants tested more than the CPP-ACPF toothpaste (MI Paste Plus).

Key words:Fissure sealants, fluoride release, fluoride uptake, glass ionomer cements.

Fluoride release/uptake from different orthodontic adhesives: a 30-month longitudinal study

The aim of this study was to test the null hypothesis that there is no difference in fluoride release between resin-modified glass ionomer cements (RMGICs) and composites in the long term. The materials were divided into 5 groups: a nonfluoride-releasing composite - Group TXT (Transbond XT), a fluoride-releasing composite - Group QC (Quick-Cure), and three RMGICs - Groups FOLC, FOB and MC (Fuji Ortho LC, Fuji Ortho Band, and Multi-Cure). Fluoride release was measured at time intervals of 1 h, 1, 7, 14, 21 and 29 days, followed by further evaluations performed at 6, 12, 18, 24 and 30 months using selective ion electrodes connected to an ionic analyzer. Fluoride releasing and re-releasing experiments were analyzed using the Kruskal-Wallis test and Mann-Whitney test with the Bonferroni correction. The amount of fluoride released by FOB was larger in comparison with the other adhesives (p=0.01). In the long-term, FOLC and MC had a similar performance (p>0.05). The composites presented a low fluoride release, but fluoride ion uptake and re-release capacity of QC was statistically significant (p<0.05) during the experiment. In conclusion, the null hypothesis was rejected, the RMGIC Fuji Ortho Band and the composite Quick-Cure presented greater fluoride release and re-release capacity when recharged.

Efficacy of professional hygiene and prophylaxis on preventing plaque increase in orthodontic patients with multibracket appliances: a systematic review

BACKGROUND

Plaque increase is a troubling side-effect of fixed orthodontic therapy. This generally arise as a consequence of long-term difficulty in maintaining adequate oral hygiene while wearing multibracket appliances. Demineralization, also known as white spot, causes particular concern as it spoils the aesthetic outcome of the treatment itself, not to mention the integrity of the enamel.

OBJECTIVES

To collate the existing literature by evaluating the efficacy of dental hygienist intervention on plaque increase in fixed orthodontics patients.

MATERIALS AND METHODS

A targeted search of the Medline database (Entrez PubMed), EMBASE, and CENTRAL using relevant Medical Subject Headings was performed. The articles selected were all published before June 2013 and comprised randomized clinical trials, prospective longitudinal controlled clinical trials, and before/after studies onto the plaque increase of fixed appliances.

RESULTS

The search strategy yielded 630 articles. Following the application of inclusion and exclusion criteria, 10 articles qualified for the final review.

CONCLUSION

The quality of the retrieved researches ranged from low (one study) to high (one study). Six controlled trials were considered at unknown risk of bias. Data showed that regular patient motivation sessions and mechanical tooth cleaning by a professional dental hygienist help maintaining good oral hygiene during fixed orthodontics.

Influence of different mechanisms of fluoride release from adhesive systems

The objective of this study was to evaluate in vitro the time-dependent fluoride (F) release from three adhesive systems: Clearfil Protect Bond (CPB - Kuraray), FL Bond II (FLB- Shofu) and Adper Single Bond 2 (SB2 - 3M ESPE) (negative control). CPB and FLB are fluoride containing adhesives that use different F releasing mechanisms. The tested hypothesis was that the F releasing mechanism influences the amount of released F in water. Disc-shaped specimens (5 mm × 3 mm) were fabricated using a plastic matrix (Demetron Research Corp). Three specimens were produced for each material and each period of evaluation (1, 7, 14, 21 and 28 days) (n=3). Subsequently, the specimens were stored in 10 mL distilled water at 37° C until the analyses were done using a liquid membrane for selective F ion electrode (Orion 710). Four readings were performed on the first day and the remaining evaluation times had one reading/day. Results were statistically analyzed by two-way ANOVA and Tukey's test (α=0.05). CPB released the greatest amount of fluoride in all evaluated periods with the greatest value at 6th h (0.183 ppm) thereafter decreasing gradually up to the 7th day when it significantly increased again until the 21st day. In most measurements, FLB showed similar mean fluoride release values as SB2. Therefore, the fluoride release mechanism influenced the amount of fluoride released in water, confirming the study hypothesis.

Orthodontic cements: immediate protection and fluoride release

OBJECTIVES: The objective of the authors was to evaluate fluoride release of 3 glass ionomer cements with immediate protection of fluoride varnish (Cavitine, SS White), divided into 3 groups: Group M (Meron, VOCO), Group V (Vidrion C, SS White) and Group KC (Ketac-Cem, 3M ESPE). METHODS: Fluoride release was measured during 60 days by means of an ion-selective electrode connected to an ion analyzer. After 4 weeks, the test specimens were exposed to a solution of 0.221% sodium fluoride (1000 ppm of fluoride). RESULTS: Results showed that the cements reached a maximum peak of fluoride release in a period of 24 h. There was a statistically significant difference between the amount of fluoride released after the applications of fluoride among the groups from the 31st to 60th day (p> 0.05). CONCLUSION: The Vidrion C and Meron cements showed better performance to uptake and release fluoride when compared with Ketac-Cem cement.

Effects of enamel deproteinization on bracket bonding with conventional and resin-modified glass ionomer cements

The objective of this study was to test the effects of enamel deproteinization on bracket bonding with conventional and resin-modified glass ionomer cement (RMGIC). One hundred premolars, extracted for orthodontic reasons, were divided into five groups (n = 20). Group 1 (control): enamel was etched with 35 per cent phosphoric acid, a thin layer of adhesive was applied, and the brackets were bonded with Transbond XT. Group 2: enamel was etched with 10 per cent polyacrylic acid and the brackets were bonded with conventional glass ionomer cement (GIC). Group 3: enamel was treated with 5.25 per cent NaOCl, etched with 10 per cent polyacrylic acid, and the brackets were bonded with conventional GIC. Group 4: enamel was etched with 10 per cent polyacrylic acid and the brackets were bonded with RMGIC. Group 5: enamel was treated with 5.25 per cent NaOCl, etched with 10 per cent polyacrylic acid, and the brackets were bonded with RMGIC. The teeth were stored in distilled water for 24 hours before they were submitted to shear testing. The results demonstrated that bond strength values of group 1 (17.08 ± 6.39 MPa) were significantly higher in comparison with the other groups. Groups 2 (3.43 ± 1.94 MPa) and 3 (3.92 ± 1.57 MPa) presented values below the average recommended in the literature. With regard to adhesive remnant index, the groups in which the enamel was treated with NaOCl showed a behaviour similar to that of the resin composite. It is conclude with enamel treatment with NaOCl increased bonding strength of brackets bonded with GIC and RMGIC, but increased bond strength was not statistically significant when compared to the untreated groups.

An in-vitro assessment of weekly cumulative fluoride release from three glass ionomer cements used for orthodontic banding

OBJECTIVES

To compare the in-vitro Weekly Cumulative Fluoride Release (WCFR) of three Glass Ionomer Cements (GICs) used for orthodontic banding.

MATERIALS AND METHODS

The GICs tested were Granitec (Confi-Dental, Louisville, CO, USA), Bandtite (American Orthodontics, Sheboygan, WI, USA) and Ariadent (Apadana Tak Co, Tehran, Iran). Fifteen discs of each GIC were constructed (6mm diameter and 1.5mm depth). Specimens were immersed in 5 ml of deionised water and the WCFR was measured at weekly intervals, on days 1, 8, 15, 22 and 29 after immersion in deonised water, using the potentiometery device and single junction saturated calomel electrode technique (Jenway, England, UK). To compare the WCFR profile of 3 GICS, data were subjected to the one-way analysis of variance (ANOVA), and were appropriate, the Scheffe or Tamhane multiple comparison tests (post-hoc). For assessing the longitudinal changes of average WCFRs in 3 GICs, the repeated measures ANOVA were used. Post hoc tests using the Bonferroni correction was also used to compare the average WCFRs at different time-points.

RESULTS

One-way ANOVA and post-hoc multiple comparison tests revealed significant differences in WCFR among 3 GICs at five time-points (p<0.05). The post-hoc multiple comparison test revealed Bandtite cement had consistently higher WCFR at all time-points, compared to Granitec and Ariadent cements (p<0.05). The one-way ANOVA test revealed significant differences in WCFR at different time-points for all GIC groups (p<0.05). The day 8 exhibited the highest WCFR for all GICs. The repeated measures ANOVA test revealed significant differences in WCFR at different time-points for all GIC groups (p<0.0005). Reviewing average WCFR on days 22 and 29, these values for Granitec, Bandtite and Ariadent GICs, were higher (p<0.05), not different (p>0.05), and significantly lower (p<0.05) than the day 1 values, respectively.

CONCLUSIONS

Bandtite followed by Granitec showed higher WCFR compared to Ariadent.

Efficacy of light-activated sealant on enamel demineralization in orthodontic patients: an atomic force microscope evaluation

OBJECTIVE

The purpose of this study was to investigate the efficacy of (Pro Seal) sealant in preventing enamel decalcification in-vivo and compare its effect with fluoride varnish and unfilled sealant using atomic force microscopy.

MATERIALS AND METHODS

Eight orthodontic patients who were candidates for extraction of all first premolars for orthodontic treatment were recruited to this study. Thirty two premolars (upper and lower) were randomly divided into four groups (n=8) for each group, 4 maxillary and 4 mandibular); Control (no -treatment); Fluoride varnish, Unfilled sealant (Light Bond) and filled sealant (Pro-Seal). After two months the brackets were debonded and the teeth were extracted and prepared for Atomic force microscopic scanning. Each sample was scanned twice at two different scan areas 50 and 10µm at the buccal cervical third of the crown. Images were recorded with slow scan rate and resolution and the mean roughness height and total surface area were calculated for each scan area. Comparison between groups was performed using one way analysis of variance test with level of significance was set to be 0.05.

RESULTS

Pro Seal treated samples show the lowest roughness height and total surface area.

CONCLUSION

Pro Seal was the most effective prophylaxis technique in preventing enamel demineralization during orthodontic treatment.

Effect of 10% papain gel on enamel deproteinization before bonding procedure

OBJECTIVE

To test the null hypothesis that enamel deproteinization with 10% papain gel does not increase the shear bond strength of orthodontic brackets bonded with resin-modified glass ionomer cement (RMGIC).

MATERIALS AND METHODS

One hundred and twenty bovine incisors were used and divided into eight groups: 1) Transbond XT according to the manufacturer's recommendations, 2) Transbond XT deproteinized with 10% papain gel, 3) RMGIC without enamel deproteinization and without etching, 4) RMGIC without enamel etching and with deproteinization with 10% papain gel, 5) RMGIC deproteinized with 10% papain gel and etched with polyacrylic acid, 6) RMGIC deproteinized with 10% papain gel and etched with phosphoric acid, 7) RMGIC deproteinized with 2.5% sodium hypochlorite, and 8) RMGIC etched with polyacrylic acid. After bonding, the mechanical tests were performed in a Universal mechanical test machine. The values obtained were submitted to an analysis of variance and afterward to the Tukey test (P < .05).

RESULTS

It was demonstrated that group 2 presented the highest shear bond strength value, and this differed statistically from the others; group 3 presented the lowest value and showed no differences from groups 4, 5, 7, and 8. Regarding the Adhesive Remnant Index, groups 2 and 6 presented the best results and groups 3 and 8 the worst. It could be concluded that enamel deproteinization with 10% papain gel increases the shear bond strength, irrespective of the etching agent.

CONCLUSIONS

The hypothesis is rejected. Papain gel was shown to be a new ally in the orthodontic clinic.

Release of metal ions from orthodontic appliances by in vitro studies: a systematic literature review

In the present work, a systematic literature review on release of metal ions from orthodontic appliances under in vitro conditions is described. Detailed and schematic analysis of used materials and applied methods (immersion media, incubation time, temperature, and analytical techniques) is provided. The PubMed search identified 40 studies, among which eight met the selection criteria. One additional study was included in the review. All the authors agreed that the doses of released metal ions were far below the toxic level and the dietary intake. Although the concentrations of metal ions in immersion media greatly differed, the general conclusions were coherent. It must be underlined that the main disadvantage of in vitro tests was that the experimental setup did not reflect in vivo conditions, e.g., the presence of biofilm, which grows on the surface of the materials in oral cavity. The presence and activity of microflora to a large extent is responsible for the process of corrosion, in particular, biodeterioration. The further scheme of in vitro research should incorporate changeable conditions of oral cavity environment (pH, dynamic conditions-saliva flow) and the presence of microbiological flora (microbiological attack) in the experimental design and, first of all, the real proportions of appliance elements.

Avaliação da resistência ao cisalhamento de braquetes colados com resinas ortodônticas fluoretadas

OBJETIVO: avaliar a resistência ao cisalhamento de braquetes metálicos colados com resinas que contêm flúor, comparando-as a uma resina convencional; e analisar a quantidade de adesivo remanescente na superfície do esmalte. MÉTODOS: sessenta pré-molares foram divididos aleatoriamente em 3 grupos: Grupo I - Concise (3M), Grupo II - Ultrabond (Aditek do Brasil) e Grupo III - Rely-a-Bond (Reliance). Após a colagem dos braquetes, as amostras foram termocicladas (500 ciclos) nas temperaturas de 5°C e 55°C. Após 48 horas, foram submetidas aos ensaios mecânicos de cisalhamento na direção oclusocervical, com velocidade de carga de 0,5mm/min, em uma máquina MTS 810. RESULTADOS: foram observadas resistências médias ao cisalhamento de 24,54±6,98MPa para o Grupo I, de 11,53±6,20MPa para o Grupo II e de 16,46±5,72MPa para o Grupo III. A Análise de Variância determinou diferença estatística entre as médias de resistência ao cisalhamento entre os grupos (p < 0,001). O teste de Tukey evidenciou que as médias dos três grupos foram significativamente diferentes entre si (p < 0,05), com a maior resistência para o Grupo I e a menor para o Grupo II. O teste de Kruskal-Wallis não mostrou diferença estatística significativa na quantidade de adesivo remanescente entre os grupos (p = 0,361). CONCLUSÃO: todos os materiais apresentaram resistência adesiva adequada para uso clínico, com maior resistência ao cisalhamento para a resina Concise, sem diferenças significativas para o Índice de Adesivo Remanescente entre os grupos.

Long-term fluoride release from resin-reinforced orthodontic cements following recharge with fluoride solution

The aim of this study was to test the hypothesis that there is no difference in the fluoride release behavior of resin-reinforced glass ionomer cements before or after fluoride recharge. The materials were divided into 5 groups: 2 resin-reinforced glass ionomer cements used for attaching orthodontic bands, that is, group FOB (Fuji Ortho Band) and group MCB (Multi-Cure Glass Ionomer Orthodontic Band Cement); 2 resin-reinforced glass ionomer cements and a composite used for bonding orthodontic brackets, that is, group OGLC (Ortho Glass LC), group FOLC (Fuji Ortho LC), and group TXT (Transbond XT), respectively. Fluoride release was measured during a 60-day period by using selective ion electrodes connected to an ionic analyser. After 4 weeks, the samples were exposed to 0.221% sodium fluoride solution. The results showed that cements achieved a maximum fluoride release 24 h after initial setting. No statistically significant differences were observed between groups FOB and OGLC regarding the amount of released fluoride following fluoride recharge from day 31 to day 36 (p>0.05). In conclusion, FOB and OGLC cements showed a higher capacity of capturing and releasing fluoride compared to the other cements studied.

Effect of different bonding agents on prevention of enamel demineralization around orthodontic brackets

INTRODUCTION

Demineralization around the bracket is an undesired side effect of orthodontic treatment. The aim of this in-vitro study was to evaluate the efficacy of 5 bonding agents to prevent enamel demineralization. Two quantification methods were used.

METHODS

Eighty-five extracted teeth were randomly allocated to 5 groups: (1) Transbond Plus SEP and Transbond XT (both, 3M Unitek, Seefeld, Germany), (2) 37% phosphoric acid, Pro Seal (Reliance Orthodontic Products, Itasca, Ill) and Transbond XT, (3) Clearfil Protect Bond (Kuraray Medical, Okayama, Japan) and Transbond XT, (4) 37% phosphoric acid and Light Bond (Reliance Orthodontic Products), and (5) Ortho Conditioner and Fuji Ortho LC (both, GC, Tokyo, Japan). In-vitro caries was created by pH cycling for 30 days. After demineralization, the teeth were scanned with a commercial cone-beam microtomographic system. Then the teeth were examined by polarized light microscopy.

RESULTS

The 2 methods of examination showed significant differences among the 5 groups according to lesion depth and mineral loss (P < 0.01). The resin-modified glass ionomer cement (group 5) had the lowest values for lesion depth and mineral loss.

CONCLUSIONS

Fuji Ortho LC showed a significantly smaller lesion depth and less mineral loss compared with the other materials. The cone-beam microtomographic system is suitable for evaluation of subsurface lesions and has considerable advantages.

Antibacterial properties of 4 orthodontic cements

BACKGROUND

White spot lesions are observed in nearly 50% of patients undergoing orthodontic treatment. Long-lasting antibacterial properties of orthodontic cements can reduce this phenomenon.

METHODS

The antibacterial properties of 4 orthodontic cements were evaluated by direct contact test (DCT) and agar diffusion test (ADT). With the DCT technique, octet specimens of glass ionomer (CX-Plus; Shofu, Kyoto, Japan), reinforced glass ionomer (GC Fuji ORTHO LC; GC Corporation, Tokyo, Japan), and 2 composite (Transbond XT and Transbond Plus; 3M Unitek, Monrovia, Calif) orthodontic cements were placed on the sidewalls of wells of a 96-microtiter plate. Streptococcus mutans cells (ca. 1 x 10(6) ) were placed on the surface of each specimen for 1 hour at 37 degrees C. Then, fresh media was added to each well, and bacterial growth was monitored for 16 hours with a temperature-controlled spectrophotometer. This was repeated on specimens aged in phosphate-buffered saline for 1 day, 1 week, and 1 month. The ADT was performed by placing specimens in wells punched in agar plates.

RESULTS

Measurement of the halo in bacterial lawn after 48 hours showed that only the glass ionomer cement (CX-Plus) produced an inhibition zone (1.2 mm around the sample). Results at the DCT showed that only the reinforced glass ionomer cement (GC Fuji ORTHO LC) exhibited potent antibacterial activity, which lasted 1 week and diminished over the next 3 weeks.

CONCLUSIONS

The reinforced glass ionomer cement possessed the most potent and long-lasting antibacterial activity.

Bond strength comparison of 2 self-etching primers over a 3-month storage period

The purpose of this in vitro study was to evaluate the shear-peel bond strength of 2 self-etching primer systems, Transbond Plus (3M/ Unitek, Monrovia, Calif) and First Step (Reliance Orthodontic Products, Itasca, Ill), with their respective adhesives, and compare them with a control adhesive system (Transbond XT, 3M/ Unitek) over a 3-month period. Two hundred seventy extracted human premolars were obtained and randomly divided into 9 groups of 30 teeth. Metal orthodontic brackets were bonded to the enamel, and each adhesive group was stored for 24 horrs (T1), 30 days (T2), or 3 months (T3) in deionized water at 37 degrees C. All bonded specimens were thermocycled at 10 degrees C and 50 degrees C for 24 hours before debonding. Brackets were debonded by using a shear-peel load on a testing machine at a cross-head speed of 2 mm/min. Bond failure was also evaluated. The shear-peel bond strengths of the 3 bonding systems were clinically acceptable with the possible exception of First Step at 30-day storage. Repeated measures analysis of variance showed a statistically significant (P < .0001) difference in mean bond strengths between the 3 adhesive systems. The shear-peel bond strength of the adhesives over the 3 time intervals showed statistically significant (P = .005) changes. In each group, there were statistically significant differences in shear-peel bond strength between time intervals T1-T2 and T2-T3 for Transbond Plus and T2-T3 for First Step. The change in mean shear-peel bond strength of the 3 adhesives demonstrated a consistent pattern of behavior over the 3 storage intervals. The lowest mean shear-peel bond strength values were noted at the 30-day storage. Bond failure analysis (adhesive remnant index) demonstrated mainly cohesive bond failures.

Fluoride coatings on orthodontic wire for controlled release of fluorine ion

The purpose of this study was to develop a new method of releasing fluorine in a controlled manner for applications in the field of orthodontic Ti-based wire, namely the coating of fluorides on Ti. Thin films of two fluoride compounds, CaF(2) and MgF(2), were coated on Ti via the electron-beam evaporation method. The fluorine was released rapidly from the as-deposited MgF(2) coating within a short period(,) and then the release rate slowed down. When the MgF(2) coating was heat treated, this initial burst effect was decreased, but a significant amount of cracks were generated. On the other hand, in the case of the as-deposited CaF(2) coating, fluorine was released linearly for the entire period, without an initial burst. In the heat-treated CaF(2) coatings the trend was similarly observed. The linear fluorine release from the CaF(2) coatings, even in the as-deposited state, was attributed to the high degree of crystallinity of the coatings. A preliminary cell test showed favorable cell viability on both the fluoride coatings. Given their sustained and controlled fluorine release, these fluoride coatings, particularly CaF(2), are suggested to be potentially useful in the field of orthodontic Ti-based wire.

Assessing patient-specific decalcification risk in fixed orthodontic treatment and its impact on prophylactic procedures

This longitudinal and prospective clinical study determined the decalcification rate during multibracket treatment (mean duration, 22 months) in 80 randomized, selected adolescents divided into 4 groups of 20 patients each. The study had 2 objectives. The first was to establish whether patient selection based on predefined caries risk indicators, ie, plaque index, approximal plaque index, D(3-4)MFT/d(3-4)mft index, initial lesions, and gingiva index, carried out before the start of treatment allows for valid predictions of the decalcification risk associated with multibracket treatment. The second objective was to determine whether an extended prophylaxis regimen, including regular mechanical tooth cleaning by a hygienist, scaling, and chlorhexidine treatment, as an adjunct to an initial prophylaxis introductory program consisting of patient motivation, oral hygiene checkups, and fluoridation, reduces or prevents decalcification more effectively than initial prophylaxis alone. The results showed that patient selection based on caries risk factors provides a simple and effective method for predicting the decalcification risk in multibracket treatment (P <or=.001). The tests showed a sensitivity of 75% and a specificity of 88%, thereby proving the clinical validity of the results. Although extended prophylaxis significantly reduced the decalcification frequency in the risk group (P <or=.05) compared with the control group, decalcification frequency did not reach the low rate found in the low-risk group (P <or=.05).