Varnish or polymeric coating for the prevention of demineralization? An ex vivo study

Caries Prevention Using Silver Diamine Fluoride: A 12-Month Clinical Trial

OBJECTIVE

This clinical trial aimed to compare the caries-preventive effect of annual application of 38% silver diamine fluoride solution (SDF) with 5% sodium fluoride varnish (FV) to the anterior primary teeth of children. The hypothesis was that SDF was superior to FV at 1 year. Secondary objectives were to determine the child's cooperation and the parent's satisfaction and assess adverse effects.

METHOD

We recruited 688 3- to 4-year-old children and randomly allocated them to receive SDF or FV (positive control) on their 6 upper anterior teeth. Tooth-surface status was recorded using the decayed, missing, and filled surfaces index. A trained observer rated the child's cooperation as "totally cooperative" or "not totally cooperative." We used a questionnaire to determine the parent's satisfaction as "satisfied," "neutral," or "dissatisfied." Adverse effects (yes/no) were evaluated 1 day and about 1 year after treatment.

RESULTS

Of the children, 434 (SDF, n = 209; FV, n = 225) completed the trial. The mean new decayed tooth surfaces developed for SDF and FV groups were 0.4 ± 1.5 and 0.4 ± 1.3, respectively (P = .65). Child's cooperation for SDF and FV therapy was 71% (244/344) and 70% (241/344), respectively (P = .89). Parent's satisfaction for SDF and FV therapy was 71% (148/209) and 69% (155/225), respectively (P = .29). Adverse effects were found neither at 1 day nor at about 1 year after treatment for either treatment arm.

CONCLUSIONS

SDF is not superior to FV for caries prevention in primary upper anterior teeth at 1-year follow-up. Child's cooperation and parent's satisfaction were similarly high with SDF and FV therapy at 1-year follow-up. Neither short-term nor long-term adverse effects were observed. This study is registered at ClinicalTrials.gov (NCT04399369).

Decalcification prevention around orthodontic brackets bonded to bleached enamel using different topical agents

BACKGROUND

The present study was conducted to evaluate the effect of different topical agents utilized for prevention of enamel decalcification around orthodontic brackets bonded to bleached and non-bleached enamel.

METHODS

Human maxillary premolars (n = 120) were divided into two equal groups. Teeth in group I were left without bleaching while those in group II were bleached with Vivastyle gel. Metal brackets were bonded to all the teeth using light-cured adhesive. Each group was divided into six equal subgroups (A, B, C, D, E, and F). In subgroup A, no material was applied (control). In subgroups B, C, D, E, and F, the following materials were applied respectively: Profluorid varnish, Enamel Pro Varnish, Ortho-Choice Ortho-Coat, GC Tooth Mousse, and GC MI Paste Plus. All teeth were cycled in a demineralization solution/artificial saliva for 15 days. Laser fluorescence was used to measure the level of enamel mineralization. The data were statistically analyzed.

RESULTS

Regarding the non-bleaching subgroups, all studied material revealed significant demineralization reduction in comparison to the control subgroup (P < 0.05). Ortho-Choice Ortho-Coat revealed the highest significant effect while GC Tooth Mousse showed the least effect. In bleached subgroups, Profluorid varnish, Enamel Pro Varnish, and Ortho-Choice Ortho-Coat significantly reduced demineralization (P < 0.05) while either GC MI Paste Plus or GC Tooth Mousse had no significant effects (P > 0.05).

CONCLUSIONS

Ortho-Choice Ortho-Coat, and Profluorid and Enamel Pro varnishes could be utilized successfully to reduce enamel demineralization around brackets bonded to either bleached or non-bleached enamel. GC MI Paste Plus and GC Tooth Mousse were effective only in non-bleached enamel.

Effects of near infrared laser radiation associated with photoabsorbing cream in preventing white spot lesions around orthodontic brackets: an in vitro study

OBJECTIVE

The present study aims to investigate the effect of a low-power infrared laser on the inhibition of bovine enamel demineralization around orthodontic brackets.

BACKGROUND DATA

Near infrared lasers have been suggested as alternative approaches because they may produce an increase in resistance to dental caries.

METHODS

Forty-eight blocks of enamel obtained from bovine incisor teeth were divided into six groups: Group 1 (control), without treatment; Group 2 (C), photoabsorbing cream; Group 3 (CF), photoabsorbing cream with fluoride; Group 4 (L), irradiation with low-level infrared laser (λ=830 nm) at an energy density of 4.47 J/cm2; Group 5 (L+C), photoabsorbing cream followed by low-level infrared laser irradiation; and Group 6 (L+CF), photoabsorbing cream with fluoride followed by low-level infrared laser irradiation. After these procedures, the enamel blocks received an assortment of orthodontic brackets and were then submitted to pH cycling to simulate a highly cariogenic challenge. The enamel surface demineralization around the orthodontic brackets, according to the different treatments, was quantified by fluorescence loss analysis by quantitative light-induced fluorescence (QLF). The fluorescence loss, expressed as ΔF (percentage of loss fluorescence), was statistically examined by analysis of variance and the Tukey test.

RESULTS

The control group (-10.48±2.85) was statistically similar to Group C (-14.52±7.80), which presented the lowest values of ΔF when compared with Groups FC (-3.67±3.21), L (-2.79±1.68), CL (-1.05±0:50), and CFL (-0.60±0:43). However, Groups FC, L, CL, and CFL showed no statistically significant differences among them.

CONCLUSIONS

It can be concluded that both the low-level infrared laser and photoabsorbing cream with fluoride were effective in inhibiting the development of caries in enamel around orthodontic brackets, even in situations of high cariogenic challenge.

Preventive Effect of Ozone on the Development of White Spot Lesions during Multibracket Appliance Therapy

Objective: To test the null hypotheses: (1) there is no difference in the caries protective effect of ozone and Cervitec/Fluor Protector during multibracket (MB) appliance therapy, and (2) DIAGNOdent and quantitative light-induced fluorescence (QLF) are not superior to a visual evaluation of initial caries lesions.

Materials and Methods: Twenty right-handed patients with a very poor oral hygiene who required full MB appliance therapy were analyzed during 26 months. In a split-mouth-design, the four quadrants of each patient were either treated with ozone, a combination of Cervitec and Fluor Protector, or served as untreated controls. The visible plaque index (VPI) and white spot formation were analyzed clinically. DIAGNOdent and QLF were used for a quantitative assessment of white spot formation.

Results: The average VPI in all four dental arch quadrants amounted to 55.6% and was independent of the preventive measure undertaken. In the quadrants treated with Cervitec/Fluor Protector, only 0.7% of the areas developed new, clinically visible white spots. This was significantly (P &lt; .05) less than in the quadrants treated with ozone (3.2%). The lesions detected with QLF only partially corresponded to the clinically detected white spots, while DIAGNOdent proved to be unable to detect any changes at all.

Conclusions: The caries protective effect of Cervitec/Fluor Protector during MB therapy was superior to ozone, and a visual evaluation of initial caries lesions was superior to both DIAGNOdent and QLF.

Evaluation of the shear bond strength of 3 curing bracket bonding systems combined with an antibacterial adhesive

INTRODUCTION

The purpose of this in-vitro study was to investigate the shear/peel bond strength of metal brackets bonded to human enamel with differently cured bonded systems combined with an antibacterial adhesive component.

METHODS

One hundred twenty extracted molars were divided into 3 groups. Stainless steel brackets were bonded with 1 of 3 systems: group 1, no-mix bonding adhesive (Unite, 3M Unitek, Monrovia, Calif) (n = 40); group 2, 2-paste chemically cured bonding resin (Concise, 3M Unitek) (n = 40); and group 3, light-cured adhesive (Transbond XT, 3M Unitek) (n = 40). Each bonding group was separated into experimental (n = 20) and control groups (n = 20). In the 3 experimental groups, an antibacterial self-etch adhesive (Clearfil Protect Bond, Kurary, Osaka, Japan) was also applied to the enamel. Specimens in the control groups were bonded only with their relevant bonding systems according to the manufacturers' instructions. All specimens were stored in distilled water for 24 hours and thermocycled before testing. Debonded specimens were scored with the adhesive remnant index.

RESULTS

The mean bond strengths (in megapascals) were 9.8 (control, 15.7) in group 1, 12.0 (control, 18.5) in group 2, and 11.6 (control, 12.4) in group 3. Statistical analysis with t tests showed no difference between group 3 and its control (P = .178), whereas groups 1 and 2 were statistically different from their controls (P = .000).

CONCLUSIONS

The results indicated that the newly developed antibacterial self-etch adhesive can be combined with various bonding systems; achieved bond strengths were clinically more than satisfactory.

Effect of blood and saliva contamination on bond strength of brackets bonded with a protective liquid polish and a light-cured adhesive

INTRODUCTION

The application of a polymer coating to the labial enamel tooth surface before bonding can help keep white spot lesions from forming. Previous studies evaluating the effects of blood and saliva contamination on the bond strengths of light-cured composites showed significant reductions in bond strength values. The purpose of this study was to investigate whether the bond strength of a light-cured system (Transbond XT, 3M Unitek, Puchheim, Germany) used with a liquid polish (BisCover, Bisco, Schaumburg, Ill) is affected by contamination with blood or saliva.

METHODS

One hundred twenty permanent human premolars were randomly divided into 6 groups of 20. Various enamel surface conditions were studied: dry, blood contaminated, and saliva contaminated. A light-cured bonding system (Transbond XT) was used in all groups. The teeth in group 1 were bonded with Transbond XT. In the second group, BisCover polymeric resin polish was applied on the etched tooth surfaces before the brackets were bonded with Transbond XT resin. Comparison of the first and second groups showed no statistically significant difference. Groups 3 through 6 were bonded without Transbond XT. For groups 3 and 5, a layer of blood or saliva, respectively, was applied to the etched enamel followed by BisCover. In groups 4 and 6, blood or saliva, respectively, was applied on the light-cured BisCover. Shear forces were applied to the samples with a universal testing machine, and bond strengths were measured in megapascals.

RESULTS

The protective liquid polish (BisCover) layer did not affect bond strength.

CONCLUSIONS

Blood contamination on acid-etched surfaces affects bond strength more than saliva contamination. When a protective liquid polish (BisCover) is applied to the tooth surface, the effect of contamination by blood or saliva is prevented.

Demineralization Effects of 2 Bleaching Procedures on Enamel Surfaces With and Without Post-treatment Fluoride Application

The results of this study suggest that post-treatment fluoride application prevents mineral loss in bleached enamel surfaces.

The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study

OBJECTIVES

To test the hypothesis that fluoride varnish is effective in reducing demineralization (white spot) lesions adjacent to bonded orthodontic brackets.

DESIGN

Two similar samples of extracted bovine incisors, with bonded orthodontic brackets, were separated into an experimental group (fluoride varnish was applied) and control group (no fluoride varnish) to examine the preventive effects of fluoride varnish.

SETTING AND SAMPLE POPULATION

The dental clinic of the State University of Maringá--UEM (Maringá, Paraná, Brazil). Thirty-eight extracted bovine incisors with bonded orthodontic brackets.

EXPERIMENTAL VARIABLE

Fluoride varnish was applied topically to half of the sample of extracted bovine teeth. No varnish was applied to the other half.

OUTCOME MEASURE

The depths of enamel demineralization (white spot) lesions were measured from polarized light microscopy images using image analysis software.

RESULTS

The teeth in both the experimental and control groups had been exposed to a cariogenic environment twice a day for 35 days. Those teeth that had been treated with two applications of fluoride varnish (one at the outset and another 15 days later) demonstrated about 38% less mean lesion depth than teeth where no varnish had been applied.

CONCLUSION

Orthodontists may wish to consider the application of fluoride varnish during fixed orthodontic therapy to help reduce the development of enamel white spot lesions.