Reliability analysis of two methods for measuring active enamel demineralization: An in vitro study

Influence of topical fluoride on shear bond strength of orthodontic brackets and enamel white spot lesions formation

Abstract Introduction Fluoride is considered a key element in the remineralization process of tooth enamel. Objective To evaluate the influence of a topical solution of sodium fluoride (NaF) on the shear bond strength of orthodontic brackets and white spot lesions formation. Material and method Sixty bovine teeth were divided into three groups (n=20). Group 1 (Control): shear bond strength; Group 2: shear bond strength after pH cycling; Group 3: shear bond strength after pH cycling and treatment with 0.04% NaF solution. Groups 2 and 3 underwent pH cycling with demineralizing (6hs) and remineralizing (17hs) solutions at pH of 4.3 and 7.0 respectively for 15 days. The specimens were submitted to the shear bond strength and the Adhesive Remnant Index was verified (ARI). The specimens of each group (n=3) were qualitatively analyzed by means of Scanning Electron Microscopy (SEM). Kruskal-Wallis test assessed the shear bond strength and Fisher's exact test evaluated ARI, with significance level of 5%. Result There was no significant difference among the three groups in shear bond strength (p=0.2679). Significant difference was found in ARI (p=0.0199). The frequency of ARI 1 was 55% in group 1, 90% in group 2, and 80% in group 3. SEM showed difference between the enamel and bonding. Group 2 showed structural change of the enamel surface, adjacent to the bond area; and group 3 showed enamel with characteristics similar to those of group 1. Conclusion It was concluded that there was no NaF influence on the bracket shear bond strength and even in low concentrations it prevented the development of areas of demineralization of white spot lesions.

Microcomputed tomography evaluation of white spot lesion remineralization with various procedures

INTRODUCTION

The aim of this study was to use microcomputed tomography to evaluate the effects on white spot lesions of 3 remineralizing agents compared with artificial saliva (Inonu University, Malatya, Turkey). The agents were GC Tooth Mousse (GC International, Itabashi-ku, Tokyo, Japan), 50-ppm sodium fluoride solution (Inonu University, Malatya, Turkey), and Clinpro 5000 (3M ESPE Dental Products (St Paul, Minn). The experimental and control teeth were stored in artificial saliva.

METHODS

Forty-four extracted premolars were divided into 4 groups of 11 teeth each (3 experimental groups and 1 control group). After white spot lesions were created on the teeth, a remineralizing agent was applied. Microcomputed tomography scanning was performed at the following times: T0 (sound enamel), T1 (day 0, when the white spot lesion was formed), T2 (day 15), and T3 (day 30). Volume, depth, surface area, and mineral density changes of the white spot lesions were evaluated at different time points using CTAn software (SkyScan; Bruker, Kontich, Belgium).

RESULTS

GC Tooth Mousse and Clinpro 5000 improved all measurements after 30 days. However, Clinpro 5000 was not as effective in reducing lesion depth as it was in the other parameters. The artificial saliva group and the 50-ppm sodium fluoride solution did not show significant effects in the regression of the white spot lesions at the end of the 30-day experiment.

CONCLUSIONS

GC Tooth Mousse and Clinpro 5000 were more effective in remineralization of white spot lesions than sodium fluoride solution and artificial saliva. They can be preferred for use clinically. Microcomputed tomography is a novel and effective method that shows promise in accurately evaluating white spot lesions and remineralization.