الفهرس | Only 14 pages are availabe for public view |
Abstract This study was carried out to compare the effectiveness of fluoride varnish, unfilled resin and filled resin materials in inhibition of enamel demineralization around orthodontic brackets in laboratory and clinical conditions. In the in-vitro part of the study a sample of sixty sound premolars where divided into four groups each containing fifteen teeth. An orthodontic bracket was bonded in the same manner to all teeth in the four groups. Teeth in the first group received a single application of fluoride varnish (Fluor Protector) while those in the second group received the unfilled resin material (Light Bond Sealant) whereas the third group received the filled resin material (L.E.D. Pro Seal) and the last group served as control. All teeth in the four groups after treatment with the specified products, received 15,000 brush strokes in order to simulate clinical tooth brush abrasion. In addition teeth were subjected to a course of acidic challenge for thirty five days simulating the alternating demineralization and remineralization processes occurring intra-orally. The teeth were sectioned and the depth of enamel lesions was determined using polarized light microscopy. The efficacy of the same materials used in the in-vitro study was evaluated clinically in the in-vivo part. A sample of twelve patients with age range from 15 to 20 years was selected from out patient clinic of the Orthodontic Department, Faculty of Dentistry; Ain Shams University Screening determined that the patients had no buccal caries or visible demineralization. Baseline measurements of the enamel mineralization of each tooth, from second premolar to second premolar in both arches, were made with a laser fluorescence device (DIAGNOdent pen). The buccal surface of each tooth was divided into four quadrants (mesial, distal, gingival, and occlusal) .The peak fluorescence measurement shown on the display was recorded for each quadrant. Metal brackets were bonded using a light cured composite resin and adhesive (Transbond XT). A split arch technique was utilized which allowed teeth in different quadrants (maxillary right, maxillary left, mandibular right and madibular left) to be subjected to the three different materials used in our study. Laser fluorescence readings were recorded again after four months. Decalcification was calculated for each tooth by averaging the values from the four quadrants. Each quadrant (gingival, occlusal, mesial, and distal) was also appraised individually. Intra-group evaluation between the three different materials was performed. 120 from the obtained results of both parts of this study one can conclude that: 1. All materials tested provided reduction in enamel demineralization as compared to untreated controls. 2. The fluoride varnish (Fluor Protector) and the unfilled resin (Light Bond Sealant) both resulted in a 64% and 70% decrease in lesion depth ,respectively when compared to controls in the invitro study. 3. The filled resin (L.E.D Pro Seal) provided significantly more protection about 87% reduction in lesion depth than the othertested materials. That is why Pro Seal should be considered as the “gold standard” for preventing enamel demineralization in orthodontics. 4. Clinically (Pro seal) has proven to be of superior efficacy in reducing and inhibiting incipient enamel demineralization, especially in the gingival portion of the teeth. 5. Unsurprisingly the maxillary teeth showed greater changes in laser fluorescence when compared to the mandibular teeth receiving the same protective material. Enamel demineralization around orthodontic brackets is almost the same between the right and left sides of both jaws. |