The effectiveness of a fluoride varnish in preventing the development of white spot lesions

A prospective examination of 10 consecutively treated orthodontic patients was undertaken to examine the effectiveness of fluoride varnish in reducing enamel demineralization. Pairs of dental quadrants for each patient's mouth (ie, maxillary right and mandibular left; maxillary left and mandibular right) were randomly assigned to an experimental or control group. After placement of resin-bonded orthodontic brackets, fluoride varnish was applied to the 2 experimental dental quadrants for each patient. Subsequent applications were done every 3 months during 12 months of orthodontic treatment. A double-blinded examination of intraoral photographs of the 100 experimental and 100 control teeth was done. The presence of white spot lesions was registered using the enamel decalcification index and the 2 groups were compared using paired Student t tests with a significance level of 5% (P < .05). There was no statistically significant difference between the mean enamel decalcification index for the control and experimental groups before or after treatment, since demineralization increased for both groups. Most importantly, the change in mean enamel decalcification index was significantly smaller for the experimental group (0.34), compared to the control group (0.51). In other words, there was 44.3% (P <.05) less demineralization noted for teeth that had been treated with fluoride varnish during orthodontic treatment.     

Effect of fluoride varnish on demineralization adjacent to brackets bonded with RMGI cement.

Far too often a less-than-optimal esthetic result occurs after orthodontic treatment due to demineralization of enamel adjacent to fixed orthodontic appliances in patients with inadequate oral hygiene. In vitro studies have shown that a resin-modified glass ionomer (RMGI) cement and a fluoride varnish might help clinicians combat this problem. The purpose of this study was to evaluate, in vitro, the effect of a fluoride-releasing cavity varnish on inhibition of enamel demineralization adjacent to orthodontic brackets bonded with RMGI and composite resin cements. Brackets were bonded to 48 extracted human third molars. Half were bonded with a composite resin (Transbond, 3M Unitek, Monrovia, Calif) and half with an RMGI (Fuji Ortho LC, GC America, Alsip, Ill). Each group was further divided into 2, with half receiving an application of fluoride-releasing varnish (Duraflor, Pharmascience, Montreal, Québec, Canada). The samples were cycled in an artificial caries solution for an hour twice daily for 31 days. After each caries challenge, the teeth were brushed with a soft toothbrush to simulate normal mechanical wear of the varnish. The loss of fluoride varnish was timed. Teeth were sectioned longitudinally and photographed under polarized light microscopy. Mean lesion depth was measured, and analysis of variance (ANOVA) (P 相似文献   

护牙素在正畸治疗中对减少牙齿脱矿及促进再矿化的功效研究

目的评价Tooth Mousse护牙素对减少离体牛牙粘接托槽周围的釉质脱矿及促进再矿化的功效。方法将60颗粘接托槽的离体牛牙随机分成实验组、阳性对照组和阴性对照组,分别在牙面上涂擦Tooth Mousse护牙素、Duraphat氟保护漆和蒸馏水。将3组样本轮流放置入人工致龋液和人工唾液中浸泡,然后使用偏光显微镜、扫描电镜、电子探针检测。结果偏光显微镜下观察,实验组釉质表面完整,主要表现为以脱矿为主的正性双折射区明显减少;扫描电镜观察实验组釉质表面有大量的矿物质沉积,填补釉质表面局限性的小凹陷;电子探针检测结果显示,实验组釉质表面钙、磷含量明显高于阴性对照组（P<0.05）,与阳性对照组之间无统计学差异（P>0.05）。结论Tooth Mousse护牙素在体外实验模型中能使牛釉质在人工致龋环境中减少脱矿和促进再矿化。     

Effect of a fluoride varnish on demineralization adjacent to orthodontic brackets.

Home fluoride regimens have long been used to reduce the amount of demineralization adjacent to orthodontic appliances. In the absence of patient compliance, another method of applying the fluoride must be used. The purpose of this study was to evaluate, in vitro, the ability of a fluoride varnish, Duraflor, to directly inhibit demineralization of enamel surrounding orthodontic brackets. Brackets were bonded to 36 extracted human canines and premolars with a traditional composite resin and randomly assigned to three equal groups of twelve. Group 1 served as the control with no topical application after bonding. Group 2 was treated with a single application of a nonfluoridated placebo varnish. Group 3 was treated with a single application of Duraflor. All groups were cycled in an artificial caries challenge for 1 hour two times daily for 37 days and were brushed with a medium bristled toothbrush to simulate mechanical wear of the varnish. Demineralization of enamel was evaluated in longitudinal buccolingual tooth sections using polarized light microscopy. Both average depth and area of demineralization were measured with a sonic digitizer. ANOVA (P 相似文献   

Tooth Mousse护牙素抑制牙釉质脱矿和促进牙釉质再矿化的实验研究

目的评价Tooth Mousse护牙素抑制离体牛牙牙釉质脱矿及促进牙釉质再矿化的作用。方法60颗带托槽的离体牛牙随机分成3组,每组20颗。实验组涂擦Tooth Mousse护牙素,阴性对照组涂擦蒸馏水,阳性对照组涂擦氟化物。3组标本在人工致龋液和人工唾液中循环浸泡60d,用扫描电镜与偏光显微镜检查牙釉质脱矿及再矿化情况,用显微硬度计检查牙釉质显微硬度并进行统计学分析。结果扫描电镜观察结果显示实验组牙釉质表面有不规则的矿化物沉积;偏光显微镜下实验组牙釉质表面完整,以矿化为主的负性双折射区变宽;实验组牙釉质显微硬度高于阴性对照组(P<0.05),与阳性对照组间差异无统计学意义(P>0.05)。结论Tooth Mousse护牙素在体外实验中能抑制酸性环境中牛牙釉质脱矿,促进釉质再矿化。     

Inhibition of enamel demineralization by a bioerodible fluoridated resin

PURPOSE: To investigate the efficacy of a bioerodible fluoridated resin on inhibition of enamel demineralization. METHODS: Eighteen extracted permanent molars were sectioned mesiodistally to obtain 36 caries-free enamel surfaces. Each sample was prepared by painting an acid-protective varnish, excluding a 2 x 8 mm window on either the buccal or lingual surface. The windows of exposed enamel were randomly divided into three separate groups (n = 12). Group 1 received an application of a 5% (by weight) sodium fluoride varnish. Group 2 had an experimental 5% sodium fluoride bioerodible resin applied to the window. Group 3 was left untreated and acted as a control. The samples were then exposed to an artificial caries challenge for 17 days, until a visible white spot lesion had been created on the control group. The samples were brushed for 1 minute daily. Following the acid challenge, the teeth were sectioned longitudinally to obtain 100 microm sections. Sections were then photographed under polarized light. Quantitatively the areas of the lesions were measured by utilizing a computerized imaging system. Finally, a comparison was made between mean lesion sizes of the sample groups in order to determine their respective efficacy of enamel demineralization inhibition. RESULTS: The mean areas (microm)2 of the artificial lesions (+/- SD) were: bioerodible fluoridated resin 3,785 +/- 1,794; fluoride varnish 7,362 +/- 2,853, and control 11,398 +/- 4,238. ANOVA was performed and identified a significant variance (P < 0.001). Tukey's multiple comparison test demonstrated that bioerodible fluoridated resin had significantly less enamel demineralization than the fluoride varnish and control groups (P < 0.05). The fluoride varnish group demonstrated significantly less enamel demineralization than the control group (P < 0.05).     

Enamel demineralization adjacent to orthodontic brackets bonded with hybrid glass ionomer cements: An in vitro study

Enamel demineralization is recognized as a possible side effect of bonding orthodontic brackets with composite resins. Fluoride-releasing restorative materials have been shown to inhibit tooth demineralization. The purpose of this study was to evaluate two fluoride-releasing hybrid glass ionomer bonding agents for inhibition of enamel demineralization surrounding orthodontic brackets under two experimental conditions. This in vitro study used 72 extracted human premolars. Twenty-four teeth were bonded with Advance resionomer, 24 were bonded with Fuji Ortho LC hybrid glass ionomer and 24 were bonded with Transbond XT composite resin as the control. The teeth were cycled in an artificial caries challenge three times daily for 30 days. Half of the teeth in each group were brushed twice daily with a fluoridated dentifrice, and the other half were not brushed. Demineralization of enamel surrounding orthodontic brackets was evaluated with polarized light microscopy. Enamel lesions were photographed under maximum illumination. Images were projected, and demineralized areas were traced. Both average depth and area were measured with a sonic digitizer. Analysis of variance (P < .0001) and Duncan’s test (P < .05) indicated significant differences in depth and area of demineralized enamel such that lesion size was: Transbond XT no brush > Transbond XT brush > Advance no brush = Advance brush = Fuji Ortho LC no brush = Fuji Ortho brush. The promising results of this in vitro study warrant further clinical investigation of hybrid glass ionomer adhesives as orthodontic bonding agents to minimize enamel demineralization. (Am J Orthod Dentofacial Orthop 1998;114:668-74)     

酪蛋白磷酸肽-无定形磷酸钙对正畸术后釉质再矿化的效果评价

目的: 比较含氟漱口水、护牙素即酪蛋白磷酸肽-无定形磷酸钙（casein phosphopeptide calcium phosphate complex,CPP-ACP）对正畸治疗后发生釉质脱矿的再矿化效果。方法: 应用Image J图像分析技术观察正畸治疗后釉质的再矿化。将固定矫治器正畸治疗后发生牙釉质脱矿的21例患者（女13例,男8例,84颗患牙）分为3组,每组28颗患牙。对照组仅用含氟牙膏每天刷牙2次,每次3 min。氟化物组用含氟牙膏每天刷牙2次,每次3 min,同时使用20 mL 0.01%氟化物冲洗牙2次。CPP-ACP组用含氟牙膏每天刷牙2次,每次3 min。同时按要求使用CPP-ACP 2次,3组均持续使用6个月。采用SPSS17.0软件包对数据进行统计学分析。结果: 正畸治疗后6个月,3组牙釉质脱矿白斑区域面积均有不同程度减少,3组治疗前、后均有显著差异（P<0.05）。CPP-ACP组效果尤为明显（51.68%）,显著高于氟化物组（44.42%）和对照组（42.71%）。结论: 正畸治疗后6个月内,正确刷牙、氟化物漱口、配合护牙素的使用,对正畸治疗中脱矿牙的再矿化均有一定效果, 而且CPP-ACP可以更有效地减小牙釉质脱矿白斑区域面积。     

Demineralization around orthodontic brackets bonded with resin-modified glass ionomer cement and fluoride-releasing resin composite.

PURPOSE: Enamel demineralization adjacent to orthodontic brackets is one of the risks associated with orthodontic treatment. Glass ionomer cements have been shown to decrease enamel demineralization adjacent to brackets and bands but do not exhibit bond strengths comparable to resin composites. The purpose of this in vitro study was to compare a fluoride-releasing resin composite versus a resin-modified glass ionomer cement for inhibition of enamel demineralization surrounding orthodontic brackets. METHODS: Forty-five teeth were randomly assigned to 3 groups of 15 teeth. Fifteen were bonded with Concise (3M), a non-fluoride-releasing resin composite (control); 15 teeth were bonded with Light Bond (Reliance), a fluoride-releasing resin composite; and 15 teeth were bonded with Fuji Ortho LC (GC Corporation), a resin-modified glass ionomer cement. The teeth were placed in an artificial caries solution to create lesions. Following sectioning of the teeth in a buccolingual direction, polarized light microscopy was utilized to evaluate enamel demineralization adjacent to the orthodontic bracket. The area of the lesion was measured 100 microns from the orthodontic bracket and bonding agent. RESULTS: MANOVA (P < .0001) and Duncan's test (P < .05) indicated the resin-modified glass ionomer cement (Fuji Ortho LC) and the fluoride-releasing resin composite (Light Bond) had significantly less adjacent enamel demineralization than the non-fluoride-releasing resin composite control. However, there was no significant difference between the resin-modified glass ionomer cement and the fluoride-releasing resin composite. CONCLUSIONS: Based on the results of this in vitro study, it can be concluded that Fuji Ortho LC and Light Bond exhibit significant inhibition of adjacent demineralization compared to the non-fluoride-releasing control.     

正畸粘接用玻璃离子粘固剂防治托槽周围釉质脱矿的体外pH循环实验

目的　通过体外pH循环实验研究树脂改良型玻璃离子粘固剂 (resin modifiedglassionomercement)对托槽周围釉质脱矿的抑制作用。方法　选择 5对离体前磨牙 ,实验组用树脂改良型玻璃离子粘固剂粘接托槽 ,对照组用复合树脂粘接剂粘接托槽。全部样本每天进行pH循环实验 ,共60d。用偏振光显微镜观察托槽周围釉质脱矿病损并测量病损体部的深度、面积以及病损边缘与粘接材料边缘的距离。结果　对照组托槽周围釉质脱矿病损的深度和面积均大于实验组 ,配对t检验表明 2组间差异有非常显著性 (P <0 0 0 1 )。实验组病损均远离玻璃离子粘固剂边缘 ,而对照组病损均深入复合树脂粘接剂边缘的下方。结论　树脂改良型玻璃离子粘固剂是一种可以减少正畸治疗中釉质脱矿的粘接材料     

多乐氟在正畸治疗中对牙釉质脱矿的影响

目的：评价多乐氟在正畸固定矫治中对釉质脱矿的预防作用。方法选择接受正畸固定矫治的患者56例,采用自身对照,粘接托槽后,将患者牙齿以中线为界,左侧牙设为试验组（包括21、22、23、24、31、32、33、34）,右侧牙设为对照组（包括11、12、13、14、41、42、43、44）,共观察896颗牙（每组448颗牙）,试验组每3个月在托槽和带环周围牙面涂布多乐氟,对照组不做处理。分别在治疗开始后第6、12个月时对受试牙进行检查,观察牙面釉质脱矿的发生率及脱矿指数。结果正畸开始前试验组和对照组的脱矿率和脱矿程度比较差异均无统计学意义（P＞0.05）;在固定矫治6个月后对照组脱矿率较试验组高,两组间差异无统计学意义（P＞0.05）,但脱矿程度对照组高于试验组;矫治12个月后,对照组的脱矿率和脱矿程度均高于试验组程度（P＜0.05）。结论多乐氟对固定正畸过程中釉质脱矿具有预防作用。     

Orthodontic appliances and enamel demineralization. Part 1. Lesion development

A clinical trial was conducted to investigate carious lesion development associated with fixed orthodontic therapy. Specially designed orthodontic bands for plaque accumulation were attached to premolars scheduled to be extracted as part of an orthodontic treatment. Visible white spot lesions were seen within 4 weeks in the absence of any fluoride supplementation. Both microradiographic and SEM examinations showed surface softening of the enamel surface--that is, a surface layer was not seen in the lesions. The clinical significance of the present study is that enamel demineralization associated with fixed orthodontic therapy is an extremely rapid process caused by a high and continuous cariogenic challenge in the plaque developed around brackets and underneath ill-fitting bands. Careful inspection of the appliance at every visit and preventive fluoride programs are therefore required.     

Quantification of white spot lesions around orthodontic brackets with image analysis

OBJECTIVE: To investigate the use of image analysis for diagnosis and quantification of artificial white spot lesions on digital photographs before and after removal of orthodontic brackets. MATERIALS AND METHODS: Enamel demineralization was artificially induced on the labial surface of 20 teeth bonded with orthodontic brackets. Standardized digital photographs were taken at angles of 90 degrees and 110 degrees to the labial surface, before and after bracket removal. All images were analyzed by two observers using image-processing software, and the area of the white spot lesion was calculated. Reproducibility was assessed by the Pearson correlation coefficient for interobserver reliability and by the paired t-test for differences between observers. Differences between the known and the measured demineralization area were tested using the t-test. Differences between both stages and angles were assessed by application of the paired t-test. RESULTS: Reproducibility was very good for all measurements. For the photographs taken at an angle of 110 degrees , there was a statistically significant but clinically irrelevant difference between the observers. The difference between the surface measured and the true surface was dependent on the stages and angles but was always <1 mm2. CONCLUSION: Image analysis is a reproducible and reliable method for quantification of artificial enamel demineralization around orthodontic brackets.     

4种防龋方法在固定矫治中预防牙釉质脱矿的研究

目的:比较4种防龋方法在正畸固定矫治中预防牙釉质脱矿的效果.方法:采用固定矫治器矫治的200名患者随机分为4组(n=50),分别用普通牙膏、含氟牙膏、氟保护漆和护牙素对牙釉质进行处理,定期随访,比较矫治完成后4组患者的牙釉质脱矿情况.结果:按牙齿数计算含氟牙膏、普通牙膏、氟保护漆和护牙素4组牙釉质的脱矿率分别为16.3％、21.9％、9.3％和8.5％ (x2=99.7,P=0.000001)氟保护漆和护牙素组脱矿率低于其他2组,该2组脱矿率之间的差异无统计学意义(x2=0.39,P=0.529851).结论:应用含氟制剂可以有效预防固定矫治中牙釉质脱矿的发生,护牙素和氟保护漆的效果更明显.     

Prevention of enamel demineralization: an in-vitro study using light-cured filled sealant.

INTRODUCTION: Enamel demineralization is an undesirable side effect of orthodontic treatment with fixed appliances. The purpose of this in-vitro study was to evaluate the efficacy of applying a light-cured filled sealant onto the buccal tooth surfaces to prevent demineralization. METHODS: Fifty extracted human third molars were allocated to 1 of 5 groups: (1) enamel surface untreated (control); (2) surface etched; (3) fluoride varnish applied; (4) enamel etched and coated with a light-cured, unfilled sealant (control sealant); and (5) enamel etched and coated with a light-cured, filled sealant (Pro Seal, Reliance Orthodontic Products, Itasca, Ill). The enamel surface of each specimen was brushed for 15,000 strokes with nonfluoride toothpaste slurry with a piston-action brushing machine under a standardized load. All samples were then cycled for 14 days through a daily procedure of demineralization for 6 hours and remineralization for 17 hours. Then the teeth were sectioned and evaluated quantitatively by cross-sectional microhardness testing. RESULTS: Demineralization in the Pro Seal group was significantly less (P < .05) than in the other groups. Teeth treated with fluoride varnish exhibited 30% less demineralization than the control teeth, the enamel-etched teeth, and the teeth treated with a light-cured, unfilled sealant (P < .05). CONCLUSIONS: Pro Seal can be considered for use as a preventive method to reduce enamel demineralization adjacent to orthodontic attachments, particularly in patients who exhibit poor compliance with oral hygiene and home fluoride use.     

Dental enamel around fixed orthodontic appliances after fluoride varnish application

Poor oral hygiene has been considered one of the main problems routinely faced in the orthodontic treatment. Orthodontic appliance creates an environment that provides mineral loss from the dental enamel. Such condition is clinically seen as white spot lesions and cavitations in the most severe cases. The aim of this study was to evaluate the effects of a fluoride varnish application as a caries prevention method for clinical orthodontics. The experiment analyzed dental enamel adjacent to orthodontics accessories after treatment. In addition, it was observed the calcium, phosphorus and fluoride contents on enamel treated with a fluoride varnish. The results showed that fluoride varnish application is a simple and fast technique that could be useful in preventing enamel demineralization associated to orthodontic treatment. Scanning electron microscopy revealed significant amount of calcium fluoride-like material deposited on enamel and energy dispersive x-ray analysis demonstrated a large incorporation of calcium and fluoride to the enamel of the treated specimens. It was concluded that fluoride varnish could indeed be considered an efficient preventive method to enhance enamel resistance against the cariogenic challenges during orthodontic therapy.     

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目的探讨GC护牙素与氟保护漆在正畸治疗中抑制牙釉质脱矿的临床效果。方法选择2011年1月至2012年9月在沈阳市口腔医院正畸科就诊的固定矫治患者117例共计2620颗牙齿,按就诊编号将患者随机分为3组。第1组患者（39例,868颗牙齿）矫治过程中左侧牙齿涂布GC护牙素,右侧牙齿涂布相似口味牙膏作为对照;第2组患者（39例,862颗牙齿）矫治过程中左侧牙齿涂布氟保护漆,右侧牙齿涂布釉质粘接剂A液作为对照;第3组患者（39例,890颗牙齿）矫治过程中左侧牙齿涂布GC护牙素,右侧牙齿涂布氟保护漆。GC护牙素的用法为患者每月复诊时涂布牙齿1次,氟保护漆的用法为患者每隔3个月复诊时涂布牙齿1次。观测记录3组患者矫治前、后的牙釉质脱矿情况,并对数据进行统计分析。结果第1组及第2组患者中涂布GC护牙素及氟保护漆侧牙齿的釉质脱矿指数明显低于对照侧,差异有统计学意义（P〈0．05）。第3组患者涂布GC护牙素侧牙齿的釉质脱矿指数与涂布氟保护漆侧的差异无统计学意义（P〉0．05）。结论GC护牙素及氟保护漆均能抑制正畸患者牙釉质脱矿,临床操作简便,疗效可靠。     

氟涂料预防正畸治疗中釉质脱矿的实验研究

目的　明确氟涂料对釉质脱矿进程的抑制效果。方法　研究分两组 ,实验组釉质表面覆盖氟涂料 ,对照组釉质表面暴露。经短期人工龋后 ,用偏振光显微镜观察托槽周围釉质脱矿病损的分布并测量病损体部深度。结果　对照组全部样本均出现较明显的釉质脱矿 ,病损体部的平均深度为 4 8.8± 15 .1微米 ,实验组中只有少数样本出现孤立的脱矿病损 ,其余样本没有发生明显的脱矿。结论　氟涂料对短期釉质脱矿的抑制作用较明显 ,可以成为正畸治疗中釉质脱矿的预防手段之一。     

氟缓释型粘结剂预防正畸治疗中釉质脱矿的疗效观察

目的观察含氟离子释放型的正畸粘结剂在预防固定正畸治疗中牙釉质表面脱矿的临床疗效。方法选择24例固定矫治的正畸患者,采用自身对照法分别用树脂增强型玻璃离子粘结剂(GC)和含自酸蚀底涂剂的树脂粘结剂(Transbond)粘固托槽,于正畸治疗前、治疗后3个月及治疗后6个月应用DIGNOdent激光龋齿诊断仪检测牙釉质表面,分析前后仪器读数(DD)的变化反映牙釉质脱矿的情况,同时观察并记录牙釉质脱矿指数(EDI)及釉质白斑(WSL)的检出率。结果在治疗前及治疗3个月后两组间的EDI值、DD值、WSL值比较,差异均无统计学意义(P>0.05),而在治疗6个月后,GC组的EDI值、DD值、WSL值显著小于Transbond组,差异有统计学意义(P<0.05)。结论树脂增强型玻璃离子粘结剂和含自酸蚀底涂剂的树脂粘结剂对预防固定正畸过程中的釉质脱矿均具有较好的防护作用,但从长期性而言,树脂增强型玻璃离子优于含自酸蚀底涂剂的树脂粘结剂。     

Effect of fluoride varnish on the in vitro bond strength of orthodontic brackets using a self-etching primer system.

To reduce the number of steps involved with bonding procedures, manufacturers have simplified adhesive systems by combining the hydrophilic primer and the adhesive, or by combining the etchant, the primer, and the adhesive into 1 bottle and application. The purpose of this study was to investigate the relationship between the shear bond strength of orthodontic brackets to enamel, with or without fluoride varnish, by using either conventional or self-etching primer systems. Forty-eight extracted teeth were divided into 4 groups of 12 teeth each: group 1, fluoride varnish, conventional adhesive; group 2, fluoride varnish, self-etching primer system; group 3, no fluoride varnish, conventional adhesive; and group 4, no fluoride varnish, self-etching primer system. The bonding procedure followed the manufacturers' recommendations for the materials. Precoated adhesive orthodontic brackets were light-cured to the facial surfaces of the teeth and stored in whole human saliva at 37 degrees C for 24 hours. The specimens were subjected to a shear force in a testing machine until failure. The adhesive remnant index was used to score the teeth. Data were analyzed with a 2-way analysis of variance to test for differences in shear bond strength with respect to fluoride varnish and type of adhesive system used. The results showed no difference in bond strength among any of the experimental groups. Similarly, chi-square analysis determined that adhesive remnant index scores were not statistically different. The application of fluoride varnish does not affect the bond strength of orthodontic brackets to enamel with conventional or self-etching primer systems.