Comparative Assessment of In Vitro Effect of Three Fluoride Releasing Agents on Enamel Demineralization around Orthodontic Brackets


Background: White spot lesion considered as irreversible tooth demineralization presenting challenge to orthodontistsduring treatment schedules, fluoride was the most successfully used measure to overcome this challenge.Materials and method: A total of forty sound human permanent premolars were used in the present study andcategorized into four groups, in one group the teeth were bonded with stainless steel brackets using Resin-modifiedglass ionomer cement (RMGIC) and the other three groups the teeth were bonded with light cured compositeResilience® (Ortho technology Co., USA). Group A; Acidulated phosphate fluoride (APF) topical gel (Mfg by DEEPAKPRODUCTS, INC, USA), fluoride ion 1.23% applied on examine area for four minute. Group B; RMGIC (GC Fuji OrthoLC, GC Corporation/Japan) used as bracket adhesive. Group C; Stannous and sodium phosphate fluoride gelyielding 0.72% fluoride ion (Mfg. for: dental resources DS-8) (0.4% Stannous fluoride, 1% sodium fluoride), was applieddaily through the experimental study. D; the control group represents the conventional bonding procedure with nopreventive method. The entire labial surfaces except 2 mm gingival to the bracket were isolated by acid resistancevarnish. All the teeth were subjected individually during 30 days in to acid challenge cycle. After longitudinalsectioning of the teeth by using a hard-tissue microtome, the depth of the artificial lesion was estimated by takingthe average of three penetration depths at the lesion centre under stereomicroscope. Also the enamel surface wasclassified according to acid etch pattern. Comparisons of the average caries penetration of the groups weresubmitted to ANOVA and LSD tests. The statistical significance level was set at p ≤ 0.05.Results: The results revealed that there were statistically significant differences among the tested groups. Withdifferent caries reduction abilities, APF group showed 14%, RMGIC Group 49%, group Stannous and sodiumphosphate fluoride 39% depth reduction compared to the control group.Conclusions: While all the groups showed caries reduction by different fluoride agents used in this study, the lessaverage lesion depth was found at group B making the RMGIG the best caries fighting fluoride measure