Jorge César Borges Leão Filho

Effectiveness of varnish with CPP-ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation

OBJECTIVE To evaluate the in vitro efficiency of applying varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) in prevention of caries lesions around orthodontic brackets. MATERIALS AND METHODS For this purpose, brackets were bonded to the vestibular surface of bovine incisors, and eight groups were formed (n = 15) according to exposure of oral hygiene substances and enamel varnish: 1 (control) brushing only performed, 2 (control) brushing + use of mouth wash with fluoride, 3 Duraphat varnish application only (Colgate-Palmolive Ind. E Com. Ltda, São Paulo, SP, Brazil), 4 Duraphat + brushing, 5 Duraphat + brushing + mouth wash, 6 MI Varnish application (GC America, USA), 7 MI + brushing, and 8 MI + brushing + mouth wash. The experimental groups alternated between pH cycling and the procedures described and were kept in an oven at temperature of 37°C. Both brushing and immersion in solutions was performed in a time interval of 1 minute, followed by washing in deionized water three times a day for 28 days of experimentation. Afterwards, evaluation by optical coherence tomography (OCT) of the special type (Ganymede OCT/Thorlabs, Newton, USA) was performed. In each group, a scanning exam of the white spot lesion area (around the region where brackets were bonded) and depth measurement of caries lesions were performed. RESULTS Groups 1 and 3 were shown to differ statistically from groups 5, 6, 7, and 8 (p = 0.000). MI Varnish was shown to be more effective in diminishing caries lesion depth, compared with Duraphat, irrespective of being associated with brushing and mouth wash, or not. LIMITATIONS The major limitation of this study is that it is a study in which demineralization was obtained with the use of chemical products, and did not occur due to the presence of Streptococcus mutans and its acid byproducts. CONCLUSION Application CPP-ACP-containing varnish irrespective of being associated with brushing and mouthwash, or not, reduced depth of caries lesions around orthodontic brackets.

Optical coherence tomography for debonding evaluation: an in-vitro qualitative study.

INTRODUCTION The purpose of this research was to demonstrate the potential of the optical coherence tomography technique on the evaluation of changes and damages in the enamel structure caused by debonding and cleanup procedures. METHODS Twin metal and ceramic brackets were bonded to the labial enamel surfaces of 120 incisors; the brackets were debonded 24 hours later. The anterior surfaces of the teeth were scanned, and optical coherence tomography images were captured in 2-dimensional and 3-dimensional modes before and after debonding and cleanup. A commercial spectral domain optical coherence tomography system with a 5-μm axial spatial resolution was used. The system is based on the Michelson interferometer setup. It is connected to a preconfigured personal computer, and the images are captured with a scanner probe that controls the light beam position at the sample. A total of 960 images were evaluated. RESULTS The analysis of the 2-dimensional and 3-dimensional images obtained with optical coherence tomography allows observation and evaluation of adhesive remnants, enamel damage, and superficial aspects of enamel from different methods of adhesive remnant removal. The 2-dimensional optical coherence tomography analysis allows in-depth observation of the adhesive remnant layer. CONCLUSIONS Optical coherence tomography can be a powerful tool for academic and clinical applications for the evaluation of debonding procedures.

Enamel Quality after Debonding: Evaluation by Optical Coherence Tomography

The aims of this study were to evaluate quantitatively the enamel fractures, adhesive remnants and bracket fragments on enamel after debonding of metal and ceramic brackets, and to quantify the layer of adhesive remnants in depth after two different cleanup procedures. Metal and ceramic brackets were bonded on 120 human incisors and then debonded using two different techniques with Side Cutter (SC) and Anterior Bracket Removal plier (ABR). After this, a high-speed tungsten carbide finishing bur or a low-speed tungsten carbide finishing bur was used. The debonded samples were submitted to enamel assessment with optical coherence tomography (OCT). In sequence, two different methods of removing the remaining adhesive (tungsten carbide burs at high and low speed) were performed and at the end of these procedures, the remaining adhesive layer was measured with OCT. The results demonstrated that enamel fractures were observed only in the samples bonded with ceramic brackets, and the type of pliers did not influence the incidence and extent of enamel damage. Moreover, the type of debonding technique (with side-cutting pliers or anterior bracket removal pliers) and the type of bracket did not influence the amount of adhesive remaining after debonding. The burs at low speed removed the remaining adhesive more effectively during cleanup procedures.

Influence of different beverages on the force degradation of intermaxillary elastics: an in vitro study

Objective: The aim of this study was to evaluate in vitro the effects of frequently ingested beverages on force degradation of intermaxillary elastics. Material and Methods: One hundred and eighty 1/4-inch intermaxillary elastics (TP Orthodontics) were immersed into six different beverages: (1) Coca-Cola®; (2) Beer; (3) Orange juice; (4) Red wine; (5) Coffee and (6) artificial saliva (control). The period of immersion was 15 min for the first and second cycles and 30 min for the third to fifth cycles. Tensile forces were read in a tensile testing machine before and after the five immersion cycles. One-way repeated measures ANOVA was used to identify significant differences. Results: Force degradation was seen in all evaluated groups and at all observation periods (p<0.05). A greater degree of degradation was present at the initial periods, decreasing gradually over time. However, no statistically significant differences were seen among groups at the same periods, showing that different groups behaved similarly. Conclusion: The chemical nature of the evaluated beverages was not able to influence the degree of force degradation at all observation periods.

A cytological analysis of the oral mucosa adjacent to orthodontic devices

Objectives: The objective of this study, was to evaluate the cytometry and cytomorphology of oral mucosa epithelial cells adjacent to orthodontic accessories using liquid-based exfoliative cytology. Materials and Methods: We placed metallic brackets on the upper pre-molars with stainless steel wires and metal or elastic ties on 20 people of both sexes, with an average age of 22.7 years. We evaluated nucleus area (NA), cytoplasm area (CA), and NA/CA ratio before installation (T0, baseline), 30 days after installation (T1), and 30 days after the accessories were removed (T2). Results: We verified a reduction in NA and an increase in CA with both types of ties at T1 ( P P Conclusions: The orthodontic appliance causes adaptive cell changes characterized by an increased level of keratinization of the oral mucosa, with a tendency to return to the normal state after removal of the mechanical stimulus of the orthodontic devices.

Effect of sodium bicarbonate air abrasive polishing on resistance to sliding during tooth alignment and leveling: An in vitro study

Objective: The aim of this in vitro study was to evaluate the Resistance to Sliding (RS) provided by metallic brackets and 3 types of orthodontic wires (TMA, SS and NiTi), before and after the use of sodium bicarbonate airborne particle abrasion, in an experimental model with 3 non leveled brackets. Materials and Methods: The bicarbonate airborne abrasion was applied perpendicularly to the bracket slots at a distance of 2 mm, for 5 seconds (T2) and 10 seconds (T3) on each bracket slot. In a universal testing machine, the wires were pulled through a set of 3 non leveled brackets at a cross head speed of 50 mm/min for a distance of 10 mm, and static and kinetic friction readings were registered at T1 (no airborne abrasion), T2 and T3. Results: For all tested wires, a significant RS increase between T1 and T3 ( P P P P Conclusions: Sodium bicarbonate air abrasive polishing during orthodontic treatment is not recommended, once this procedure promoted a significant RS increase between the metallic brackets and all the three types of wires tested.

Effectiveness of fluoride sealant in the prevention of carious lesions around orthodontic brackets: an OCT evaluation

Abstract Objective: This article aimed to evaluate in vitro the efficiency of Pro Seal fluoride sealant application in the prevention of white spot lesions around orthodontic brackets. Material and Methods: Brackets were bonded to the buccal surface of bovine incisors, and five groups were formed (n = 15) according to the exposure of teeth to oral hygiene substances and the application of enamel sealant: G1 (control), only brushing was performed with 1.450 ppm fluoride; G2 (control) brushing associated with the use of mouthwash with 225 ppm fluoride; G3, only Pro Seal sealant application was performed with 1.000 ppm fluoride; G4 Pro Seal associated with brushing; G5 Pro Seal associated with brushing and mouthwash. Experimental groups alternated between pH cycling and the procedures described. All specimens were kept at a temperature of 37 °C throughout the entire experiment. Both brushing and immersion in solutions were performed within a time interval of one minute, followed by washing in deionized water three times a day for 28 days. Afterwards, an evaluation by Optical Coherence Tomography (OCT) of the spectral type was performed. In each group, a scanning exam of the white spot lesion area (around the sites where brackets were bonded) and depth measurement of carious lesions were performed. Analysis of variance (ANOVA) was applied to determine whether there were significant differences among groups. For post hoc analysis, Tukey test was used. Results: There was statistically significant difference between groups 1 and 2 (p = 0.003), 1 and 3 (p = 0.008), 1 and 4 (p = 0.000) and 1 and 5 (p = 0.000). The group in which only brushing was performed (Group 1) showed deeper enamel lesion. Conclusion: Pro Seal sealant alone or combined with brushing and/or brushing and the use of a mouthwash with fluoride was more effective in protecting enamel, in comparison to brushing alone.

Orthodontic treatment in an endodontically treated maxillary incisors

The purpose of this study was to analyze the effect of orthodontic movement on non-vital teeth, illustrated with a clinical case. A review of the literature shows it is controversial as to whether or not orthodontic forces can be initiated and sustained without the resorptive process occurring. Induced resorption during tooth movement depends on multiple factors, which require the close attention of the dentist to ensure an accurate diagnosis and correct mechanotherapy with respect to the periodontium. The orthodontic treatment described here was performed on a woman 36 years of age with endodontically treated teeth. This case demonstrated that the biomechanics follow biological principles and thus prevent deleterious effects on the components of the periodontium and the bone and maintains the integrity of the root length.