Mihri Amasyali

Effects of different topical agents on enamel demineralization around orthodontic brackets: an in vivo and in vitro study

BACKGROUND The aim of this study was to evaluate the in vivo and in vitro effects of a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride containing topical agents in reducing enamel demineralization around orthodontic brackets, and to compare this with a control group. METHODS Twenty-one patients and 60 extracted premolars were divided into three groups: two experimental and one control. Tooth Mousse® (CPP-ACP gel; GC-Corp, Tokyo, Japan) and Fluoridin N5® (Fluoride gel; Voco-GmbH, Cuxhaven, Germany) were applied to tooth surfaces around orthodontic brackets in the experimental groups. Teeth were extracted after 60 days to evaluate the in vivo effects of the testing materials. For the in vitro experiment, samples were cycled for 14 days through a daily procedure of demineralization. All teeth were sectioned and evaluated by superficial microhardness analysis. An indentation was made from two positions (occlusal-cervical) and one depth (10 μm). RESULTS Comparisons of occlusal and cervical microhardness scores for all specimens showed no statistically significant side differences. A multiple comparison test showed that the use of CPP-ACP and fluoride containing topical gels were more significantly efficient than the control group (p<0.001). No significant differences were detected between CPP-ACP and the fluoride groups against demineralization. CONCLUSIONS In vivo and in vitro evaluations indicated that CPP-ACP and fluoride containing agents successfully inhibited caries around orthodontic brackets.

Effect of antibacterial monomer-containing adhesive on enamel demineralization around orthodontic brackets: An in-vivo study

INTRODUCTION The aims of this study were to evaluate the effect of an antibacterial monomer-containing self-etching adhesive in reducing enamel demineralization around orthodontic brackets in vivo and to compare it with the conventional adhesive system quantitatively. METHODS Fourteen orthodontic patients were randomly divided into 2 equal groups; they received brackets fitted to all their teeth, bonded with either Clearfil Protect Bond (Kuraray Medical, Okayama, Japan) (experimental group) or Transbond XT (3M Unitek, Monrovia, Calif) (control group). Block randomization to obtain equal numbers in each group was used. After 30 days, all first premolars were extracted with orthodontic indications and longitudinally sectioned. Demineralization was assessed by cross-sectional microhardness. Determinations were made at the bracket edge cementing limits and at occlusal and cervical points 100 and 200 μm away from the edge. In all of these positions, 6 indentations were made at depths of 10 to 90 μm from the enamel surface. Analysis of variance (ANOVA) and the Tukey post-hoc test were used. The statistical significance level was set at P <0.05. RESULTS ANOVA showed statistically significant differences for adhesive type, position, depth, and their interactions (P <0.05). The multiple comparison test showed that the antibacterial monomer-containing adhesive was significantly more efficient than the conventional adhesive system, reducing enamel demineralization in almost all evaluations (P <0.05). CONCLUSIONS The results indicated that using antibacterial monomer-containing adhesive for bonding orthodontic brackets successfully inhibited caries in vivo. This cariostatic effect was localized at the area around the brackets and was significant after 30 days.

In vivo effects of amorphous calcium phosphate-containing orthodontic composite on enamel demineralization around orthodontic brackets

BACKGROUND The aim of this study was to evaluate the in vivo effects of an amorphous calcium phosphate-containing orthodontic composite in reducing enamel demineralization around orthodontic brackets, and to compare it with the control. METHODS Fourteen orthodontic patients were divided into two equal groups. They received brackets fitted to all first premolars, bonded with either Aegis Ortho® (The Bosworth Co.), an ACP-containing orthodontic composite (experimental group), or Concise® (3M Dental Products), a resin-based orthodontic composite (control group). After 30 days, the teeth were extracted and longitudinally sectioned, and evaluated by superficial-microhardness analysis. The determinations were made at the bracket edge cementing limits and at occlusal and cervical points 100 and 200 μm away from the edge. In all of these positions, indentations were made at depths of 10, 20, 30, 50, 70, and 90 μm from the enamel surface. Analysis of variance (ANOVA) and Tukey post hoc test was used. The statistical significance level was set at p<0.05. RESULTS The ANOVA showed statistically significant differences for position, material, depth, and their interactions (p<0.001). The multiple comparison test showed that the ACP-containing orthodontic composite was significantly more efficient than the control composite, reducing enamel demineralization in almost all evaluations (p<0.001). CONCLUSIONS Present results indicated that ACP-containing orthodontic composite for bonding orthodontic brackets successfully inhibited demineralization in vivo. This effect was localized to the area around the brackets and was statistically significant after 30 days.

Does a chitosan-containing dentifrice prevent demineralization around orthodontic brackets?

OBJECTIVE To test the null hypothesis that there is no significant difference between the chitosan-containing and conventional nonfluoridated dentifrices in inhibition of enamel demineralization around orthodontic brackets. MATERIALS AND METHODS Sixteen orthodontic patients who were scheduled to have extraction of four first premolars for orthodontic reasons were divided into two groups after the power of the study was estimated. Patients in the experimental group were instructed to use chitosan-containing dentifrice (AloeDent), and patients in the control group were instructed to use nonfluoridated dentifrice (Sensodyne Mint). After 60 days, the teeth were extracted and longitudinally sectioned. The demineralization was assessed by cross-sectional microhardness. The determinations were made at the bracket edge cementing limits and at occlusal and cervical points, 100 µm and 200 µm away from the edge. In all these positions, indentations were made at depths of 10, 20, 30, 50, 70, and 90 µm from the enamel surface. Analysis of variance (ANOVA) and Tukey test were used for statistical evaluation at P < .05 level. RESULTS ANOVA showed statistically significant differences for the factors of dentifrice type, position, and depth (P  =  .000). Statistically significant differences for microhardness values between two tested dentifrices were observed up to 20 µm of depth from the enamel surface (P < .05). Lower microhardness values were found for nonfluoridated dentifrice. Significant microhardness differences were also determined between materials at occlusal and cervical 0 µm positions (P < .05). At these positions, chitosan-containing dentifrice showed lower demineralization than the control. CONCLUSION Chitosan-containing dentifrice may reduce the enamel decalcification found in patients with poor oral hygiene. The null hypothesis is rejected.

Effect of a self-etching adhesive containing an antibacterial monomer on clinical periodontal parameters and subgingival microbiologic composition in orthodontic patients

INTRODUCTION The aims of this study were to evaluate the effect of a self-etching adhesive system containing an antibacterial monomer on periodontal health and subgingival microbiologic composition in orthodontic patients and to compare it with a conventional adhesive system. METHODS A split-mouth design was chosen, and 15 patients were included in the study. Brackets in contralateral quadrants were bonded with either a conventional adhesive system (control) or a self-etching adhesive system that contained an antibacterial monomer. Clinical periodontal parameters including plaque index, gingival index, probing depths, and bleeding on probing were determined. Subgingival plaque samples were collected before bracket placement (T0) and at the 6-month follow-up (T1). The real-time TaqMan polymerase chain reaction assay was used to determine the subgingival counts of Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Campylobacter rectus. For clinical periodontal parameters, analysis of covariance (ANCOVA) and, for bacterial counts, Wilcoxon tests were used for statistical comparisons at the P <0.05 level. RESULTS Clinical periodontal parameters were not changed, and they were not different between the groups from T0 to T1. T forsythensis and F nucleatum increased during the treatment period in both groups (P <0.05). The majority of the bacteria were T nucleatum at T0 and T1 in both groups. Changes in bacterial load from T0 to T1 were not different between groups except for T forsythensis and F nucleatum (P <0.05). CONCLUSIONS The use of an antibacterial monomer did not have an additional positive effect on clinical periodontal parameters. When used in bonding orthodontic brackets, the antibacterial monomer failed to reduce periodontopathogenic bacteria when compared with the conventional adhesive system during a 6-month treatment period.

Effect of periosteal stimulation therapy on bone formation in orthopedically expanded suture in rats

OBJECTIVE The aim of this experimental study was to evaluate the effects of periosteal stimulation therapy (PST), on bone regeneration in response to expansion of the interpremaxillary suture, in rats. MATERIAL AND METHODS Sixteen male, 50-60 days old Wistar rats were divided into two equal groups (control and experimental). Both groups were subjected to expansion for 5 days, and 30 cN of force was applied to the maxillary incisors with helical spring. On the 2nd day of the expansion procedure in the experimental group, the periosteum over the interpremaxillary suture was stimulated locally by intraperiosteal penetrations with a hypodermic needle. Bone regeneration in the interpremaxillary suture was evaluated by bone histomorphometry and the new bone area, bone perimeter, ferets diameter and new bone/old bone percentage parameters were evaluated. Mann-Whitney U-test was used for statistical evaluation at p < 0.05 level. RESULTS Significant differences were found between groups for all investigated histomorphometric parameters. New bone area (p < 0.01), bone perimeter (p < 0.05), ferets diameter (p < 0.01) and new bone/old bone percentage (p < 0.01) measurements were significantly higher in the experimental group than that in the control. Bone histomorphometric measurements revealed that bone architecture in the PST group was improved. CONCLUSIONS Local stimulation of the periosteum of the sutural area during expansion stimulates bone formation and improves healing.

Microleakage between composite/wire and composite/enamel interfaces of flexible spiral wire retainers: direct versus indirect application methods

OBJECTIVE The aim of this in vitro study was to compare the microleakage of flexible spiral wire retainers (FSWR) at composite/wire and composite/enamel interfaces produced by an indirect application method to that of a conventional direct application method. MATERIALS AND METHODS Forty freshly extracted human mandibular incisor teeth were randomly divided into two equal groups. Group 1 was bonded directly according to the manufacturers recommendations. Group 2 consisted of 20 teeth bonded indirectly with Transbond LR as the adhesive and Sondhi Rapid Set A/B Primer (3M Unitek, Monrovia, CA, USA), a filled resin primer. After bonding, specimens were further sealed with nail varnish, stained with 0.5% basic fuchsine for 24 h, sectioned and examined under a stereomicroscope that measured microleakage at the composite/wire and composite/enamel interfaces from both mesial and distal margins. Statistical analyses were performed using Wilcoxon and Mann-Whitney U-tests with Bonferroni correction. RESULTS Statistical comparisons indicated that no statistically significant differences were observed between composite/wire and composite/enamel interfaces for direct vs. indirect application procedures (Direct method p = 0.630 and Indirect method p = 0.930). Comparisons of the microleakage scores between direct and indirect FSWR application groups at composite/wire and composite/enamel interfaces indicated no statistically significant microleakage differences at mesial or distal margins (Composite/enamel interface p = 0.361 and Composite/wire interface p = 0.270). CONCLUSION The type of FSWR application procedures (direct vs. indirect) did not significantly affect the amount of microleakage at the enamel/composite/wire complex.

Demineralization properties of newly erupted and mature premolars around orthodontic brackets: an in-vivo study.

INTRODUCTION The aims of this study were to evaluate the in-vivo reaction of newly erupted enamel to demineralization around orthodontic brackets and to compare it with that of mature enamel. METHODS Thirteen orthodontic patients scheduled to have 4 first premolars extracted for orthodontic reasons were divided into 2 groups. Group 1 included 7 younger patients with newly erupted teeth (4 boys, 3 girls; mean age, 11.21 +/- 1.12 years; range, 11-13 years). Group 2 contained 6 adults with mature teeth (5 men, 1 woman; mean age, 34.64 +/- 4.01 years; range, 25-41 years). Brackets were placed, and, 30 days later, the teeth were extracted. These teeth were longitudinally sectioned, and demineralization was assessed by cross-sectional microhardness. Determinations were made at the bracket-edge composite limits and at occlusal and cervical points 100 mum away. Evaluations under the brackets and at the lingual surfaces were made as controls. In all these positions, 6 indentations were made at depths from 10 to 90 mum from the enamel surface. Analysis of variance (ANOVA) and Tukey tests were used for statistical evaluation at the P <0.05 level. RESULTS ANOVA showed statistically significant differences for tooth type, position, depth, and their interactions (P <0.05), except the tooth type and position interaction. The multiple comparison test showed less demineralization in the enamel around orthodontic brackets bonded to mature teeth campared with newly erupted teeth (P <0.05). CONCLUSIONS During the 30-day study period, the tooth enamel in the adult orthodontic patients was more resistant to demineralization than that of the younger patients.

Ortodontide beyaz nokta lezyonları ve güncel teşhis, korunma ve tedavi yaklaşımları

As oral hygiene becomes more difficult in patients with fixed orthodontic appliances; the decalcification of the enamel surface adjacent to these appliances is prevalent. Decalcification is manifested as a white spot lesion (WSL) on enamel, and orthodontic patients develop significantly more WSLs than non-orthodontic patients. If these lesions are left untreated, they may progress to produce carious cavitations, and may also present aesthetic problems. Thus, the prevention, diagnosis, and treatment of WSLs are crucial to minimize tooth decay as well as tooth discoloration that could compromise the aesthetics of the smile. Clearly, it is the orthodontists’ responsibility to be aware of the risk for decalcifications and take precautions to avoid or limit their development. The present review presents the most recent researches about formation, prevention and treatment methods against WSLs; before, during and after orthodontic treatment with fixed appliances. OZET Sabit ortodontik tedavi goren hastalarda dis fircalamanin ve agiz bakiminin zor olmasindan dolayi, braketlere komsu mine yuzeylerinin dekalsifikasyonu yaygin olarak gozlenmektedir. Dekalsifikasyon mine yuzeyinde beyaz bir noktasal lezyon olarak gozlenir ve ortodontik tedavi goren hastalarda gormeyenlere gore daha yaygin olarak gelismektedir. Bu lezyon tedavi edilmeden birakilirsa minede curuk kavitesi olusabilir ve ileri estetik problemler ortaya cikabilir. Beyaz nokta lezyonlarinin onlenmesi, dogru tanisi ve tedavisi; estetik ve fonksiyonel sorun olusturan dis curugunu en aza indirmek icin gereklidir. Dekalsifikasyon risklerinin farkinda olmak, onlarin gelisimini sinirlandirmak ve kacinmak icin onlem almak ortodonti uzmanlarinin sorumlulugundadir. Bu derleme sabit ortodontik tedaviler sirasinda ve sonrasinda beyaz lezyonlarin olusmasi, onlenmesi ve tedavisi hakkinda guncel arastirmalari sunmaktadir. Anahtar Kelimeler: Beyaz nokta lezyonlari, demineralizasyon, dekalsifikasyon