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BackgroundThis study was conducted to evaluate the efficiency of resin infiltration to improve the color of white spot lesions (WSLs) and to estimate the effect of different numbers of etching and resin infiltrant applications on the color change of WSLs with various depths. Ninety-six sound extracted premolars were subjected to acid attack inducing different depths of WSLs. Using a DIAGNOdent, teeth were divided into four main groups according to the depth of the WSLs: shallow enamel, deep enamel, shallow dentine, and deep dentine without cavitation. Then each of the main groups was subdivided into four groups: six teeth each with different protocols of resin infiltration as follows: 1 etching + 1 infiltrant application (EA), 1 etching + 2 infiltrant applications (EAA), 2 etchings + 1 infiltrant application (EEA), 2 etchings + 2 infiltrant applications (EEAA). Spectrophotometric analysis was measured at baseline (T0), after inducing the WSLs (T1), and following resin infiltration application (T2) for each group.ResultsIn shallow enamel, EA produced the least mean color difference (1.62 ± 0.85), with high significant difference (P < 0.001), when compared with the clinically detectable threshold (ΔE = 3.7). While in deep enamel, EAA showed the least mean color change (1.95 ± 0.4), with P < 0.001 when compared with the critical value. Also, in shallow dentine, the least mean change was noticed with EAA (3.0 ± 0.45), with P < 0.001 when compared with the clinical color detection threshold. Furthermore, in deep dentine, EAA had the least mean difference (3.76 ± 0.6) but with no significant difference, when compared with the clinically detectable threshold.ConclusionsAs the WSL got deeper, the color of the lesion became more clinically visible. In shallow enamel, the best treatment option was one etching with one resin infiltrant application. For deep enamel and shallow dentine, one etching with two applications of infiltrant gave the best lesion masking. In deep dentine, it is advisable to perform one etching with two infiltration steps, taking in consideration that all deep dentine lesions without cavitation were partially masked, remained clinically detectable, and might require more invasive restorative procedures.

Objectives To compare the effect of use of laser, casein phosphopeptide–amorphous calcium phosphate (CPP–ACP), and their combination on prevention of enamel demineralization using polarized light microscopy to assess lesion depth. Materials and Methods Eighty premolars were randomly allocated to four equal groups (n = 20): Group I: Control group, no preventive measures. Group II: CPP–ACP. Group III: Er,Cr:YSGG laser. Group IV: Er,Cr:YSGG laser followed by CPP–ACP. Specimens were subjected to thermocycling and brushing protocols equivalent to 1 year intraorally. Then, all teeth were subjected to acid challenge. Teeth were then sectioned longitudinally and examined under a polarized light microscope and lesion depth was measured. Results Group IV resulted in the least lesion depth with a significant difference between it and all other groups. CPP–ACP alone and laser alone also showed a significant difference in white spot lesion (WSL) depth compared to the control group; however, no significant difference was found between them. Conclusions The combined use of laser and CPP–ACP showed the best prevention against WSL development. The use of CPP–ACP or laser alone also resulted in a significant reduction in lesion depth but was significantly less than their combined use, with no significant difference between them.

Background Preventive measures are essential during the length of orthodontic treatment to reduce the risk of decalcification and white spot lesions formation. With the evolution of procedures that enable coating of the orthodontic brackets using nanoparticles known for their good antibacterial activity, coating the brackets with nanoparticles of silver, zinc oxide and combination of silver and zinc oxide to evaluate their antibacterial effect in comparison to a control group without coating was carried out in this study. Methods Four groups of 12 brackets each were included in the study. The coating procedure was carried out using physical vapor deposition. The antibacterial activity was tested on Streptococcus mutans and Lactobacillus Acidophilus using colony forming count. The antibacterial activity was evaluated immediately after coating and later after 3 months. Results Brackets coated with combination of silver and zinc oxide nanoparticles had the highest ability on reduction of both Streptococcus mutans and Lactobacillus Acidophilus count followed by silver nanoparticles and then zinc oxide nanoparticles. No significant difference was found between the first and second antibacterial tests. Conclusion The silver/zinc oxide nanoparticles coated brackets had the highest antibacterial effect in comparison to silver nanoparticles and zinc oxide nanoparticles individually coated brackets on Streptococcus mutans and Lactobacillus acidophilus, and all types of coatings showed enhanced antibacterial effect in comparison to the uncoated bracket. Coating of orthodontic brackets could be further assessed in clinical application to prevent decalcification.

Soft tissue changes following maxillary posterior teeth intrusion with zygomatic miniplates and premolar extractions appear to be stable 4 years after treatment.