Bionic effects of nano hydroxyapatite dentifrice on demineralised surface of enamel post orthodontic debonding: in-vivo split mouth study

Abstract

Background Orthodontic debonding procedure produces inevitable enamel surface alterations, sequelae to which are enamel demineralization, sensitivity and retention of pigments. Several agents have been employed to counterbalance the same. The purpose of this study was (1) To evaluate the hypothesis that no significant difference exists in the remineralising potential of nano hydroxyapatite (NanoHAP) dentifrice and fluoridated dentifrice after orthodontic debonding, (2) To estimate the enamel topographic parameters following use of nano HAP dentifrice, post orthodontic debonding. Methods Sixty upper first bi-cuspids (30 subjects) planned for therapeutic extraction for the orthodontic treatment were bonded with a light cured adhesive. Envelope method of randomisation was followed in this prospective in-vivo study. In each subject, one of the first premolar brackets was debonded using a debonding plier and polished following standard protocols. Envelope method of randomisation was used to determine the side of the premolar to be debonded first. Patient was advised to use fluoridated (Group I) dentifrice for the first 15 days, then the first premolar was covered with a heavy-bodied putty cap, extracted and subjected to atomic force microscopy (AFM). Contralateral first premolar was then debonded and polished using similar protocol, and patient was advised to use nano hydroxyapatite dentifrice (Group II) for next 15 days. The premolar was then extracted and analyzed for surface roughness using AFM. The remineralizing potential of dentifrices was assessed by evaluating surface roughness parameters of the two groups and were compared using a two-sample t test. Results A significant difference was found amongst Group I (Fluoridated dentifrice) and Group II (NanoHAP dentifrice) (p > 0.001***) for enamel surface roughness variables which reflect remineralising potential of dentifrices. Group II showed significantly lesser value of surface roughness characteristics. Conclusions NanoHAP dentifrice was shown, after 15 days, to be superior to fluoridated dentifrice in remineralising enamel post orthodontic debonding.

Biomimetic hydroxyapatite paste for molar–incisor hypomineralization: A randomized clinical trial

“…Conversely, biomimetic hydroxyapatite even leads to a mineral deposition, thus forming a real coating on enamel and dental surfaces (Lelli et al, 2014) together with composite resins (Butera, Pascadopoli, et al, 2021). Hydroxyapatite toothpastes have been shown superior remineralizing effect to fluoridated toothpastes, in post orthodontic debonding patients (Verma & Muthuswamy, 2021). Furthermore, fluoride may be linked to a risk of toxicity in case of high dosage intake, with fluorosis in children and bone diseases in the elderly (Pajor et al, 2019).…”

Remineralization of Artificially Demineralized Human Enamel and Dentin Samples by Zinc-Carbonate Hydroxyapatite Nanocrystals

“…Moreover, it was found that synthetic hydroxyapatite crystals efficiently bind to enamel, acting as fillers of small defects and depression sites [ 11 , 17 ]. Furthermore, it was concluded that the bionic effect of nano-hydroxyapatite particles transmits to processes that mimic early enamel mineralization, due to increased concentrations of calcium and phosphate ions [ 15 , 18 , 19 ].…”

Nano-Hydroxyapatite (nHAp) in the Remineralization of Early Dental Caries: A Scoping Review

“…Human extracted premolars were the most frequently used permanent teeth in vitro, with only two studies utilizing human incisors [26,27]. While one in vitro study [5] assessed the effects of nHAp alone, the remaining studies compared the effects of nHAp alone to those of other components such as 20% zinc carbonate nHAp, 0.14 wt percent amine fluoride, 5% NovaMin (bioactive glass), and 8% Proargin. Various concentrations of nHAp were utilized in the in vitro investigations, ranging from 1% [28] to 20% [29,30].…”

“…Dental caries damage the surface of teeth and progress through stages of demineralization and remineralization before invading deeper levels of tooth lesions [4]. Similarly, during orthodontic bonding and debonding, an uneven enamel surface with micro-damage and white spot lesions is frequently observed [5], which also contributes to the likelihood of demineralization [6]. A gradual decrease in prismatic mineral content (critical layer) is the hallmark of the early stage of enamel demineralization [4].…”

“…Additionally, it is more biocompatible, and has stronger bioactivity, resorption, and mechanical qualities than HA; nHAp has been shown in studies to have a remineralizing effect on artificial carious lesions and to build a new enamel layer [2,[14][15][16][17]. Due to nHAp's remineralizing ability on enamel, some experts believe it is a bionic material capable of regenerating enamel [5,18].…”