Evaluation of the Demineralization Development around Different Types of Orthodontic Brackets

Abstract

The aim of this study was to compare the demineralizations of the enamel surfaces around different types of orthodontic brackets in an artificial cariogenic environment. A total of 90 extracted human maxillary first premolar teeth were used in this in vitro study. The teeth were divided into 6 groups, 5 study and 1 control, each consisting of 15 samples. Victory metal, Gemini metal, Clarity self-ligating ceramic, APC Clarity Advanced ceramic and Clarity Advanced ceramic brackets (3M Unitek, Monrovia, Calif) used in the study groups were bonded to the teeth with the direct technique. The gingival, occlusal and proximal enamel surfaces adjacent to the brackets were measured with a DIAGNOdent pen (KaVo, Biberach, Germany) (T0). Then, the teeth were placed in a cariogenic suspension environment containing Streptococcus mutans, sucrose and artificial saliva. The teeth were removed from the cariogenic suspension at the end of 28 days. Enamel surfaces were remeasured with DIAGNOdent and the values were recorded (T1). Whether the obtained data were homogeneously distributed or not was determined by the Kolmogorov–Smirnov test, within-group comparisons were performed with the Wilcoxon test, and between-group comparisons were performed with Mann–Whitney U and Kruskal–Wallis tests. Significance level was accepted as p < 0.05. In all groups, the demineralization values of the enamel surfaces in the gingival, proximal and occlusal surfaces adjacent to the brackets were significantly higher in the T1 period than in the T0 period (p < 0.05). In the T1 period of Gemini metal, Clarity self-ligating ceramic and Clarity advanced ceramic bracket groups, the demineralization values of the proximal enamel surfaces were found to be significantly higher than the Victory metal and APC Clarity Advanced ceramic bracket groups (p < 0.05). In the T1 period, the demineralization values of the occlusal enamel surfaces of the Victory metal, APC Clarity Advanced ceramic bracket groups and control group were significantly lower than the Gemini metal, Clarity self-ligating ceramic and Clarity Advanced ceramic bracket groups (p < 0.05). Significant increases in enamel demineralization values were observed as a consequence of increased retention areas for microbial dental plaque on enamel surfaces adjacent to the bracket. Considering the importance of minimizing enamel demineralization in fixed orthodontic treatments, less enamel demineralization in Victory metal and APC Clarity Advanced ceramic bracket groups showed that these brackets can be preferred in patients with poor oral hygiene.

Do Different Types of Adhesive Agents Effect Enamel Demineralization for Orthodontic Bonding? An In Vitro Study

“…The teeth were stored in a 0.1% thymol solution until study [18]. The storage period of the teeth did not exceed six months [19]. The sample size of the study, in which the effect size was calculated using the mean and standard deviation of the groups, was performed by the G*Power 3.1.9.7 program.…”

“…Artificial saliva was prepared with the same formula as Toz Ertop et al did [19]. Artificial saliva was prepared with 0.4 g of sodium chloride (NaCl), 0.4 g of potassium chloride (KCl), 0.8 g of calcium chloride (CaCl 2 •2H 2 O), 0.78 g of sodium dihydrogen phosphate (NaH 2 PO 4 •2H 2 O), 0.005 g of sodium sulfate (NaS•9H 2 O) and 1 g urea of in 1000 mL of deionized water [19,22] (see Figure 1c).…”

“…Artificial saliva was prepared with the same formula as Toz Ertop et al did [19]. Artificial saliva was prepared with 0.4 g of sodium chloride (NaCl), 0.4 g of potassium chloride (KCl), 0.8 g of calcium chloride (CaCl 2 •2H 2 O), 0.78 g of sodium dihydrogen phosphate (NaH 2 PO 4 •2H 2 O), 0.005 g of sodium sulfate (NaS•9H 2 O) and 1 g urea of in 1000 mL of deionized water [19,22] (see Figure 1c). After the prepared artificial saliva solution was sterilized in an autoclave, 140 mg of mucin (Mucin Type II; SigmaAldrich Chemie GmbH, Deisenhofen, Germany) was added per 100 mL of artificial saliva solution.…”

Orthodontic Risk Perspectives among Orthodontists during Treatment: A Descriptive Pilot Study in Greece and Slovakia

“…Patients must also be informed about potential extraction needs [26,27], surgical procedures, and the likelihood of relapse [10]. Additional risks involve appliance breakage, detached brackets, broken or protruding wires, time and cost for repairs, and even the possibility of inadvertently swallowing orthodontic components [28][29][30]. Notably, the recent focus on infectious disease transmission, particularly in the context of the COVID-19 pandemic, has underscored the need for heightened attention to infection control within dental offices [31].…”

Antimicrobial Effects of Edible Mixed Herbal Extracts on Oral Microorganisms: An In Vitro Study

“…The human oral cavity is inhabited by over 700 different bacterial species, some of which are disease-causing pathogens that can induce gastrointestinal dysfunction and tooth loss [1]. White spot lesions that develop due to Streptococcus mutans (S. mutans) retention in plaque can accumulate around orthodontic brackets and lead to enamel demineralization, based on studies using simulated cariogenic environments [2]. When streptococci accumulate in the mouth (via attachment to the initially acquired pellicle), plaques (comprising the bacterial cells, glycoproteins, and polysaccharides) can form.…”