Todd M A, Staley R N, Kanellis M J, Donly K J, Wefel J S
Am J Orthod Dentofacial Orthop. 1999 Aug;116(2):159-67. doi: 10.1016/s0889-5406(99)70213-1.
Home fluoride regimens have long been used to reduce the amount of demineralization adjacent to orthodontic appliances. In the absence of patient compliance, another method of applying the fluoride must be used. The purpose of this study was to evaluate, in vitro, the ability of a fluoride varnish, Duraflor, to directly inhibit demineralization of enamel surrounding orthodontic brackets. Brackets were bonded to 36 extracted human canines and premolars with a traditional composite resin and randomly assigned to three equal groups of twelve. Group 1 served as the control with no topical application after bonding. Group 2 was treated with a single application of a nonfluoridated placebo varnish. Group 3 was treated with a single application of Duraflor. All groups were cycled in an artificial caries challenge for 1 hour two times daily for 37 days and were brushed with a medium bristled toothbrush to simulate mechanical wear of the varnish. Demineralization of enamel was evaluated in longitudinal buccolingual tooth sections using polarized light microscopy. Both average depth and area of demineralization were measured with a sonic digitizer. ANOVA (P </=. 0001) and Duncan's test (P </=.05) indicated significant differences in depth and area of demineralized enamel. Those teeth treated with Duraflor exhibited 50% less demineralization than the control teeth and an even greater difference when compared to the placebo group. Fluoride varnishes should be considered for use as a preventive adjunct to reduce enamel demineralization adjacent to orthodontic brackets, particularly in patients who exhibit poor compliance with oral hygiene and home fluoride use.
家庭使用氟化物疗法长期以来一直用于减少正畸矫治器附近的脱矿质现象。若患者不配合，就必须采用另一种施用氟化物的方法。本研究的目的是在体外评估一种氟化物清漆Duraflor直接抑制正畸托槽周围牙釉质脱矿质的能力。用传统复合树脂将托槽粘结到36颗拔除的人类犬齿和前磨牙上，并随机分为三组，每组12颗。第1组作为对照组，粘结后不进行局部施用。第2组用非氟化安慰剂清漆单次处理。第3组用Duraflor单次处理。所有组每天两次在人工龋挑战中循环1小时，持续37天，并用中毛牙刷刷牙以模拟清漆的机械磨损。使用偏光显微镜在牙齿颊舌向纵剖面评估牙釉质的脱矿质情况。用超声数字转换器测量脱矿质的平均深度和面积。方差分析（P≤0.0001）和邓肯检验（P≤0.05）表明脱矿质牙釉质的深度和面积存在显著差异。用Duraflor处理的牙齿脱矿质程度比对照牙齿低50%，与安慰剂组相比差异更大。应考虑使用氟化物清漆作为预防性辅助手段，以减少正畸托槽附近的牙釉质脱矿质，特别是对于那些口腔卫生和家庭使用氟化物依从性差的患者。
