Senthilkumar Indira, Johnson Perala, Polisetty Siva Krishna, Singaraju Gowri Sankar, Vivek Reddy Ganugapanta, Mandava Prasad
Orthodontics and Dentofacial Orthopaedics, Narayana Dental College, Nellore, IND.
Orthodontics and Dentofacial Orthopaedics, Government Dental College and Hospital, Kadapa, IND.
Cureus. 2024 Jun 13;16(6):e62337. doi: 10.7759/cureus.62337. eCollection 2024 Jun.
Introduction Incorporation of remineralizing agents with fluoride-releasing bracket adhesives may prevent the development of white spot lesions (WSL) or reverse the established WSL in patients undergoing fixed orthodontic treatment. We aimed to find out how effectively casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride varnish (FV) can remineralize teeth when mixed with fluoride-releasing orthodontic adhesive. Materials and methods We randomly assigned a total of 60 premolar teeth, therapeutically extracted for orthodontic purposes, into two equal groups. Group I (n = 30) utilized fluoride-releasing adhesive (FR), and Group II (n = 30) bonded with non-fluoride adhesive (NFR). Based on the applied remineralizing agent, we further divided each of the two groups into three equal subgroups of 10: Group IA (FR+FV), Group IB (FR+CPP-ACP), Group IC (control-only FR), Group IIA (NFR+FV), Group IIB (NFR+CPP-ACP), and Group IIC (control-only NFR). Following bonding procedures, all the samples underwent pH cycling for 28 days, where the enamel samples were immersed in 20 ml of demineralizing solution for three hours, followed by immersion in 30 ml of remineralizing solution for 17 hours. The samples were analyzed for shear bond strength (SBS) on a universal testing machine and hardness values (HV) by the Vickers microhardness test (VMT) using the indentation method. We also evaluated the adhesive remnant index (ARI) scores to determine the site of bracket failure. Statistical analysis The shear bond strength (SBS) and hardness value (HV) were expressed as the mean, standard deviation (SD), and median for each subgroup. We used the non-parametric Kruskal-Wallis test to analyze the SBS and HV, followed by the Dunn-Bonferroni test for intra-pair differences. The ARI score was expressed as the frequency of the percentage distribution, and the difference in the distribution of ARI scores between the groups was assessed by the Cochran chi-square test. The probability (p) value equal to or less than 0.05 was considered statistically significant. Results The results show that Group IB, bonded with a fluoride-releasing adhesive and a CPP-ACP remineralizing agent surface treatment, has the highest HV of 300.23 units. Group IIC (only NFR) has the lowest hardness of 153.3 units, which is statistically significant (p < 0.001). However, the ARI scores are not statistically significant between the groups tested. Conclusion The bond strength of the adhesive and the surface hardness of the enamel increased with the addition of fluoride varnish and CPP-ACP to both the fluoride-releasing and non-fluoride-releasing adhesives.
引言 将再矿化剂与含氟托槽粘合剂相结合，可能会预防接受固定正畸治疗的患者出现白斑病变（WSL），或逆转已形成的WSL。我们旨在了解酪蛋白磷酸肽 - 无定形磷酸钙（CPP - ACP）和氟化物漆（FV）与含氟正畸粘合剂混合时，对牙齿再矿化的效果如何。
材料与方法 我们将总共60颗因正畸治疗而拔除的前磨牙随机分为两组，每组30颗。第一组（n = 30）使用含氟粘合剂（FR），第二组（n = 30）使用不含氟粘合剂（NFR）。根据所应用的再矿化剂，将两组中的每组进一步平均分为三个亚组，每组10颗：第一组IA（FR + FV）、第一组IB（FR + CPP - ACP）、第一组IC（仅FR对照组）、第二组IA（NFR + FV）、第二组IB（NFR + CPP - ACP）和第二组IC（仅NFR对照组）。在粘结程序之后，所有样本进行28天的pH循环，其中牙釉质样本在20毫升脱矿溶液中浸泡3小时，然后在30毫升再矿化溶液中浸泡17小时。使用万能试验机分析样本的剪切粘结强度（SBS），并通过维氏显微硬度测试（VMT）的压痕法测量硬度值（HV）。我们还评估了粘结剂残留指数（ARI）分数，以确定托槽脱落的部位。
统计分析 每个亚组的剪切粘结强度（SBS）和硬度值（HV）以平均值、标准差（SD）和中位数表示。我们使用非参数Kruskal - Wallis检验分析SBS和HV，随后使用Dunn - Bonferroni检验分析组内差异。ARI分数以百分比分布的频率表示，通过Cochran卡方检验评估组间ARI分数分布的差异。概率（p）值等于或小于0.05被认为具有统计学意义。
结果 结果表明，用含氟粘合剂和CPP - ACP再矿化剂进行表面处理的第一组IB，其HV最高，为300.23单位。第二组IC（仅NFR）的硬度最低，为153.3单位，具有统计学意义（p < 0.001）。然而，在测试的组之间，ARI分数没有统计学意义。
结论 在含氟和不含氟的粘合剂中添加氟化物漆和CPP - ACP，可提高粘合剂的粘结强度和牙釉质的表面硬度。
