Operative Dentistry Department, Faculty of Dentistry, Zagazig University, Zagazig, Egypt.
Kareem Dental Clinic, Al Guesh St, Mansoura City, 35516, Egypt.
BMC Oral Health. 2024 Nov 28;24(1):1446. doi: 10.1186/s12903-024-05237-y.
White spot lesions are initial sign of enamel caries that compromise esthetic appearance following orthodontic treatment. Thus, the systematic review was conducted to evaluate the remineralization potential of orthodontic adhesives on early-enamel lesions surrounding orthodontic bracket.
Search strategy was performed through three databases (PubMed, Web of Science, and Scopus). A total number of 1712 studies were identified for being potentially relevant, 62 among them were further assessed. Finally, 24 studies were included in this systematic review after adopting the eligibility criteria. The methodologies used to assess enamel remineralization were micro-computed tomography, cross-sectional microhardness, and polarized light microscopy for evaluating remineralization extent; surface microhardness, color change, and laser-induced fluorescence for evaluating superficial surface mineralization; Fourier Transform InfraRed, and Energy Dispersive Spectroscopy technique for chemical characterization.
Bioactive glass (BAG), nano-hydroxyapatite (n-HAP), nano-amorphous calcium phosphate (n-ACP), nano-calcium fluoride (n-CaF), fluorinated amorphous calcium phosphate nanoparticles (AFCP), and ammonium-based methacrylate monomer were incorporated into orthodontic adhesives. Seven out of the 24 included studies utilized commercially available orthodontic adhesives. While the remaining studies utilized experimental bioactive adhesives; 13 studies evaluated adhesives containing (BAG), two studies evaluated adhesives containing (n-ACP), one study evaluated adhesives containing (AFCP), and one study evaluated adhesives containing (n-HAP). Orthodontic adhesives containing the previously mentioned additives showed significant remineralization power compared to control group. Majority of studies that evaluated bioactive-based orthodontic adhesives revealed significant remineralization effect in comparison with their corresponding control groups. Out of 24 studies, 8 have assessed ion-release. However, few numbers of included studies evaluated the ion-release peak values. The output of most studies reported a significant increase of ion-release over time. Only one study reported a mark decrease of calcium and phosphate ions after 72 h. Following the high risk of bias in the majority of studies, and lack of standard evaluation protocol, meta-analysis was not conducted.
The outcome of the included studies supports the effectiveness of incorporation of remineralizing agents into orthodontic adhesives.
白色斑点是釉质龋的初始迹象，会在正畸治疗后影响美观。因此，进行了系统评价，以评估正畸粘接剂在正畸托槽周围早期釉质病变中的再矿化潜力。
通过三个数据库（PubMed、Web of Science 和 Scopus）进行搜索策略。确定了总共 1712 项可能相关的研究，其中 62 项进一步评估。最后，采用纳入标准后，有 24 项研究纳入了本系统评价。评估釉质再矿化的方法有：微计算机断层扫描、横截面显微硬度和偏光显微镜评估再矿化程度；表面显微硬度、颜色变化和激光诱导荧光评估表面矿物质化；傅里叶变换红外光谱和能量色散光谱技术用于化学特性。
生物活性玻璃（BAG）、纳米羟基磷灰石（n-HAP）、纳米无定形磷酸钙（n-ACP）、纳米氟化钙（n-CaF）、氟化无定形磷酸钙纳米颗粒（AFCP）和基于铵的甲基丙烯酰胺单体被掺入正畸粘接剂中。24 项纳入研究中有 7 项使用了市售的正畸粘接剂。其余研究则使用了实验性的生物活性粘接剂；其中 13 项研究评估了含有（BAG）的粘接剂，2 项研究评估了含有（n-ACP）的粘接剂，1 项研究评估了含有（AFCP）的粘接剂，1 项研究评估了含有（n-HAP）的粘接剂。与对照组相比，含有上述添加剂的正畸粘接剂具有显著的再矿化能力。与对照组相比，大多数评估生物活性基正畸粘接剂的研究显示出显著的再矿化效果。在 24 项研究中，有 8 项评估了离子释放。然而，纳入研究的数量很少评估离子释放峰值。大多数研究的结果报告了随着时间的推移离子释放显著增加。只有一项研究报告说，在 72 小时后钙和磷酸盐离子明显减少。由于大多数研究存在高偏倚风险，且缺乏标准评估方案，因此未进行荟萃分析。
纳入研究的结果支持在正畸粘接剂中加入再矿化剂的有效性。
