THE EFFICACY OF A FLUORIDE-CONTAINING ORTHODONTIC PRIMER IN PREVENTING DEMINERALIZATION

Purpose: To evaluate the efficacy of a fluoride-containing orthodontic primer in preventing demineralization adjacent to brackets and compare the quality of enamel on tooth surfaces that received interproximal reduction (IPR). Methods: Patients at the VCU Orthodontic clinic who consented to orthodontic treatment involving extraction of at least 2 premolars were recruited to this pilot clinical study. Brackets were bonded to premolars using one of two primers, fluoride-containing experimental or control. IPR was also performed, and the experimental primer was applied to randomly selected teeth. Extracted teeth were analyzed visually for the presence of white spot lesions (WSLs). Micro-CT analyses were also performed to evaluate demineralization and measure the lesions. Results: A total of 18 teeth from 6 subjects were included in the following analyses. Based on micro-CT imaging, lesions were found on 89% of teeth treated with the experimental primer compared to 67% with the control primer, but this difference was not statistically significant (p=0.5765). There was also no significant difference between the depths of the lesions (p=1.00), handedness (p=0.5765), hygiene (p=0.7804), or time in the mouth (p=0.5601). According to visual examination, there was no significant difference in the incidence of WSLs between the two groups (89% and 89%; p=1.00) Also, there was no association with treatment (p=1.00), handedness (p=1.00), hygiene (p=0.1373), or time in the mouth (p=0.2987). No differences were noted on the microstructural characteristics of enamel at the IPR sites. Conclusion: Fluoride-containing primers do not seem to provide any additional benefit over conventional non-fluoride primers in orthodontic patients

Fluoridated elastomers: effect on disclosed plaque

OBJECTIVE: To investigate the effect of fluoridated elastomers on the quantity of disclosed dental plaque surrounding an orthodontic bracket in vivo. DESIGN: A randomized, prospective, longitudinal clinical trial, employing a split mouth, crossover design. Setting: The Orthodontic Departments of Liverpool and Sheffield Dental Hospitals. Subjects and methods: The subjects were 30 individuals about to start fixed orthodontic treatment. The study consisted of two experimental periods of 6 weeks with a washout period between. Fluoridated elastomers were randomly assigned at the first visit to be placed around brackets on 12, 11, 33 or 22, 21, 43. Non-fluoridated elastomers were placed on the contra-lateral teeth. After 6 weeks (visit 2) the elastomers were removed, the teeth disclosed and a photograph taken. Non-fluoridated elastomers were placed on all brackets for one visit to allow for a washout period. At visit 3, fluoridated elastomers were placed on the contra-lateral teeth to visit 1. At visit 4, the procedures at visit 2 were repeated. The photographs were scanned, then the area and proportion of the buccal surface covered with disclosed plaque was measured using computerized image analysis. A mixed-effects ANOVA was carried out with the dependent variable being the area or percentage area of disclosed plaque. RESULTS: There was no evidence of a systematic error and substantial agreement for the repeat readings of the same images. The only significant independent variable for the area of disclosed plaque was the subject (p<0.001). The significant independent variables for the proportion of disclosed plaque were the subject (p<0.001) and the tooth type (p=0.002). The independent variable describing the use of fluoridated or non-fluoridated elastomers was not significant for either the area or the proportion of disclosed plaque. CONCLUSION: Fluoridated elastomers do not affect the quantity of disclosed plaque around an orthodontic bracket

The Dilemma of the Open Gingival Embrasure Between Maxillary Central Incisors

Aim: The aim of this report is to present the etiology, diagnosis, and treatment planning strategy in the presence of an open gingival embrasure between the maxillary central incisors. Background: The open gingival embrasure or “black triangle” is a visible triangular space in the cervical region of the maxillary incisors. It appears when the gingival papilla does not completely fill in the interdental space. The space may occur due to: (1) disease or surgery with periodontal attachment loss resulting in gingival recession; (2) severely malaligned maxillary incisors; (3) divergent roots; or (4) triangular-shaped crowns associated with or without periodontal problems and alveolar bone resorptions. Report: The post-treatment prevalence in adult orthodontic patients is estimated to be around 40% compromising the esthetic result. Conclusion: Several methods of managing patients with open gingival embrasure exist, but the interdisciplinary aspects of treatment must be emphasized to achieve the best possible result. The orthodontist can play a significant role in helping to manage these cases

Chemico-therapeutic approach to prevention of dental caries

The program of chemical preventive dentistry is based primarily upon the development of a procedure for stabilizing stannous fluoride in solution by forcing it into glycerin. New topical fluoride treatment concentrates, fluoride containing gels and prophylaxis pastes, as well as a completely stable stannous fluoride dentifrice are made possible by the development of a rather complicated heat application method to force stannous fluoride into solution in glycerin. That the stannous fluoride is clinically effective in such a preparation is demonstrated briefly on orthodontic patients

Dentistry

The specialty of Dental Surgery has progressed from the "blood and acrylic" of the early seventies. Dentistry has undergone a quantum leap over the past twenty-five years, with improvements in both technique and technology, bringing us the sophisticated procedures used in today's practice.peer-reviewe

An overview on interproximal enamel reduction

Ever since its first introduction seven decades ago, there has been continuous advancement of the concept and technique of Interproximal enamel reduction (IPR). It’s demonstrated that with correct case selection and clinical performance, IPR is safe and effective for alleviating crowding, improving dental and gingival aesthetics as well as facilitating post-treatment stability. The fulfilment of treatment outcomes depends on careful pre-treatment examination and planning, appropriate clinical procedures and effective post-treatment protection. This review aims to provide a general introduction to IPR in terms of its history background, risks and benefits and clinical performance.published_or_final_versio

Interproximal Enamel Reduction: What Clinicians Should Know

AbstractInterproximal enamel reduction (IPR) is an orthodontic treatment option for gaining space to correct mild to moderate crowding malocclusions. Presently, there are many IPR instruments and techniques that are available for clinicians. No matter which instruments or techniques of IPR are used, the important thing is that clinicians should be aware of the considerations, advantages, anddisadvantages before performing IPR.Keywords: Interproximal enamel reduction (IPR), Orthodontic treatment, IPR instruments and techniques SWU Dent J. 2022;15(2):102-112

The Effects of a Fluoride Releasing Orthodontic Primer on Demineralization around Brackets: An in-vivo study.

The purpose of this study was to investigate the effects of a fluoride releasing orthodontic primer on demineralization adjacent to brackets. Twenty-two patients were recruited for this study. One premolar was randomly chosen as the experimental tooth, the contralateral tooth was the control. Teeth were visually analyzed for white spot lesions (WSLs). Knoop microhardness was used to determine hardness. Visual examination results showed no significant difference in the number of WSLs observed between Opal Seal and Transbond XT over the duration of this study. Solid conclusions could not be drawn from the results of microhardness testing. Therefore, it cannot be concluded that there is a difference in enamel hardness between Opal Seal and Transbond XT. However, prior to 90 days, teeth showed a significant difference in WSLs. Suggesting a protective effect of Opal Seal that diminished with time. Future studies are necessary to determine the clinical performance of this product

Effects of active reminders and motivational techniques on oral hygiene and gingival health in orthodontic patients: a randomized clinical trial

Purpose: To compare repeated oral hygiene instructions and motivation to text message reminders in improving oral hygiene compliance Methods: For this prospective, randomized controlled clinical trial, 60 patients were assigned to one of four groups. Group 1 served as a control. Group 2 received weekly text message for oral hygiene. Group 3 received in-person oral hygiene instructions at each visit. Group 4 received both text messages and in person oral hygiene instructions. Oral hygiene was measured with Bleeding Index (BI), Modified Gingival Index (MGI), and Plaque Index (PI). Baseline measurements were obtained at the day of bonding (T0) and then at the subsequent 3 adjustment visits (T1, T2, T3). Results: Repeated measures ANOVA was used to determine the effect of the intervention groups on the change in oral hygiene across the visits. The average age was 15 and 43% were male. Based on the data from 242 total visits, intervention group was not associated with a significant change in plaque index (p=0.26), modified gingival index (p=0.78), or bleeding index (p=0.12). Conclusions: Patients who presented with good oral hygiene initially were able to maintain it during the first four months of treatment regardless of the intervention. Practitioners should highly consider a patient’s pretreatment oral hygiene status before starting orthodontic treatment

Effect of Office Bleaching Agents on the Shear Bond Strength of Metallic Brackets Bonded Using Self-Etching Primer System at Different Time Intervals – An In-Vitro Study

A common method of treating discoloured teeth is to bleach them using hydrogen peroxide. Many studies in the literature have concluded that bleaching reduces shear bond&nbsp; strength of composite resin significantly and thus, to achieve clinically adequate shear bond strength of composite for bonding brackets to bleached enamel, it is important to find out the various methods of reducing adverse effects of bleaching. It has been proposed by some authors that a delay in bonding effectively reverses the effects of&nbsp; bleaching on bond strength. OBJECTIVES- To test the null hypothesis that there is no statistical significance in (1) bond strength and (2) failure site location with bleached and unbleached enamel prepared with TransbondPlus Self-etching Primer between&nbsp; different time intervals. MATERIALS AND METHODS- Sixty freshly extracted human premolar teeth were randomly divided divided into three groups of 20 teeth each Bleaching treatment was performed at two different time intervals (bleaching immediately before bonding and bleaching 30 days before bonding). All brackets were bonded with a self-etching primer system. The shear bond strength of these brackets was measured and recorded in MPa. Adhesive remnant index (ARI) scores were determined after the brackets failed. RESULTS- The mean shear bond strength of Group A (control) is found to be 20.4315 MPa (SD&plusmn; 6.81041) which was reduced to 11.1955 MPa (SD &plusmn; 4.58041) when bonding was done immediately after bleaching (group B). The shear bond strength increased to 14.9910 MPa (SD &plusmn; 4.74545) when enamel was 14.9910 MPa (SD &plusmn; 4.74545) when enamel was Group C) Pair wise comparison of shear bond strength between the three groups&nbsp; using Post hoc Tukey test showed that there is a very high statistically significant difference between shear bond strength of all three groups. CONCLUSION This study shows that bonding immediately after bleaching significantly reduces the shear bond strength , it can be reversed by a delay in the bonding by 30 days which shear bond strength , it can be reversed by a delay in the bonding by 30 days which improves the shear bond strength as reflected&nbsp; in the results of the study ,So it is advisable to delay the orthodontic bonding procedure by an interval of 30 days to improve survival rates and prevent frequent breakages of brackets due to bond failure