Effectiveness of varnish with CPP-ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation.

OBJECTIVE: To evaluate the in vitro efficiency of applying varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) in prevention of caries lesions around orthodontic brackets. MATERIALS AND METHODS: For this purpose, brackets were bonded to the vestibular surface of bovine incisors, and eight groups were formed (n = 15) according to exposure of oral hygiene substances and enamel varnish: 1 (control) brushing only performed, 2 (control) brushing + use of mouth wash with fluoride, 3 Duraphat varnish application only (Colgate-Palmolive Ind. E Com. Ltda, São Paulo, SP, Brazil), 4 Duraphat + brushing, 5 Duraphat + brushing + mouth wash, 6 MI Varnish application (GC America, USA), 7 MI + brushing, and 8 MI + brushing + mouth wash. The experimental groups alternated between pH cycling and the procedures described and were kept in an oven at temperature of 37°C. Both brushing and immersion in solutions was performed in a time interval of 1 minute, followed by washing in deionized water three times a day for 28 days of experimentation. Afterwards, evaluation by optical coherence tomography (OCT) of the special type (Ganymede OCT/Thorlabs, Newton, USA) was performed. In each group, a scanning exam of the white spot lesion area (around the region where brackets were bonded) and depth measurement of caries lesions were performed. RESULTS: Groups 1 and 3 were shown to differ statistically from groups 5, 6, 7, and 8 (p = 0.000). MI Varnish was shown to be more effective in diminishing caries lesion depth, compared with Duraphat, irrespective of being associated with brushing and mouth wash, or not. LIMITATIONS: The major limitation of this study is that it is a study in which demineralization was obtained with the use of chemical products, and did not occur due to the presence of Streptococcus mutans and its acid byproducts. CONCLUSION: Application CPP-ACP-containing varnish irrespective of being associated with brushing and mouthwash, or not, reduced depth of caries lesions around orthodontic brackets.

Effect of different concentrations of papain gel on orthodontic bracket bonding.

BACKGROUND: The objective of this study was to verify the hypothesis that enamel deproteinization with papain gel at concentrations of 2%, 4%, 6%, 8%, and 10% increases shear bond strength as concentration increases. METHODS: A total of 180 bovine mandibular permanent incisors were used, divided into six groups (n=30), and denominated as follows: group 1 is the control group (CG) in which brackets are bonded with resin-modified glass ionomer cement (RMGIC) according to the manufacturer's recommendations and groups 2, 3, 4, 5, and 6 have brackets bonded with RMGIC after enamel deproteinization with papain gel at concentrations of 2%, 4%, 6%, 8%, and 10%, respectively. After bonding, teeth were immersed in artificial saliva and kept at a temperature of 37°C for 24 h. Mechanical tests were then performed in a universal mechanical test machine EMIC DL 5000 (Sao Jose dos Pinhais, Brazil). Values obtained were submitted to analysis of variance and then to Tukey's test (p<0.05). RESULTS: The results demonstrated that groups 5 and 6 showed the highest shear bond strength, differing statistically from the other groups (p<0.05). CG with no papain gel used showed the lowest value and in turn showed no differences for groups 2, 3, and 4. As regards adhesive remnant index, CG showed statistical differences from the others. Groups 2, 3, 4, 5, and 6, in which papain gel was used, presented no statistical differences among them (p>0.05). CONCLUSIONS: It was concluded that enamel deproteinization with 8% and 10% papain gel increases shear bond strength of orthodontic brackets bonded with RMGIC.